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COUNTY OIL I iIlf pNIO: S�INITATION DEPARTMENt m
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INDIVIDUAL SEWAGE DISPOSAL PERMIT 1� „1,„1 logg „°i1„ abuildingoruse y 1 { � �li
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owner Glen C. Harris 11 d , n 4.
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1 System Location r 032 104 'Road - CarboRdal 1 1” k
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ar Llcensed Installer i'+
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' Conditional Construction approval is hereby granted for o 1 ,Q� g fil gallon d ol l Ito: ,.
Id , i is4 - _x_ Septic Tank or Aerated treatment it,
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t ..�41 111w V 1� „.
Absorption area (or dispersal area) computed as follow': '. ' r r
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Pere rate of one inch in i minutes requires a mini IV m pf , sq. ft. of absorptlo per bedroom. 'fi
Therefore the no. of bedrooms 3 x , 23$ g i t l ^ 1 in i mu m, r • e total of (� (sq.- of absorption ard 1 ' ° i t � ”:
May we suggest 1 2 b 01 K 3 0 I i eX e l t',/ X$ t„ r ru
Date S. e,_ . 1 .ry i i Z""" 1 ' in actor £vistas .CSw -t..& ....._ _ y _
rt I FINAL APPROVAL OF` SYSTEM: °rr-
stem shall be deemed to be 1n.com compliance with the a Is , i1 I r,:.,.
11 k No system p ha 1 ge O pose) Laws until the assembles( system is approved prior t0 dovgf. yillu'=
ing any part. 11 1 1 111- i rt-
1 Septic Tank access for inspection end cle.ning within 12" of ground surface or 'heisted eccets ports above gr I i i s
surface. - vL, 1 1 s
Proper materials and assembly. +h "�a�G t " 1 � 1 1 µ` ^,
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Trade name of septic tank or aerated tree men{ unit. \ I _
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4— Adequate absorption (or dispersal) area, 41 8/x4 Z.4 3 h1 ) n'1,:
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0 { .-- Adequate compliance with permit requirements. 0 1
" compliance w ith County n ',
q p ty a ds to re ufatlons /requirements. I s,1,,
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Other .. •
Date .. Inspector I _ /� d,T.
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tP RETAIN WITH RECEIPT RE' ORDS'AT CONSTRUCTION SITE � 1y1
ID 'CONDITIONS: "
1. All installation must comply with all requirements of fi t County individual Sewage Disposal Regulations, adopted pursuant to au.' .1 i
thority granted in 6644 44, CRS 1963, amended 68-3.I4 RS1963. i
2. This permit is valid only for Connection to structure' Ich hive fully complied with County lofting and building requirem 4 '*
Connection to or use with any dwelling or structures n apyt ve the Building and Z a oning o fice shall automatically be Viola I "1t , j
tion of a requirement of the permit and cause for bot aI e ion'; and revocation of the permit, ' I
3. Section III, 3.24 requires any person who constructs,"s1 ers, or installs an individual sewage disposal system in a manner which i ; 1 i ,; ,
volves a knowing and material variaYdn frdm the , termt l l or specifications contained in the application of permit commits a Class 1, m, .
' Petty Offense (5500.00 fine 46 months in jail or both i ie
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Applicant: Cron C ola D epartment: Pink Copy
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INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION [Date /,23_5/
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Owner: c_ D.4 wJ212
Y Mail Address: 03 (b 20 City: ()wtRg -Nn4C Zip: ed/,23 Phone:3 t8
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 , necu %
Location Address u %or
Legal Description ■n Lot Size Ae_ tt S
2. No. of Bedrooms o, Septic Tank Capacity Inn O Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? 116
5. Distance to nearest sewer system: d k I. p` 5 \ aa1ZOUflA ■8
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.
Date Signature of Applicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
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.)
Date P Zf3 ) lkg
Tester
PERCOLATION TEST DATA
Address • 2 . • � , /
Profile hole
TEST HOLE #1 #2 #3
TIME (Min.) Level Drop Level Drop Level Drop
0 d,fr h //// jffl li 7 4 545
5 ! I ! eg IV 9 13" ("
10 ► I S 3 1 % b 11 3 rg % ►►
15 3 4h 11 S / n 5 /1 / /I
20 7 911 94,9; 11 , l 7 f, z - y 11
25 2 '2 /1 1/ � >t 2-- ►
30
35
40
45
50
55
60
Percolation Rate 1 I minutes per inch.