HomeMy WebLinkAbout03381 t ' GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N '_ 3 3 R 1 I ; : t i
109 8th Street Suite 303 Assessor's Parcel No. t
Glenwood Springs, Colorado 81801
( , Phone (303) 945.8212 ',
i 4 I This does not constitute 'i a
6 INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. il
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C ' PROPERTY
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. Owner's Name RI S / /— Present Ad dres s r — Phone `
{ System Location 02 t1 tt)GE1 ci. I L3.) S I l.T
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r Legal Description of Assessor's Parcel No. i� `
i •. SYSTEM DESIGN • t
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i Septic Tank Capacity (gallon) Other L
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
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f ' Required Absorption Area - See Attached 1 1 r p
Special Setback Requirements: Y S I G A N �lJ G/�j,„� '
Date Inspector e ■ • A • 4 FINAL SYSTEM INSPECTION AND APPROVAL (as installed) i t
• Call for Inspection (24 tours notice) Before Covering Installation It
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' 5 System Installer ' ■
ant) A Jr.& ' °<
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i t' Septic Tank Capacity j / S ) (' I
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Septic Tank Manufacturer or Trade Name � C 1 1 �
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t Septic Tank Access within 8" of surface Y C /
? ' Absorption Area IS cry C2 ' NP ' ) LM y C r r7/ SJ> 5 ,/(� Tg rN C I r c 7 C , a .
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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 CM", ) Y }
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Other / 4 Y .:"
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t, Date 1-13- V✓ Inspector 4 1 , - i j ��
1 RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE { e
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*CONDITIONS: li g
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter 1
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- 1 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 F
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 s ystem I n a manner which Involves a knowing and material ,
q • t variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (5500.00 fine — 8 r r
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months in jail or both). c
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