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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
2014 lake Avenue
Glenwood'Sp ngs, Colorado 81601
Phone 1803) 945.8241
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This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO 1161 a building or use permit. I li
NC
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owner Robert & Lots Messner . '
stem Location 0748 Mesa Drive - Rifle
Licensed Installer N.. .../91- / er y't i y G A.
Conditional Construction approval is hereby granted fora 1 gallon
__1(._ Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in 27 minutes requires a minimum of 23R sq. ft of absorption area per bedroom.
Therefore the no of bedrooms _3 x 238 sq. ft minimum requirement = a total of 4 s ft of absorption area.
May we suggest 12' x 60' x 3' or 18' x 40' x 3'
Date / // 1 InsPe • , I LI � L i // aa
/Ltd
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FINAL APPROVAL OF SYSTEM: i
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to coven
ing any part.
Jet
. +Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
s1Yl'face.
Q f' Proper materials a asserliely.
V co l /090 tpa. -/ •
K Tr ad nam of septic tank or aerated tree ant unit.
(7 PC Adequate absorption (or dispersal) area
O PC Adequate compliance with permit requirements.
ah O' \ Adequate compliance with County and State regulations/requirements.
4 P Y
- Other
Date t� to / Inspector ' ( (
RETAIN WITH RECEIPT RECORDS 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 66-44-4, 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 not approved by the Building and Zoning office shall automatically be a viola-
'ion of a requirement of the permit and cause for both legal action and revocation of the permit.
vtion III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which in
� s a knowing and material variation from the term or specifications contained in the application of permit commits a Class 1,
ffense ($500.00 fine -- 6 months in jail or both).
r r ' \r\ Applica Orlin CORY D.psrtmmt: Pink CoPY 0
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Page—Two
— - Fees Paid $ 7,j7,00
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date y -/3 -0
Owner: 1 Loll MeisN11oz - -
Mail Address:()')4t, MOM Da, City: \p,. Zip: &IOW Phone idici)(pf 1
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 Q ) F147
Location Address & /or
Legal Description O'14$ 141frivA T2_• Lot Size OjA9 xdCJD ,
2. No. of Bedrooms S Septic Tank Capacity)1,4Q Celt,. Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name): IFL‘ napaz_e; rpMMInJr?7
Private: Well Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? Air)
5. Distance to nearest sewer system: 4 PA f , ,
Have you attempted to arrange a connection with the system? 40.
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.
,,; 13�-C IlelEt LS(Z
Z fe � �v/ n a ure of A �� ou�wSe)
Signpplicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
Page Three
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
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INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
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(TO BE RETURNED TO BLDG. & SANI. DEPT.)