HomeMy WebLinkAbout03029 f r 1 e 3002‘1 f •
in f GA RFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N o 3 O 4,4 i ) ' 109 8th Street Suite 303 Assessor's Parcgl No. �1 t k
0 , Glenwood Springs, Colorado 81801 i f ■
r I) Phone (303) 945-8212 J j
Thi does not constitute -:.' V ; '
a building or use permit r a
i ;# g INDIVIDUAL SEWAGE DISPOSAL PERMIT ? . M .
E PROPERTY t i / 11 r1 1 /? ' 'p
K ( T. `Y Coph PresentAddress (( LIVV t %411.77 lC1QIZ`opti (a5 - 534 i
i
i Owner's Name (�
150o G RA .. a 5S & t - E\ e Co e L5o e
i � , Syste m Locat ' +
I.
F Legal Description of Assessor's Parcel No. I` S
l A0C L_ c404- prEc-1) Z +
') SYSTEM DESIGN L I C E AC </— Q - �' cfG , v a . r r
i
^ ) v 4e = 720 3e ....— ) ,
1 0 0 0 Septic Tank Capac (gallon) Other k '
4 (S
. , ( i /y o ( Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 « , t
ii i
f t Required Absorption Area - See Attached -
i Special Setback Requirements: i
t Date C? ( 4 7 Inspe ctor �'1 ) a • t
FINAL SYSTEM INSPECTION AND APPROVAL (as installed) :
Call for Inspection (24 hours notice) Before Covering Installation !
, t
System Installer 0 LJ kt E e' • q
5 Septic Tank Capacity 12' s Q `-� / / - +I ' s
r C 0 S C- /fit1 -( 'i
Septic Tank Manufacturer or Trade Name `-' _ /
f
" ; Septic Tank Access within 8" of surface t
J t
"'' 20 $1 0 1 rLock LGAc1 /- rt(e4)
pi Absorption Area
1
Absorption Area Type and/or Manufacturer or Trade Name $ 1
• a Adequate compliance with County and State regulations/requirements A•-'..."
- i Y y il''
Other "E R
Y
i, Date l C — 1 -- 9 Inspector A 2 N(a i 1
4
i RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE e S
f f' •CONDITIONS: 1
1. All installation must comply with all requirements of the Colorado State Board of Health individual Sewage Disposal Systems Chapter y
' t 25, Article 10 C.R.S. 1973, Revised 1984. 1
2. This permit Is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- e i t
1 ' nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically beaviolation or r 1 5
requirement of the permit and cause for both legal action and revocation of the permit. .
"+ 3. Any person who constructs, or installs an individual sewage disposal system in a manner which Involves a knowing and material ;,
t variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 8 3 0
y months In Jail or both). . .
White - APPLICANT Yellow • DEPARTMENT 11, .