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� QARFIELD COUNTY BUILD 0 AND SANITATION DEPARTMENT'- �'� "&
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II ll 4` , 2014 aAvenue / / j8'/ L dl {
r ' I r Glenwood 6 coldrado 81801 '(/ Q //
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II '' INDIVIDUAL SEWAGE DISPOSAL PERMIT 111 1034 a building or use peimit.
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11 Owner Camp Chlstlan i.1
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I System Location New Cattle
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l ilil i Licensed Installer , ..:
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r • Conditional Construction approval s hereby granted for d gallon
III m Septic Tank or Aerated treatment unit.
IA d Absorption area (or dispersal area) mputed as follows:
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PIP p.: , Perc rate of one inch In minutes requires a m)nirslum of , sq. ft. of absorption area per bedroom.
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Therefore the no of bedrooms x sq. ft minimum requirement - a total of _ ft of absorption area.
Ill
11
May we suggest
1 1 n
Date Inspector
I, i
fi' F I IV AL APPROVAL OF SYSTEM:
tIft" II
N 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.
Septic Tank access for inspection and cleaning within 12" of ground surface or Berated accestports above ground
surface.
Proper materials and assembly.
Trade name of septic tank or aerated treatment unit.
II
Adequate absorption (or dispersal) area.
di
Adequate compliance with permit requir4nents. ..
s
Adequatcompliance with County and Stbte regulations /requirements.
'r Other
i i
Date i, Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
"CONDITIONS:
1. All installation must comply with all requirements of th County Individual Sewage Disposal Regulations, adopted pursuant to au•
thority granted in 66.444, CRS 1961 amended 66414, RS 1963. '
2. This permit is valid only for connection to structures w ich fully complied with County toning and building requirements.
Connection to or use with any dwelling or structures no approved by the Building and Zoning office shall automatically be a violet ,
tion of a requirement of the permit and cause for both 14.1 action and revocation of the permit.
3. Section III, 124 requires any person who construpts,'al rs, or installs an individual sewage disposal system in a manner which in• '
volves a knowing and materiel`variation from the terms specifications contained in the application
t P of permit commits a Class le
Petty Offense (5500.00 fine -- 6 months in jail or both).
e Applicant: Ornn COO O-p.rtment Pink C.Py +i
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Page Iwo Fees Paid $ ^1/�➢ -
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• INDIVIDUUAL HOME L SEWAGE TREATMENT SYSTEMS APPLICATION Date '7-2- R7
Owner: c ,,, t 7 co/ /�5/ //�/✓
Mail Address: pit icy /.
. C [of City: /11/22) (7}- .SfZip: Phone -2) /J
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 /VF C',4.C/4:
Location Address & /or
Legal Description Lot Size
2. No. of Bedrooms Septic Tank Capacity Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well 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?
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.
a e Signature of Applicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)