HomeMy WebLinkAbout03403 ;
r ; , GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 Q S (,,
$ 109 8th Street Suite 303 Assessor's Parcel No. $ t
Glenwood Springs, Colorado 81601 i, A
P hone (303) 945-8212
G ' This does not constitute 4
t t INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. • r
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f11 PROPERTY
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" &es-f gehl c o ' ' R� PO&J(S 6y 54644 081631 9 /'Oa / x s
f Owner's Name sent Address Y Ph one
t d System Location ::.. 194 CR c1-4 1 )3e C&s+ le 6 % I
Legal Description of Assessor's Parcel No.
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SYSTEM DESIGN
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1 r ' /0 0"b 4A Septic Tank Capacity (gallon) Other f
3 � ,, j. / 0 Percolation Rate (minutes/inch) Number of Bedrooms (or other) Q j t
3) Required Absorption Area - See Attached J W R L d L ' J 3 t X 6 + SR^ d� k t
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1 Special Setback Requirements:
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t 1 Date D 23' '� Inspector HO ALA fast ;' ;
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i 1 FINAL SYSTEM INSPECTION AND APPROVAL (as installed) a >.
t Call for Inspection (24 hours notice) Before Covering Installation '" t
fr System Installer 0 t•.) p �
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$. Septic Tank Capacity / t
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Septic Tank Manufacturer or Trade Name
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' Septic Tank Access with r of surface s
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^; Absorption Area /5 9 /3 4 6 ✓ I h y y
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0 Absorpt Area Type and /or Manufacturer or Trade Name �/f'`� w � St( 'r P I {
1` Adequate compliance with County and State re 7T r f cli
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8r Date ` 7 1 /1` 3° Inspector ', -3 4( 1
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i I RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE, ■ r
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*CONDITIONS: [ I
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chap ter Y „
25, Article 10 C.R.S. 1973, Revised 1984. , i
■ 2. This permit Is valid only for connection to structures which have fully complied with County zoning and building requirements. Con- i I
6 , nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a (R
• requirement of the permit and cause for both legal action and revocation of the permit.
• t ; . 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which Involves a knowing and material N' i
ill variation from the terms or specifications contained In the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 fi
f y months in )ail or both). nl.
t, White - APPLICANT Yellow - DEPARTMENT i__
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