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HomeMy WebLinkAbout01100 mo•.:�..Trig r,,.., -C W-•‘giqw"' ; , , " •1..tl. COUNTY DUII, Ii �1NDSANITATION DEPARTMENT t k He l it tlh l Glenwo y .. Cd do 601 u,1,114l 'I'll ,'1 �� s 310 1 241 16 ,1 ;' thls,dobs net cons C 1 S 1 4 0 . Nlh� h k 114) e bu dln6Orr ?:a • . I • a1,1 hl ' ` 111 1 ° LTD ur nrt .- I 'h wlh6llt SDr9p4 ,r,1 HP ins. ,' i � teM II 'ns8 nst Ilex , mt ' d ',) 4S MT p ,, i rtmM ��I1 " ,�* Co nditional Construc is hereby granted for , I " , . � . gallon , w ql / tic Tank or •1 Aerated treatment N I t. • „ - - I(1 G . Absorption area (or dispersal are.) computed as foliows:rr' Ml I � " " I�u ilil44 , • m, , , h V l l P rate of one Ino in " min requires a t +� dt of 14I W • ft, of a b s orption „ aree Per �rddr „ ^ n1 I a o ,,n L 1 44 ” i fj ai „ir k it till ol” r e M1 ' [ w + r , 1 p u „ f'f +I Therefore the n1), . of bedroq )1 'WO 1114. t II . ininI a total of I . ft. o f ab rPtl . 9 rtµ,fi e 1 , „� r "1 a ,� , i , 1 ' May w su / X ' 1 X 7 c/ e e p "' Aw V 40 X ' 9 5 /4 ✓ ot ,, r p i I a 1 1 1 , "I . �' ; oulnl,�l , Date r I' �Ih "•'lnspeitOf 4_... 1 .A.e,i4 4 1,, II �, «v , 1 Ir u , hl1 "FI PP ROVAL 011 S STEM: r I�pl�+ft " h a " '1 �i r r , .r l �° y' o, ',N sy stem shall be deemed to ba in comp with the w Qisposal haws until the assembl agate `Is ,h r i - . a y - u, pgl "u , ln0 any part, - "„ , i , , rw' it, ll*� , u ©r Se t an k ac cess for inspection and cr ning within 12" of ground surface or l rot,Idl, i , � lh . n I .. I 1 surface,, " li, i, 1 ( r ii� , I p K Proper ter, Is a assembl . pp 1 ,'r ' /� d ' a I b .9 plr h: 'Era',, a stem of septic t ank o aerated r � t uiii���IIIt. i � d Adequate absorption (or dispersal) artia,11 IIH b d/ Adequate , with permit reri,uir' pierits, �i° iv ii 1 I' 1 177-- Adequate compliance with County artd ate reguIations /requirements. II l r It yl Other & „ ° I U Il i h f ' Date / C9 . t ' ri" I nspe ' C Cor .��.. �I if,. LL // l vl � 1lr dl' RETAIN WITH RECEIPTR CORD ONSTRUCTION SITE 'H II 'CONDITIONS: p y i �' "1' 1. All installation must comply with all requ f irements, l e County individual Sewage Disposal Regulations, adopted pursuant, °I thority granted in (16.444, CRS 1963, amended 66.3+ t; S 19ft3. 4 1 2. This permit is valid only for Connection to structures ch have fully complied With County toning and building requlrettlents. µl u, Connection to or use with Ohio dwelling or structures , epprovep by the Building and Zoning office shall automatically be a 0lole, "I t �, tion of a requirement of the permit and cause for el Iactil n and revocation p f the permit. , " t 1 ' „ '• 1 1 3. Section 11I, 3.24 requires any person who constructs. lets qr Installs an individual sewage disposal system in a manner whlOi in , , l volves a knowing and Material variation from the tar, or specifications contained in the application of permit cammlts a ss J . Nl I III, Ill Petty Offense (5500.06 fine -�'6 months in fall or both). l w I II!' u by ApPlloonV Gran Dlpartmpnt• Plnk COPY „I ' INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLTGAl1UN j uste • ' / / I Petal ; s* Hero • Owner: Spr/ V e/ Th L c /n 7 4/%7 / y s Mail Address: ydoO -ii C fid City: r: u ,' Q f 3 Phi)/ Phone: / /7r 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 Ol enkis Dd S�tQ Location Address & /or . ew ,and Legal Description y ry n a -I I h / ?d lgpe/ s Lot Size $' ac_r es l I 2. No. of Bedrooms ,2 Septic Tank Capacity j Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): � r in 7 Private: Well Depth Other Depth to 1st ground water table 4. Is facility within boundaries of a city /town or sanitation district? /v 5. Distance to nearest sewer system: 141 /7 € S Have you attempted to arrange a connection with the system? /k/r5 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. 9'2 J 7i a le Date Signature o pp scant (TO BE RETURNED TO BLDG. & SANI. DEPT.) - 5 1 ; 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.) •