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r. % I t'l l GARFIELD COUNTY BUILDI O'AND SANITATION DEPARTMENT °
a il 1 2014 Lake Avaeue
e . Glenwood nga, I C l, q`ado 81801
Pho 803) 945x1241
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j INDIVIDUAL SEWAGE DISPOSAL PERMIT f° 1' $ aThis buildingordoes not use oo"perms s e 11 "
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Owner Reed Nelson! 0 4 ,
,IH System Location L 025 , Rifle Creek Es tes ,•, �I sly
Licensed Installer � 4s'°k 1 A n f \ r ",
, 1 11 11 , {;
Conditional Construction approval is hereby granted for a ° (/J 00 gallon I il ,W ` ' Im
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_ Se ptic Tank or Aerated treatment y 6 :,
Absorption area for dispersal area) computed as follows i i;
I
Perc rate of one inch in 6n 1 : minutes requires a mini m of , 130 sq. ft. of absorption area per bedroom. •I 1 -
Therefore the no. of bedrooms x Asa sq. ft, I minimum requirement • a total of sq. ft. of absorption area .1 + i 1 :s " ,
May we suggest it X 1P3 X 3 SAL ,r 1rd . x S' q "
Date 1 7/ 2 / 11 / b Inspector - i^t`-, Ia "
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I FINAL APPROVAL OF SYSTEM: i 11 +'i�lT
1 I�I
No system shall be deemed to be in compliance with the - Sewage Disposal Laws until the assembled system is approved prior to 0ov ej: V' "'
ing any part.
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i (') Septic Tank access inspection and Pr Sic s s for ii cle ping withi 1 2 " of ground surface or eereted access port above ground Co
surface. s
r7 PC Proper material and as mbly. I
n pPfr / /
/S Tra a name of s9ptick or aerated tr merit k nit. ' brill
0 Adequate absor (or dispersal) are
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0 k Adequate compliance with permit requir enls• . I n 1
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Adequate Compliance with County end S Ate regul /requirements. 1 1 ''
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,I Date a F1j Inspe gr
' , r , 4 . . 1 . 4 . . a .1 . 4 1 i slsr -
c • TAIN WITH RECEIPT RE'ORDS 1' ' CONSTRUCTION SITE / ^i I «'r
J 'CONDITIONS: r
1. All installation must comply " with all requirements of °li . coOpty : Sewage Disposal Regulations, adopted pursuant to au +', ^ : 1
thority granted in 80.444 1983, amended 66.314, I fV0 960. 1' IC
2. This permit is valid only fprconnection to structures d lc"h "h ' a fully complied .with County coning and building r`equlrententsl lo' °I
Connection to or th any dwelling or structure appro l by the Building and Zoning office shall automatically be a Vlole i i w
lc tion of a r o the permit and cause for both I :° c oh. end revocation of the permit. r l
u 3. Section III, 3.24 req 11 r „ c s,10 a system in a manner which 1
wage disposal s In^
unlves a knowtnn .. any person who constru ts," Y i t hs an l 5dividual'se . ° rmitmommiise,Cdasst „ '
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Page Two Fees Paid $
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INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date
Owner: fee i 74 7S ini
Mail Address: / 3 / 4 Ce/cpy City: zip:,6 2 2if
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 e'
Location Address & /or� 2 `, —G 7 c
Legal Description r Lot Size
2. No. of Bedrooms 3 Septic Tank Capacity Aeration Unit Capacity N/A
ArH prretel 3. Source of Domestic Water: Public (name): C -��
Private: Well Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? /4
5. Distance to nearest sewer system: 3 --,. e- . ( 'P_. V'
Have you attempted to arrange a connection with the system? /t��
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: /` i�
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. ....41.040.1!::::i
Date i .yr " ure o 'pp scant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)