HomeMy WebLinkAbout01023 � ' I
' 6 04 a' ' C GA RFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
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^ dry e.: Olmwood o credo 81601 ` „I I,
Phone b ) *4544241
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This does not constitute
„I; INDIVIDUAL SEWAGE .OISP9 e PtATAIT " 1 j 1023 - l a building or use permit, Rll
a^l „ Owner David & Kathy Fox
1'”' 1 i system Location 0332 Mesa Drive- Lot 4 - 9,"ifie Creek Estates >,
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"" " Licensed Installer _. , "I
• Conditional Construction approvel is hereby granted for a �O f h gallon , . . Ih
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1 1 )( Septic Tank or Aerated treatment Olt. 1 1, all'
- if ' Absorption area (or dispersal area) computed as follows:,
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Perc rate of one inch in ' Az minutes requires a minis in of 3 sq. ft. of absorption area per bedroom. I a "' fftl
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- vl l,l - _ Therefore the no. of bedrooms x X42 Isq. lnimum requirement • total of 1... .4) - -; sq. ft. of absorption are4 �' "'1 i i,
11 May we suggest / er.5 r — 4 " e / Er W3 3 , 9 ' � i ' '
Iw o /Q..�' M1 inspector y 7:4(6" / .+ 1.'
Date � '2'' �� I1/
i ' - ,01, � t "
I FINAL APPROVAL OF SYSTEM: " /' '_
1 'hi - ^ilia "I No system shall be deemed to be in compliance with the f age Qisposal Laws until the assembled system is approved prior 10 "i:6o ly ^
" ing any part. r 1I I a „ „ u'
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Septic tank ecoels for inspection and tie' ning within 12" of ground surface or aerated access ports above ground j P,
surface, S
/ Proper materials and assembly. V 1 ' r'r "HO ,u
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/ 01/2/10 Trade name of septic tank or aerated treatment unit.
° + ' 'I LC, �' Adequate absorption (or dispersal) area. I
Q.JC Adequate compliance with permit requirements. I 'al W
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6 Adequate compliance with County andState regulations /requirements. "'P
Other
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u' i i Date 49/... ` ‘ J Inspector G�i00 -•.. -- .-- /�`"� �i I 7e� l ^^
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Hill: RETAIN WITH RECEIPT REtORDS CONSTRUCTION Sift + ' j 1 in
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t �' "CONDITIONS: a a 1.=
1. All installation must comply with all requirements oft County Individual Sewage Disposal Regulations, adopted pursuant to eu " ,u
'.I thority granted in 66. 44.4,` CRS 1963, amended 66.3.14 RS 1966. '
of I 2. This permit is valid only for Connection to structures I ichitave`fully complied. with County stoning and building requirements. ,1..
Connection to or use with any dwelling or structures no approved by the Building and Zoning Office shall automatically be a viola-
-. 'i tion of a requirement of the permit end cause for both `I fl action end revocation of the permit. " u^
ti 3. Section 111, 3.24 requires an who constructs, a ers4 or' Installs an Individual sewage disposal system In a manner which Inr 1
1 M valves a knowing and materiel variation from the terms r specifications contained in the application of permit commits a Class 14 : 1 1
t I i ,,,f Petty Offense ($500ine — 6 months in jail or b
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M1 0 111
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„ I ' ' Applicant: Orlon cop O.nrtm.nt: Pink COPY
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Office Use
Page Two Fees Paid $ 01)
>n' INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date 6• —/;> — g
Owner: r k 0 t
Mail Address: 6 co City: /4 Zip: rediC) Phone:
INFORMATION REGARDING PROJE T 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
Location Address &/or
Legal Description �-+'`f /We C.r q: j Lot Size .Z y 03
2. No. of Bedrooms 3 Septic Tank Capacit Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name): H. e i d t_tt t.
Private: Well Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? 'Z.,
5. Distance to nearest sewer system:
Have you attempted to arrange a connection with the system?
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.
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V / te Si atur of
Applicant
(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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(TO BE RETURNED TO BLDG. & SANI. DEPT.)