HomeMy WebLinkAbout01060 y I 6
J i u } ' I Si t GARFIELD &UNTV BUILDING AND SANITATION DEPARTMENT
': " 2014 $lake Avenue
Glenwood Sp1ngi, Colorado 81601
11 .
Phone (803) 945.8241
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I PERC WAIVED - RATE KNOWN - FEE ONLY
X This does not constitute
I I i INDIVIDUAL SEWAGE DISPOSAL PERMIT 140 1 a building or use permit. •
Owner Robert M. & Susan T. Pau11s
,10 ,11,0 System Location. 3737 County Rnad 301 - Rrnnd'iVal1Py
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Licensed Installer
e Conditional Construction approval is hereby granted for ei' !Ann gallon
._,X._ Septic Tank or Aerated treatment upit.
1 il li i SEE PERMIT #676 -
Absorption area (or dispersal ar ) computed as follows: JOHN RICE - FOR PERC
io
/ /90
.I Perc rate of one inch in minutes requires a minimum tiiit sq. ft of absorption area per bedroom.
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WI Therefore the no of bedrooms _2 x 4r sq. ft minimum requirement - 3BO a total of .q. ft. of absorption area. 1
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May we suggest Seepage Bed: 12' x It' x 3 deep
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Date gr r V u C/ / t/ , / 1 t / Inspector ' -7-r Vri' .-/
1j1 FINAL APPROVAL OF SYSTEM:
( cover
w' inB any part.
Septic Tank access for inspection and Gleaning within 12" of ground surface or aerated access ports above ground
surface.
Proper materials and assembly.
I Trade name of septic tank or aerated treatment unit.
111 Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
il Other
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Date i Inspector
r
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
'CONDITIONS:
1. All installation must comply with all requirements of the county Individual Sewage Disposal Regulations, adopted pursuant to au-
thority granted in 6644.4, CRS 1963, amended 66-3-14X 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 not 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 III, 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 or specifications contained in the application of permit commits a Class I,
Petty Offense (5500.00 fine - 6 months in jail or both). -:
Applicant: Oran Copy Department; Pink Copy
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• INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATIONDate 1
Owner: (Votyr / S t is
Mail Address: 329 ?gtj 1J- City: Zip: el Phone:a5-7? /
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 or 1. Location of Facility: County GARFIELD City r What
Town ai
Location Address & /or Lot Size
Legal Description
2. No. of Bedrooms Septic Tank Capacity :6 Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well Depth Other Depth to 1st ground water table /90Ft
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system: 5 f. S
Have you attempted to arrange a connection with the system? // r
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.
Kt 1
Date Signature of Applicant
R te.- 4 one Wig
get r / 1 6 7, (TO BE RETURNED TO BLDG. & SANI. DEPT.)