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I;i " h I at, GARFIELD COUNTY BUI " Y it AND SANITATION DEPARTMENT h'uu i 1
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aYp alenwpodq t 1prado 81,80 i ` ^ -, l ,i r
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1IN DIVIDUALSEWAGEDISP ,OSALPERMIT 1001 a bu'ildingor use 'Per . A uIK [i
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I Owner Paul R R
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System Location 0789 Htgbvay 123 eArhonr(
J� i.ii )1 in
I , Utensed I . ,I.� 1" t 41 1 1 t y j ill i Vl
"' I " Conditional Constructioq approval is hereby granted fora, s : O 0 gallon V �u11,
IiI t/ Septic Tank or Aerated treatment unit 1 , - '1
i
Absorption area tor dispersal area) cOmpllted of follows: ,
s ° Ptrc rate of one inch In ..,,..4;t,, minutes requires a mini m Of 'sq. ft. b „bsorption,area per bedroom
I a l lr Therefore the no of bedrooms " x $ sq. ft i merit • a -total of .t
^ q. ft, of absorption arcs I '1, �',lliu it,!I
Ii ^ . 14 11 1
e / t
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u I i i , s May we suggest 3 r P , ,I , i Ip 'd y lid 7]
4r II' „1 �� I i Date Inc clot / /otn w(jf yA t 1 1 i �
t 11
I : rr,rINAL APPROVAL APPROVAL OF SYSTEM: , ?c
No system shall be deemed to be in compliance with the age Disposal Laws until the assembled
I system is approved riort oovllf' 4”
Ing any part. 9 1 N IIr
1 ° Qt//( ' Septic Tank access for inspection and 014 ning Within 12" of ground surface or aerated access ports above grou y V I Dd.,
surface. V, s hu "
m Proper maters8 and as mbly, / Ill I�,, I K T e m septic tan or am- t� " tint uhi M,lwu s�
u Ok, Adequate absorption (or dispersal) area. �' r IA •
� l 1 Ci � Adequate compliance with permit regpir `ants. Ir,l lllly'-
Adequate compliance with County and S ate regulations /requirements. 1 , ry ? ,l, l , 4iiii
Other s 4,000,0 li I .. - t1 "tl ther G 4
�! /^> /�,∎ h Ij4 I
1.#1 'Date V /�t��i ( n spe 4 o /. J# .I� J iw � PIi�IPW
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RETAIN WITH RECEIPT R".'ORD'S A ONSTRUC710N SITE , ti; ill,
•" µ "CONDITIONS: ;114,1,11$ til
1. All installation must comply with all requirements Oft 1 County Individual Sewage Disposal Regulations, adopted pursuant So act i Pt
thority granted In 86 -44,4, ORS 1963, amended 88.3•1,1 S 1083• • / , ' 11 '. , im 11 'PE-,
r 2. This permit is valid only for connection to structures I have'fully complied ,with County ironing and building requlraments p
Connection to or use with any dwelling or structures a ,f t roved by the Building and toning office shall automatically be a vIoMI 1 y ^i w 1 N
u tion of a requirement of the permit and cause for both I I action and revocation of the permit, ' 1i 1 1'� V
3. Section III, 3.24 requires any )person who constructs,, ers, or instills an Individual sewage disposal system in a manner whl ,' � In- 1 , 1 i
vo(ves a knowing and material variation from the termllpr specifications Contained in the application of permit commits a G e 1s iTlf oV u
- . °, Petty Offense 1$500.00 fine .- 6 Months in jail or both), t - 1i ,
n o „ {hl i MI I r
Applicant Orson CoOtor basolliMent: Oink Copy
�r11 f ya�1
Page Two Fees Paid $1S ,(Q)
• INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date S — S
Owner: K w.( em0 /4
Mail Address: /749, pp,/ 87. City: .v`ia4leta /t. Zip: f //7; Phone:W3 -2/ro
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW iqS g�ss
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 711,40„A04.-
Location Address & /or
Legal Description D744 ,y 1 iS Lot Size 3/0.3/ X 81:3,"- d Qvi -.. - v - /
2. No. of Bedrooms 8 Septic Tank Capacity Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well X Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system? )4 ,4
If rejected, what was the reason? �Qj /'et t 4.5e ✓n v7s ,A,0 0Ieurute7nxiver7Irc
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.
_5* 4( e i oars,
ate S gnat re of A p cant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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1
Ne$7er Mo TrvSoM ro
WNse -4 ocCet,
r7&? • //ywr /33
LLL
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
•
(TO BE RETURNED TO BLDG. & SANI. DEPT.)