HomeMy WebLinkAbout03471 1 :s e
a S , ■ 2" .
it ' c '1 :
L. 5! 00ii V�rl- '
'' GARFIELD COUNTY BUILDING AND SANITATION'ISEPARTMENT Permit N_ 3 4 7 1 a a
t 109 8th Street Suite 303 Assessor's Parcel No. 4
Glenwood Springs, Colorado 81601
1 I_ Phone (303) 945-8212
,.1 `
i I This does not constitute j" 1
1 k INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit.
'. • PROPERTY ?
4 O wper's Name-S N I / 1 I (.44118 D Present Address * 1 SDk) it LT Phone) LO 2 5'43 3 ;
t System Location Z IS Co
o W111.40 A-E KC) 1Ot o` 2
4
z, c
`9
H Legal Description of Assessor's Parcel No. ' '
f F '
} S SYSTEM DESIGN
r :, t
Y )0:C 4 A Septic Tank Capacity (gallon) - Other
t t, 14 Percolation Rate (minutes /inch) Number of Bedrooms (or other) 3 r
1 ' Required Absorption Area - See Attached ` Ou- `s / ill i4 r exuavr It A.rf cOCL1,"-
;r
!
( P Special Setback Requirements: e
Date 2' JS-` 1 Inspector y
1t
t FINAL SYSTEM INSPECTION AND APPROVAL (as installed) y
• s Call for Inspection (24 hours notice) Before Covering Installation o
System Installer - biii.Je-11. SF.avir i Lik k [' A
L Septic Tank Capacit TylIT) 4L i " � f \ De L' j- l OM l('JJC I aa0 N (,
i a
Septic Tank Manufacturer or Trade Name 71%(4/11 7 1 aTF .
_ :
Septic Tank Access within 8" of surface fa,T7` hLM ,
Y .. Absorption Area /4 S a I rt ,. ' �fi.E i : .
tt (
Absorption Area Type and /or Manufacturer or Trade Name 1) of Las. t. L-
I
�!;
1 hr
e Adequate compliance with County and State regulations/requirements 1 t -
i � +`. i. ■
Other
t _, - a(o •� ,
Date Inspector Y1
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
J; t r, 2
1 r *CONDITIONS: o
i 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1984.
1 r 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 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.
ir' a. 3. Any person who constructs, alters, or installs an Individual seWage disposal system in a manner which Involves a knowing and material '
., 6 variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense (8500.00 fine — 6 ` .i
' months In Jail or both). g r
i!
White - APPLICANT Yellow - DEPARTMENT
I zo d
•
� � �9 I
G� g z
g o
y c go
g
c ? , M
3 - --c C ).
L. S . g. 1 1-j`
I
5
. b
w N va
J 0 s. a.
ig 1
� w F o
a a: F o
M
R
4 o
0
0
w 1
z.
a
0