HomeMy WebLinkAbout01044 / ..,�r�..r _ -.,..,.,, ny.,. R! kT' 7 "wr.t+•'+rver'r.. ^v�....,+R�A -m .. -.. - .,�...T • °�S,rr,...- ._rv...., ._,r.- +v- .....r..- r.'1rYi„ .
7
w GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 Blake Avenue
Glenwood S Ings, Colorado 81801
Phone 808)945.8241
, r This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT NQ 1 44 a building or use permit ;
i s
t Owner Gerald S. & Constance R. Hicks
I, System Location , NF&, SF14 SAC. 13, TfiS, R9414 fith PM - Rffle
Licensed Installer
o il
" Conditional Construction approval is h granted for 8, 1.000 gallon
Septic Tank or Aerated treatment Unit.
i / Absorption area (or dispersal area) computed as follows: i. J �
t i ` Perc rate of one inch in minutes requires a min rI um of /7 sq. ft. of absorption area per bedroom.
4W( ii
i t
; Therefore the no. of rooms _r x sq. ft, ,r 'minimum requirement • a total of % 7 / sq. ft. of absorption area
a i May we suggest )' ' X yo / 21%iNGd � ICC 0
i' Date 1j-5'"/a2 . 1 Inspector �` l'��
' l FINAL APPROVAL OF SYSTEM: '.: 11
v / No system shall be deemed to be in compliance with the S Disposal Lows until the assembled system Is approved prior to cover-
ing any part.
4 Septic Tank access for inspection and ciepning within 12" of ground surface or aerated access ports above ground J
‘24 Proper - Proper materials and assembly.
ii
Trade name of septic tank or aerated treatment unit. '
Adequate t
absorption (or dispersal) area.. i
Adequate compliance with permit requir llnents.
d/r Adequate compliance with County and' State regulation ; /requirements. I!
Other
Date // �� i Inspector �;�r`�/
/ RETAIN WITH RECEIPT CONSTRUCTION SITE .'
i ti
In
CONDITIONS:
1. All installation must comply with all requirements of th County Individual Sewage Disposal Regulations, adopted pursuant to au. "
thority granted in 6644.4, CRS 1963, amended 66.3.14 RS 1963,
1 . , 2. This permit is valid only for connection to structures ich have fully complied with County zoning and building requirements,
P
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 I al action and revocation of the permit.
3. Section I11, 124 requires any person who constructs, al ers, 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 (5500.00 fine — 6 months in jail or both!, II
II
Applicant: Orson Copy D.PertmsnY Pink COPY
_�� 111.•
Orrice use
Page Two Fees Paid $
4 . ?
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date
Owner: G C-12,4Lb S. lI tics Ste Po 4tA cca — R. h l e1cs.s
Mail Address: IE J RAIL-120A rr #30 City: r i t c y r (II Zip: 8/bg6 Phone :( -St/6O
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 iCi p, E
Location Address & /or
Legal Descripti e% - _ , 2 Lot Size 44) Ar,rwe
5N
2. No. of Bedrooms 3' Septic Tank 'Capacity 4 Oa Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name): A)/
Private: Well ✓ Depth an ' Other Depth to 1st ground water table 260
4. Is facility within boundaries of a city /town or sanitation district? yQ
5. Distance to nearest sewer system: /4 171/4t
Have you attempted to arrange.a connection with the system? !1/O
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 ncluded therein. / �
MD73iLE //vow" 1&eWlir 2eisoZ.✓ oA) 8o-S90
ao 9 8 . �� 4 ,
/ • Date c na . w.I icant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
,` PLEASE DRAW ACCURATE MAP TO YOUR PROPERTY
•
14 04' 1
0 (V A
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
R!:TION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
a
- a
(TO BE RETURNED TO BLDG. & SANI. DEPT.)