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• + GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
109 8th Street Suite 303 See 1 ' SOS rcrft'u f"
Glenwood Springs, Colorado 81601 41. I.
Phone(303)945 -8212 � ?1 I /In
I)15 f ci 11 .' ,: r�
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT N 1947 a building or use permit.
Owner 0279 Weetbank Road Glenwood Springs
System Location Fred R. Martin*
Licensed Installer __ Gould Construct
• Conditional Construction approval is hereby granted for a gallon E �! 115 '•f • ri 1 t . i r f t -�
_— •
) ? rVl:.t Septic Tank or Aerated treatment unit. i •
Absorption area (or dispersal areal computed as follows:
44 2 3 (. d o I r •, .?. a :� , ')
Perc rate of one inch in t y minutes requires a minin%um of '' sq. ft. of absorption area per bedroom.
re
Therefore the no of bedrooms 3 x 2 &2 sq. ft minimum requirement = a total of r S sq. ft. of absorption area
May wesuggest: (..01,11 ,/ (IfAbtC "(.ti S � 5. .JR .,r71r , ' C 7
Date /!J" /2 a f 4 / Inspector 1/4r y /rl "/ < —
f • f , tia
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to cover•
ing any part.
^fit / o1. 7 Septic Tank access for inspection and cleaning within 12" of ground surface or aerated access ports above ground
surface.
Proper materials and assembly.
Trade na of septic tank or aerated treatment un t.
2 y 40 S' -2 ariiA lie
dequate absorption (or dispersal) area.
,.—_ Adequate compliance with permit requirements.
Adequate compliance with County and State regulations /requirements.
//��
Other
_-
DatejO a 3, -7/ Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
`CONDITIONS:
1. All Installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems
Chapter 25, Article 10 C.R.S. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building
requirements. Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall
automatically be a violation of a requirement of the permit and cause for both legal action and revocation of the permit.
3. Any person who constructs, alters, or Installs an IndIvIclual sewage disposal system In a manher which Involves a knowing
and material variation from the terms orspecifications dontalned In the application of permit commits a Class I, Petty Offense
($500.00 fine — 6 months in Jell or both.).
Applicant: Green Copy Department: Pink Copy
Application
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION Approval by
.. County Official:
OWNER F ?Et.) . /Yl AR! !I]/ II^
ADDRESS 0z ?4 WE rLAN(C 2 o4t3 PHONE q$ 9 37 "� Gv � ` / � V
CONTRACTOR C'7
0A D £ O NS I . 1 44
ADDRESS ( ' 74 N UJY 2 2 _ PHONE Q4(S 72'1
PERMIT REQUEST FOR: ( ) New Installation ( ) Alteration ( Repair
Attach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable building, location of potable water wells, soil percolation
test holes, soil profiles in test holes. (See page 4.)
LOCATION OF PROPOSED FACILITY: County ! ?ARFI�LLS
Near what City of Town 4LENWOO6 SPIZI Lot Size/ 1 /4 ACRE
Legal Description 0 2-7T UUPc fi4ik eves gczwk 5u4 .
WASTES TYPE: (Dwelling ( ) Transient Use
( ) Commercial or Institutional ( ) Non- domestic Wastes
( ) Other - Describe /
BUILDING OR SERVICE TYPE: heSt`cleAe ` i °l / _
Number of bedrooms 3 Number of persons -3
(>9 Garbage grinder (x) Automatic washer tC ) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) spring ( ) stream or creek
Give depth of all wells within 180 feet of system:
If supplied by community water, give name or supplier: WEST eiltuK< 1114-Tr
GROUND CONDITIONS:
Depth to bedrock: 04n lc, rtr,w _
Depth to first Ground Water Table: Uh k o w 1
Percent ground slope: ' jr--
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: S 1 -ES
Was an effort made to connect to community system? N r7
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(21 Tank ( ) Aeration Plant ( ) Vault
( ) Vault Privy ( ) Composting Toilet ( ) Recycling, potable use
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, other use
( ) Chemical Toilet ( ) Other - Describe:
FINAL DISPOSAL BY:
(> Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Underground Dispersal ( ) Sand Filter
( ) Above Ground Dispersal ( ) Wastewater Pond
( ) Other - Describe:
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF TIIE STATE? 41 b
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