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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 3 3 7 7
\, 109 8th Street Suite 303 A is Parcel No.
Glenwood Springs, Colorado 81801
Phone (303) 945 -8212
' This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
PROPERTY �+� ./ / -
Owner's Names r nI VIS / 0 1.`i Present Address Y /53GRAS )1 )ESN ? ' � lVL hone 31 gl e
System Location yb C O CR I SS MESA 'r . R 1 - L 1-- .
Legal Description o) Assessor's Parcel No. .
SYSTEM DESIGN
— Septic Tank Capacity (gallon) Other
O Percolation Rate (minutes/Inch) Number of Bedrooms (or other) s3 4- bl Sr
, $3S °' ST i'-its ) ZocK LE-4-cif $t-
Required Absorption Area - See Attached 32/ O ' LE,4 -c f C H.•7N , R4 /A 1 8 a 6 Gl rK •
Special Setback Requirements: 2107 C / 'Cµ C U'J'tn(5 /n) / T�� tires '
Date h -2e) - Inspector
e ��a
' FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation t
System Installer
Septic Tank Capacity /n?
C0e L .L
Septic Tank Manufacturer or Trade Name j t
Septic Tank Access within 8" of surface Ycs
Absorption Area h L1,}C N C/»Fjlint 4 i4 C) ! � J 7 S � t
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Absorption Area Type and /or Manufacturer or Trade Name
( Adequate compliance with County and State regulations/requirements y ES
v.o
G Other / Pc .4.14 ? �
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Dat
( en Inspecto .4.14 .4„, y '
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE f 4
;, *CONDITIONS: )?
` �, 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter i',
25, Article 10 C.R.S. 1973, Revised 1984. f
2. This permit Is valid only for connection to structures which have fully complied with County zoning and building requirements. Con -
nection to or use with any dwelling or strudtures not approved by the Building and Zoning office shall automatically be a violation or a 4;
i requirement of the permit and cause for both legal action and revocation of the permit.
,1 3. Any person who constructs, alters, or installs an individual seWage disposal system Ina manner which Involvesa knowing and material t
A variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 t
1, months in Jail or both). i t
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White - APPLICANT Yellow- DEPARTMENT ..