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HomeMy WebLinkAbout03286 IIa. -, V u. 1 i 4 1 GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N_ 3 2 Pt ' ) ° , . 9 109 8th Street Suite 903 Assessor's Parcel No. r sj Glenwood Springs, Colorado 81601 1 l Phone (303) 945 -8212 2 G ( I This does not constitute i ' INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. r PROPERTY Q I r S Co ?/6 of v 4 � y ; x] L' S +. S�Ph s� t: /5 — x 90 .3 I ( c 4 Owner's Name — A l b a, \1 -, Present Address _ Ph ne t f F)X Ruth Si (-- Co gl b5-a___ 1 f System Location e $ Legal Description of Assessor's Parcel No. L Df 5 2e te Kg M?Y p12. say lJd. r 1 SYSTEM DESIGN Cr o-F 042? Its. • Septic Tank Capacity (gallon) Other ( E FC SITE T E n A , / t J ( 1. I •' l �` /�I t : Percolation Rate (minutes /inch) Number of Bedrooms (or other) ( 1 e a Required Absorption Area - See Attached i 0 Special Setback Requirements: r i 4 y Date ____ —_ Inspector ? ve FINAL SYSTEM INSPECTION AND A (as Installed) ' CaII for Inspection (24 hours notice) Before Covering Installation t ), System Installer. -- i y Septic Tank Capacity) C50 C A ._ Len 4 � [ y {1L•' ri 4 i7 {. Septic Tank Manufacturer or Trade Name _ ' ; i Septic Tank Access within 8" of surface ___ Absorption Area • o (3 ( X G F () u M (T S IN A (3 C D OF 'f RO.-✓ -S OF (O ` ' �� ;. m 114 FI -S (c Absorption Area Type end /or FAanufacturst or�Trade Ne e ; , A t` Adequate compliance with County and State " gulatigns(requlre rents ( i if . Other 3 - 0 P A Otto' { . 4 -.r = 5 --a90 N. f r ,I Date Inspector 3 _ i3. DO RETAIN WITH RECEIPT Rt .. - f ti l *OttICTION SITE « ; l' *CONDITIONS: i a s ` 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter t • 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 - i ° nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a ,t requirement of the permit and cause for both legal action and revocation of the permit. • 3. Any person who constructs, alters, or installs an individual seWage disposal system in a manner which Involves a knowing and material ? j S variation from the terms or specifications contained In the application of permit commits a Class I, Petty Offense (6500.00 fine — 8 ,, ■ months in jail or both). • ., White APPLICANT Yellow - DEPARTMENT