HomeMy WebLinkAbout03026 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit NS 1 0 7 6
109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81601
Ph one (303) 945-8212
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� This does not constitute
� u a building or use permit. c ,
,. •' 1 INDIVIDUAL SEWAGE DISPOSAL PERMIT O
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w PROPERTY -RVO \c ((Ds r ( I ' C P
r' t Owner's Name 1 .ii1 1 • '' Present Address°- 1 t', i•�Phone �� =�+�` .
System Location. C VJ ,
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I Legal Description of Assessor's Parcel No
r SYSTEM DESIGN SO ko T C - 90� F C -C 0 •
0 QSeptic Tank Capacity (gallon) Other
t. / /1 2 - Percolation R (minutes/inch) Number of Bedrooms (or other)
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e Required Absorption Area - See Attached
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4. F Special Setback Requirements: ,
t- Date %— // 4 '1? Ins pector ' AC
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• FINAL SYSTEM INSPECTION AND APPROVAL (as installed) ,
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t I Call for Inspection (24 hours notice) Before Covering Installation
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` ■ System Installer C 4 A. ID F / C� C X
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4 Septic T ank Capa
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G . J. P( (pt_ ; +
,q Septic Tank Manufacturer or Trade Name L
Septic Tank Access within 8" of surface \� !..
Absorption Area
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Absorption Area Type and /or Manufacturer or Trade Name !
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t Adequate compliance with County and State regulations/requirements t.
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Other '.
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? Date (I 1 8 Insector V ` ,
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 Disposa 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. Con- t'.
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a ; j
requirement of the permit and cause for both legal action and revocation of the permit. • .,
p 3. Any person who constructs, alters, or installs an individual sewage disposal system In a manner which involves a knowing and material •` r
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 8 t ti
months In Jail or both). , %
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