HomeMy WebLinkAbout01086 .. T � =� n,ayss��r
A
" GARFIELD COUNTY BUILDI II AND SANITATION DEPARTMENT
i� 2014 Q late Avenue
Glenwood "SD oat 7 Iorado 81801
,� Phofle 03) 9454241
I .
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT p,)A 1 88 a building or use permit.,
r
Owner Karl Kunstodtler
System Location Lot F • 3 wI . , l
Licensed Installer • -A - l O
•
Conditional Construction approval is hereby granted fora 1" gallon
I
X Septic Tank or Aerated treatmellt.
- A. : nt u
Absorption area (or dispersal area) computed as follows:. I
Pero ate of one inch in minutes requires a mininl�m of , sq. ft. of absordti per bedroom.
Therefore the no, of bedrooms 3 x / / ° sq. ft.]in requirement a a total of S ft of absorption area: r
May we suggest /2 �x 4 8 ' x 3 ' ie ep or /2 x 3 L ' X3 / deep.
IA a
[Date 19)// 7/ / Inspector ���� �
'FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with theS4wage Disposal Laws until the assembled system is approved prior to cover+ h
,, ing any part.
I Artj! 0 k Septic Tank access for inspection and cleaning within 12" of ground surface or iterated access ports above ground
" Ihr• r surface. •
e Proper materials and asse bly.
oA Tra *44ttc4" nk o/ raQc i
re ntinit.
0 Adequate absorption (or dispersal) area. i
0 rc Adequate compliance with permit requirements.
w o /\
Adequate compliance with County and Sate regulations /requirements.
Other
Date ! 2 s' Q / Inspector /6/� `17
/ RETAIN WITH RECEIPT R OCORQS AT NSTRUCTION SITE
*CONDITIONS: I
1. All installation must comply with all requirements of tl,e County Individual Sewage Disposal Regulations, adopted pursuant to au•
thority granted in 88.444 CRS 1963, amended 88.3.144CRS 1983.
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 nd approved by the Building and Zoning office shall automatically be a viol&
tion of a requirement of the permit and cause for both I al action and revocation of the permit:
3. Section III, 3.24 requires any person who construct, it tors, or Installs an individual sewage disposal system in a manner which in
IIV r volves a knowing and material variation from the terrhs{or specifications contained in the application of permit commits a Class I, , ,`,.
Petty Offense ($500:00 fine — 6 months in jail or both).
i v 1
, Applicant: Onion coy D.p.rtm.nt Pink Copy
Page Two
Fees Paid $
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date
•
4 Owner: _ ,4 -
c y5
Mail AddressS City: a--"1"7- Zip: 8/(d/ Phone: 51 n,
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 e4
Location Address 84/or
Legal Description _ y f �.� Lot Size e
2. No. of Bedrooms 3 Septic Tank Capacity i z 5 0 Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name): „2"-
,_,,, s � A
Private: Well Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district?
5. Distance to nearest sewer system: > 02c -
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.
? / 7 _ �
Date /7:F/ i.na ure o 'pp icant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
• Page Three
•
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY
_ /Fw E,
y 5if1-1
G14t€ MOA►�
INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI-
BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES
•
(TO BE RETURNED TO BLDG. & SANI. DEPT.)