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HomeMy WebLinkAbout01071 " n°" +vwi^lR.+•r� -.:�. , ,., Al ten 1 C. S' 1 GARPIELD COUNTY BUIIL AND SANITATION DE Glenwood tap lake 81601 DEPARTMENT 2014 DII Mk Anna* Phone 08) 945.8241 1111 q • This does not constitute INDIVIDUAL SEWAGE DISPOSAL PERMIT 42 1/71 e building or Iu Owner r Andrew L. McClelland it i SyatejpCocation 0153 Navaho Street - New Cistle El I . 430,044nstader ' I 1 "' • Conditional Construction approval is hereby granted for a /000 gallon I� • . i Septic Tank or Aerated treatment Unit. 1 , ) ( Absorption area (or dispersal area) computed as follows: I + 1 �� �� �'� Perc,4 of one inch in. :'JS._ minutes requires a min of.... (sq. ft. of absorption area per b I�" 'L'm 1 III' a" �i �. h11;), Therefore the no. of bedrooms . _ x sq. f t, m requirement • a total of fYt,sq ft o � Dree. .1i I �'I / , O Ml m Maywe suggest /2 xi 5X3 c c. . � P , H /8 � 3L Xc 3 r cIee�, /g'X 6 x '11 �I Date / / Inspector ' l4 6��[ 6 ' t 'r' 1 r �, *u FINAL APPROVA L OF SYSTEM: p lip 7 Ii;, i No system shall be deemed to be in compliance with the Spwage Disposal Laws until the assembled system is approved prior to cover. i ing any part. y : ix Septic Tank access for inspection and clSening within 12" of ground surface or aerated access ports above g round i Y surface. Proper materials and assembly. /Ilr / / Trade name of septic tank or aerated treatment unit. (000 lc ^ ^ Or _ Adequate absorption (or dispersal) area z_ "X 3 S / 4 A/ 2..I ( L , A 1 yI � locet1 / dm ©K Adequate compliance with permit requirements. Y v c'� Adequate compliance with County and State regulations /requirements. ti Other / Q 91 I I ,W Date M If 1 ,1 Cl Inspector t RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 'CONDITIONS: 1. All installation, must comply with all requirements of, he 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 w hich have fully complied with County zoning and building requirements.+ 1 Connection to or use with any dwelling or structures no t approved by the Building and Zoning office shall automatically be a viola- tion of a requirement of the permit and cause for both egal action and revocation of the permit. 3. Section III, 3.24 requires any person who constructs, IIters, or installs an individual sewage disposal system in a manner which in• volves a knowing and material variation from the Bulls or specifications contained in the application of permit commits a Class I, ji Petty Offense (6501.Q0 fine — 6 months in jail or bot 1 i L t iM fl d*pV ., m 1 AApp... App... br..n Departm.nH pink Copy INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION (Date Owner: /40fi e w / / /�- `C JEE L44 4� )0 p / � ��� 55/3` Mail Address: Pa / 7 a e City: l7 Jrr C v u004.1 9 Zip: ca hone: 8' / 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). 6)/%5 3 Hove, 1-10 s l Near What 1. Location of Facility: County GARFIELD City or Town 4i u ( ea-IL Location Address & /or t. of 7 -/.j I. GK 9_ iv e T - / Legal Description I ,. Lot Size l e t y el 2. No. of Bedrooms 3 Septic Tank Capaci y Men Aeration UO(it Capacity N/A 3. Source of Domestic Water: Public (name): Air 0) ( n c tie Private: Well Depth Other Depth to 1st ground water table 4. Is facility within boundaries of a city /town or sanitation district? AJ !"J 5. Distance to nearest sewer system: x) p aD M Q. 3, / 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. / � / / / lll • Date igna ur , , r. ic a (TO BE RETURNED TO BLDG. & SANI. DEPT.) PLEASE DRAW AN ACCURATE MAP TO YUUK PKOPERlY v' /au. A--i s, R A' ���R �lr 1, -f' 7-' b 04,07 INDICATE BELOW THE LOCATION OF YOUR BUILDINGS WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES • (TO BE RETURNEII TO BLDG. & SANI. DEPT.)