HomeMy WebLinkAbout01055 t � ,
me GARFIELD COUNTY BUILQIN AND SANITATION DEPARTMENT
m 2014 lake Avenue
Glenwood Sp nbs Colorado 81601 II '
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Phone 03) 9454241
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INDIVIDUAL SEWAGE DISPOSAL PERMIT $40 1' 1055 , a building or use perinit
Owner Gordon D. Cunningham
System Location 60R% 214 Rnad . Nr+w ract1n
Licensed Installer Owner
• Conditional Construction approval is hereby granted for a ' gallon
(i Septic Tank or Aerated treatment Olt.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in _ 6 _ minutes requires a minimum of 1 25 sq. ft of absorption area per bedroom.
Therefore the no of bedrooms x 12rii "' ft.pninimum requirement: a total of ` sq. ft. of absorption area
May we suggest 12' 'X 21' X 3' Deep /
Date 8/�� �. Inspector G444 !
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be compliance with the Sewage Disposal Laws until the assembled system is approved prior, to cover•
ing any part.
C Septic Tank access for inspection and cleaning within 12 • of ground surface or Berated access ports above ground
surface.
0 K Proper / materials //me /
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nd asse y. / ( ( o
v /\ Trade name o septic to k or aerated tread cat unit 9 /� ���Yq Io(S S ,
OK Adequate absorption (or dispersal) area
Adequate compliance with permit requirements.
C Adequate compliance with County and State regulations /requirements.
Other tij
Date /O` / 'r / J / Inspector 4x .64. /'' •
RETAIN WITH RECEIPT Rt•ORDS AT `sJ4NSTRUCTION SITE
`CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 6644 CRS 1963, amended 66-3.14; CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County zoning 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 legal action and revocation of the permit.;'
3. Section 111, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in-
volves a knowing and material variation from the terms for specifications contained in the application of permit commits a Class 1,
Petty Offense ($500.00 fine — 6 months in jail or both). `+
Applicant: Onion Co0 Dapartm.nt: Pink Copy
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INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date g /d, t/
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Owner: c, /�
,R. e.✓ 17. cy.✓.✓...- f %.s►ni
Mail Address: ' /4 City: ,4/P > d fkczz/c Zip: 776 Sr7 Phone: retz88e
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 Ci ty or Town / f „,0 /e cam•
Location Address & /or
Legal Description 606 3 2 /7/ 2 Lot Size /gren•
2. No. of Bedrooms 2 Septic Tank Capacity 7S4 Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well Depth Otherc, / to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? ,r4,,..,-/,
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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C- / /10/ �,r”. __ _
Date igna ure o scant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)