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Home My WebLink About00966 n • ��` -� et/ 7J- 053 ^��- - This does not constitute a building or use permit. GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Blake Avenue Glenwood Springi, Colorado 81601 Phone (303) 945 - 7255 INDIVIDUAL SEWAGE DISPOSAL PERMIT NY 966 Owner k .lames 7elenka System Location 0590 *ttf County Road 9lh - hstween Sflt & Rifle Licensed Contractor .J "- G! ,_ ' Conditional Construction approval is hereby granted for a / 1. 2 r- n gallon Septic Tank or t Aerated treatment unit. 1 • Absorption area (or dispersalferea) computed as follows: Pere rate of one inch in _ � minutes requires a minimum of r 41. T' sq. ft. of absorption area per bedroom. Therefore the no of bedrooms 3 x /47 sq. ft minimum requirement = a total of 4.7/sq. ft, of absorption area May we suggest /2 X 40 x 3/41 P_ e • r Date 3 � �' Inspector ' C /(mil ii c. - i: .. H FINAL APPROVAL OF SYSTEM: l -' No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover- ing any part. erk Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground surface. C/< Proper materials and assembly qq ��"\ Traden slspU tank ae / t 0 t 0 a 0 ep4u a nit. ' A Q vS Adequate absorption (or dispersal) area. Or Adequate compliance with permit requirements. OK: Adequate compliance with County and State regulations /requirements. Other Date - 3 /y G/� / Inspector / Li r L� /1 JdJ2i Or RETAIN WITH RECEIPT RECORDS A''CONSTRUCTION SITE "CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au- thority granted in 66.44.4, CRS 1963, amended 66.3.14; CRS 1963. 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a viola- tion of a requirement of the permit and cause for both legal action and revocation of the permit. 3. Section 111, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in- volves a knowing and material variation frorh the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 months in jail or both). Building Official — Permit White Copy Applicaht — Green Copy Dept. — Pink Copy - ---...a.mainanstanassankas aa.aa.aaa.ulan aaaaaa - ' _.....n aa...ama.,.an.na..L._.a...,__ Page Two Office Use Fees Paid $ -, CK cs -L42,, zo I et INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 3-?3--'f Owner: (&) J Ames 70 ifri Mail Address: gnf ft) II City: ei f (p Zip: $1bSo Phone :6725 - capi5 INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percola- tion test holes, soil profiles in test holes (see Page 3). Near What I Rick- 1. Location of Facility: County GARFIELD City or Town 6e } S. �� i Location Address & /or Legal Description n (o. Qcd. Z..ly, Lot Size /t) ACRES 2. No. of Bedrooms .; Septic Tank Capacity is c Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): Private: Well X Depth So r Other Depth to 1st ground water table yS 4. Is facility within boundaries of a city /town or sanitation district ? /Vt) 5. Distance to nearest sewer system: % eV Have you attempted to arrange a connection with the system? ,i/3 If rejected, what was the reason? 6. If R.P.E. tested, state rate of absorption in test holes shown on the location map, in minutes per inch of drop in water level after holes have been soaked for 24 hours: 7. Name, address, and telephone of R.P.E. who made soil absorption tests: 8. Name, address, and telephone of R.P.E. responsible for design of the system: 9. Express permission is hereby granted for the inspection of the above property by any member of the Garfield County Building & Sanitation Department and /or such persons as they may designate. Any withdrawal of this permission shall be in writing and receipt acknowledged by the County Building & Sanitation Department. 10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula- tions of Garfield County and I hereby agree to comply with all terms, conditions and requirements included therein. 1nG- . Z v 19 b'l Date %na ure o scan (TO BE RETURNED TO BLDG. & SANI. DEPT.) Page Three PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY N _Co ._. R4. w �^ GO //z M; +0 1 uJ A i � I o RTG of L AV\ L toed • 4 -10014 P0N RuSSetI ZELCNKA P) rndt .1 S"bdi„s ..✓ C - 1 N:.-f-e Elecl,c fence G >�t a 6 -. 1 _. ? k(CS E`RN 'L i Yfo,oseD Loco of IV etc Home. INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES t 'Po A ?Rre Pr�per Wei‘ -i , Lists / Di sal orlon boos S 67/41.4 of t`.dP /` c (TO BE RETURNED TO BLDG. & SANI. DEPT.)