Loading...
HomeMy WebLinkAbout01039 ,. 'r's, :v+9f$*'r. � " � ' " T n i r r n nffliinqr^r W '‚ °'....... ' „" , ..ri •.t rr anWitfirrrr frMAIrt'^T'.cr r "".4.4:. ' 4 i. 1 .1 l� 'l ( 6,1RFIELD COUNTY BUIL6I4G AND SANITATION DEPARTMENT t ' a 20,14 lake Avenue �II' Glenwood �$ ngs,C4loredo 81801 r r - / � N Phone 303) 945-8241 L Y i � 'gy ��� , REPAIR - PERC ONLY - FEE WAIVED 25.00 - ''P4ID $$.00 This does not constitute I m I I INDIVIDUAL SEWAGE DISPOSAL PERMIT 0 „ 1039 1 a building or use pal')nit. �4 d 1' ran ° Owner Fast OlvigliRanch Company 11' ` System Location Read R11 s New 'Cacti,' 1 xr „,,• I ° Licensed Installer / /Q L j ' Y� " Conditional Construction approval is hereby granted for q ' 7.6 gallon , il X Septic tic Tank or Aerated treatment u lt. s N , td „ Absorption area (or dispersal area) computed as follows: IC " Perc rate of one in / Ceminutes requires a minilryllm of / 9 tD sq. ft, of absorption area per bedroom. t „ 1,, r;. Therefore the no of bedrooms ,2„ x / 9® sq. ft.eninimum requirement' a total of .tro sq: ft, of absorption area, y m , " i li ' 1 , ' ' May we suggest /." s(' a X / 3 ..' I r Date ,,// t Inspector , // . /� v _ "' ,1 la a„ m -- r i'FINAL APPROVAL OF SYSTEM: V( 0 iii A a ' r No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cov II � ry • am d ! ' mg any part. - 1,1 ,:I r„ ,y K Septic Tank access fpr inspection and clepning within 12" of ground surface or aerated access ports above ground ' I y surface, I " j ai © -mmat K Proper materials a assembly, a ��� '''ppp ''' 164 !g� Trad n i rat d re t rr , 11x1 0 A Adequate absorption (or dispersal) area, D /k Adequate compliance with permit requrrd rents. !< Adequate compliance with County end State regulations /requirements. °1 Other / C ate 7�� - 7/ / Inspector + 7 RETAIN WITH RECEIPT RECORDS A NSTRUCTION SITE *CONDITIONS: 1. All installation must comply with all requirements of th County Individual Sewage Disposal Regulations, adopted pursuant to au- thority granted in 66.44.4, CRS 1963, amended 66'S- 14,VRS 1963. 2. This permit is valid only for connection to structures ich have 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 viola - tion of a requirement of the permit and cause for both l al action and revocation of the permit, 1 Section III, 124 requires any person who constructs, al' or installs an individual sewage disposal system in a manner which in volves a knowing and material variation from the terms r specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or both). 1 . APpllunt: Green Copy Department: Pink Copy -1 �,. . Page Two Fees Paid $_ 1 ? 1NDIV)DUUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date /- d Owner: e, cr . D1 Um;Ox' -‘/PP cb. SO2_ Mail Address: 'Va.!) (11,3 /I City: Nk (u (yOJ? Lt zip: S) 6 97 Phone: 8>G 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 ) IT 1 CO t 0 Location Address &/o Legal Description 329 fell 1)) UN) CM $k t D ot Size f "4.1066 2. No. of Bedrooms Z Septic Tank Capacity )Q bb A erationU n it Capacity N/A 3. Source of Domestic Water: Public (name): \J.) t it CO R Private: Well 1✓ Depth Ls n Other Depth to 1st ground water table .� 4. Is facility within boundaries of a city /town or sanitation district? )Vn 5. Distance to nearest sewer system: 5 Have you attempted to arrange a connection with the system? 'NO 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 t 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- 'A tions of Garfield County and I hereby agree to comply with all terms, conditions and requirements included therein. L11t • Date ignature o 'pp i ca tom (TO BE RETURNED TO BLDG. & SANI. DEPT.) VI __.__.__^ -- __..._ Page Three ACCURATE MAP TO YOUR PROPERTY • • • O os; t) V INDICATE BELOW THE LOCATION 0 'OUR— SURGING WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES (TO BE RETURNED TO BLDG. & SANI. DEPT.)