HomeMy WebLinkAbout01075 y III QAR IELD COUNTY BUJ-DI Q AND SANITATION DEPARTMEN k. t ,ice'
Ct• 2014 Take Avenue :,
Glenwood' Sp ngs, Colorado 81601
Phone 803) 94S -8241
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" REPAIR -PERC ONLY 410
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I . 4 � This does not constitute
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INDIVIDUAL SEWAGE DISPOSAL PERMIT p42 In7; a building or use permit.
1 Owner William H. & Janie. F. Bradford •'.
m System Location 0031 Snpris Avr itP - Cltrhnnda1! ,
Licensed Installer
I' • Conditional Construction approval is hereby granted for el 1 ,nnn gallon
Septic Tank or Aerated treatment Unit.
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° Absorption area (or dispersal area) computed as follows:
Perc rate of one inch in 5 minutes requires a miniMpm of 125 sq. ft. of absorption area per bedroom.
I, Therefore the no of bedrooms 2 x 125 sq. ft Minimum requirement . a total of 950 sq. ft. of absorption area.
I fl Date we suggest 12' 21' / 3 r deep Inspector // - %i / � L .: pfd
01, FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover. h -
ing any part.
e2 A Septic Tank access for inspection and claming within 12" of ground surface or aerated access port; above ground
surface. :
r9 H. Proper terials a assem y.
p 7 , 1
i , 0 k Trade na a ofseptic tank or aerated treA dent unit.
C`J i'C Adequate absorption for dispersal) area
0 r Adequate compliance with permit requirements. 1/4
t Adequate compliance with County and Sete regulations /requirements.
Other
Date //--- l inspect° ,a ,. /L ./ /�/
RETAIN WITH RECEIPT RECORD CONSTRUCTION SITE
`CONDITIONS:
1. All installation must comply with all requirements of th County .Individual Sewage Disposal Regulations, adopted pursuant to au•
thority granted in 66 44.4, CRS 1961 amended 66-344 RS 1963. 9 ;
2. This permit is valid only for connection to structures ich 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•' r
tion of a requirement of the permit and cause for both legal action and revocation of the permit. ,II ° >.
3. Section III, 124 requires any person who constructs, eI 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 1 , "p
Petty Offense ($500.00 fine -- 6 months in jail or both),
Applicant: Cram eaPa Department: Pink Copy
Page Iwo Fees Paid $
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date Q_ Q - y'/
Owner: (,(i /It IPiM N.* TANrC F 2 3ea rota b.
Mail Address: 003/ Zopkis AVE City:07e8on/J7i+rC zipi /4LS Phone:7t 2764
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, sqil percola-
tion test holes, soil profiles in test holes (see Page 3).
Near What
1. Location of Facility: County GARFIELD City or Town CA eec, /DAL t
Location Address & /or
/
/
Legal Description 00,x/ .,Sn fR/S AVE Lot Size t' X /(olo
2. No. of Bedrooms 2 Septic Tank Capacity /pp� Aeration Unit Capacity N/A
3. Source of Domestic Water: Public / (name): ,
Private: Well )( Depth 6S� Other Depth to 1st ground water table
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4. Is facility within boundaries of a city /town or sanitation district? •544 6
5. Distance to nearest sewer system: /[/orrE
Have you attempted to arrange a connection with the system? Af0 n/E
If rejected, what was the reason?
61 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:
7.1 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.
e- W ClitiAw
Date Signature of App cant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
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