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HomeMy WebLinkAbout01125 GARFIELD COUNTY BUILDINN AND SANITATION DEPARTMENT Ir 20 4 " I Aibp�U,M ) Glenwood " y otado 81601 +` Pfionh 241 This does not constitute INDIVIDUAL SEWAGE DISPOSALPERMIT g 1� 0 I 1126 a building or use permit Owner Frank R 111A FSpdi076 . System Location - 16478 Highway 82, Caitbn0d0 Licensed Installer - ' + * Conditional Construction approval Is hereby granted for ti' 750 gallon ( ' 1 11 XX Septic Tank or Aerated treatment unit. II uN ii ' Absorption area (or dispersal area) computed as follows: Perc rate of one inch in. minutes requires a minimum of ) 1- sq. ft. of absorption area per bedroom. i li uV Therefore the no. of bedrooms 2 x / 7 sq. ft. requirement • a total of . ft. of absorption area 1 "r r. May we suggest (a t 1( thy X 3 �p ^- 1 ,1 '' 11-1 " Date 1 \o-() 7:4 ��8 Inspector 1, A Sit � a ,� u I a I I FINAL APPROVAL OF SYSTEM: W' Ir' No system shall be deemed to be in compliance with the Stowage D Laws until the assembled system Is approved prior to cover. IX' ing any part. Id i OK Septic Tank access for inspection and cleaning within 12" of ground surfaceix aerated access ports above ground .' • surface. °il © K P roper ma and assembly. "I � "' d s� Trade name of septic tank or aerated treatment unit. h / b O 0 i; ,f 7 L' /i ', 0 k Adequate absorption (or dispersal) area." /Z X 2_9 Z d c 7 /71 0 < Adequate compliance with permit requirements. 0 Adequate compliance with County and State regulations /requirements. Other _�// M" qrn i� , � Inspector .. � „i ii Aare. /// RETAIN WITH RECEIPT RECO AT CONSTRUCTION SITE will n li *CONDITIONS: 1. All installation must comply with all requirements of he County Individual Sewage Disposal Regulations, a p to aw • thority granted in 86.44.4,CRS 1963, amended 66.3- . CRS 1983. 2. This permit is valid only for connection to structure, 10h have fully complied with County zoning end building requirements; Connection to or use with any dwelling or structures 01 approyed by the Building and Zoning office shall automatically be a viola• tion revocation of the permit. n and revoca Pe Section a requ24 4 requires of a n ny pars and cause for on who constru C t s )9t aC f, Q r installs an individual sewage disposal system in a manner which In-' 3. Secon III, 3.2 rquires a person Itet volves a knowing and Material variation from the to s or Specifications contained in the application of permit commits a Class I, - 6 months in ot jail or bi Petty Offense (5600.00 fine i ` 'Y ) . Applicant: Or* Q V Department: Pink CoPV c Page Two Fees Paid $ INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION Date Owner: ,4K s C& $ E5P 0 24 Mail Address: // ./_/wy el_ City: kBoJl 4t Zip: w Phone: ?63-//4.7 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 C44.6,9,,bgt{ Location Address & /or Legal Description /& y 1—)coy Lot Size 2_,. S 4.cc 2. No. of Bedrooms 2_ Septic Tank. Capacity /06 Aeration Unit Capacity N/A 3. Source of Domestic Water: Public (name): Private: Well 1/ 'Depth/2s Other Depth to 1st ground water table Yo 0 4. Is facility within boundaries of a city /town or sanitation district? 4 5. Distance to nearest sewer system: ,, e- Have you attempted to arrange a connection with the system? ` n 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. // F/ 4 4L 74 • • Date Signature o Appint (TO BE RETURNED TO ENVIRON. HEALTH DEPT.) Page Three PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY f ( 2 - 041nu � co a VIII INDICATE BELOW THE LOCATION OF YOUR BUILDINGS, WATER SUPPLY AND DISTRI- BUTION LINES, STREAMS, IRRIGATION DITCHES, ROADWAYS, AND BOUNDARY LINES • • wC-4 `- Cask Qv rn mI •s (TO BE RETURNED TO ENVIRON. HEALTH DEPT.) 3. j �° g � f y� � s � 3 5 / 4o. 3 /0 5 rZ — fr % .54