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HomeMy WebLinkAbout03564 T • . GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit n: 3564 1 / 109 8th Street Suite 303 Assessor Parcel No. Glenwood Springs, Colorado 81601 ` • Phone (303) 945-8212 . This does not constitute • INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. PROPERTY Q t n/ x '[ �C � ,. • Owner's Name 1 D 6 1 1e " Present Address � Ce ?SQ s i /T C e Phone " ' 9L- - r+ Y System Location 4f 3a3 CR a t (1 sill co v &sa- • Legal Description of Assessor's Parcel No. — 1-0 c o ( 4 i4arick ` SYSTEM DESIGN • i ISO i ; ideptic Tank Capacity (gallon) Other ' Q 6.L.-414, //1 F Z ® Percolation Rate (minutes /inch) Number of Bedrooms (or other) 4 6.1 ? i.r.,Qca .. Roc,"t'. I_ cat i j6/3 39 -it" I ' ti Required Absorption Area - See Attached hi* v Conn, dial - Mr-QC rr - 36 a14-f ' ` F /f+' 4 3 t4N -/TJ 'I3 ' v l9 f t • Special Setback Requirements: , 77IC0 go 14 Hyra 1 `y 8, s Date 1 • 1 `CI Inspector .. .- ' FINAL SYSTEM INSPECTION AND APPROVAL (as installed) t I Call for Inspection (24 hours notice) Before Covering Installat i 1 Li System Installer r D /1 ji ∎ c4+e ) m1f (71 e.) At • Septic Tank Capacity. /5 0 c, A S � � `tf Septic Tank Manufacturer or Trade Name ( f j 4 1 • Septic Tank Access within 8" of surface Dt K w , • Absorption Area , r a Absorption Area Type and /or Manufacturer or Trade Name � S -�,„ / Ad equate compliance with County and Stateregulations /requirements.Xe— 3y� ) C'td .7x-*t7J7O N.• , Ati- pi Other '' ,, l111 ,) a ' Date ` - 01 Inspector `1-l•Sr *• ,v2 _ RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE , *CONDITIONS: S 1 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- , 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, or installs an individual sewage disposal system in a manner which involves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 fine — 6 months in )ail or both). l t White- APPLICANT Yellow - DEPARTMENT ; • .0 .■ 4 J ® \ \ k £ pd $ \ 2 - , — - f j ` %\ It / 1 /% \ • / 1 §it . c£S � • i ; O t-g _ ' \ ( � § \ , 21 % w 02. � a W' \ .t: ¢ ID sa 4- k }- I " : ∎ § { . N \ / 3 4 \ \,/ fi g• �@ t� E i - -4 ( i / cadi + 7 p. t. \ s \ ( ( / i gi k 0 4 " - \ q je 0 � . t§ - I k �" . t %k •C DO % ( § a �w. v IV ■ A I. i i i cs % 4 im E - % d 4( ( ), / & ( - ` - - - - . 0 0 - - - , 2 .4 3 t / J , 2 \/ ' 0 *4 k 4 $ - . k 2 } 1