HomeMy WebLinkAbout00974 J
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0 e • This does not constitute
a building or use permit.
GARFIELD COUNTY DEPARTMENT OP ENVIRONMENTAL HEALTH
2014 „Blake Avenue
Glenwood Springs, Colorado 81601
! Phone (303) 945 -7255
INDIVIDUAL SEWAGE DISPOSAL PERMIT N9 974 ” •
Owner Gary R. Sheveland .
System Location Lot 3, Giomi Subdivision - Silt (.p (p3D- Cs ( 3 4 ("
Licensed Contractor 1tS_. s A. — .: I
' Conditional Construction / proval is hereby granted for a / 6�" �Q g a llon
t.' Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in4'r` "L� minutes requires t a minimum of r 4 sq. ft. of absorption area per bedroom.
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Therefore the no. of bedrooms ' x r re sq. ft. minimum requirement = a total of ' /tD sq. ft. of absorption area.
May we suggest / s� >xl '9!-*) X e / c:' et, O k / t� . . . , k : C .. , ' � / . -\ _ i (J a:7 7,
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`� \ fit t 5 I n spector �.;i i' -� J 1 �j
Date F 01 'ci a
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.r'- 'e / I ' ¢' ,r. / t - V y : r ] . t - f , 4 , A v im^ , { �;
FINAL APPR6VAL DF SYSTEM: �'`
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' No system shall be deemed to be in compliance � the Sewag$ Disposal Laws until t a ssembled system is approved prior to cover-
ing any part. r
(P K Septic Tank ryccess for inspection and clrianing within 12" of ground surface or aerated access ports above ground
6 D surface.
/\ Proper materials and assembly. /
P 9 r Trade name of. septic tank or aerated treatment unit. — o f /G se et I Z 5-0 1- n . E /779S T
C (C Adequate absorption (or dispersal) area, d
c K - Adequate compliance with permit requirements.
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/ \ Adequate compliance with County and State regulations /requirements.
('J Other f —
Date ,ir �i / e /L
Inspecto / /� ,
/// RETAIN WITH RECEIPT RECORDS AT 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 from 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 Applicant — Green Copy Dept. — Pink Copy
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uI 1 Il,C use
Page Two Fees Paid $x ,V"
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Dated
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Owner: GARM R. HFtt' A,.vb
Mail Address: pjj, f » /Z ,. a City: R[fte Zip: Y, /6So - Phone :6 ;5 /4S5
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
1. Location of Facility: County GARFIELD City or Town S)(,-f,
Location Address &/o r
Legal Description 4.57 :3 ('io/h,' ti,41010, /siemo Lot Size z:63 2.36 ACers
2. No. of Bedrooms 7 Septic Tank Capacity 42 S p Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well I/ Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? tin
5. Distance to nearest sewer system: .2 rnV/ /F s
Have you attempted to arrange a connection with the system? i t/6
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.
/8i
Date Signature o pplicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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170
TawK
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(TO BE RETURNED TO BLDG. & SANI. DEPT.)