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Home My WebLink About20100118.tiff / 4 % WEL1PCOUNTY HEALTH DEPARTMENT 1555 17th Ave. :..: •H r¢_ Greeley, Colorado . No. P----- L-' Ph. 353 -0540 tWla :y :• W M.H. No. • APPli i n for Permit to Install, Construct, Alter or Repair Indivicl,i x1 Se« ,ge .DLs.posal System. V T7��L 2.26-4-:-71 \J awri6s, il 71,2 .8....-.1_4.,---)-7444-j41.-• . �tl li ' ♦- 'iiT"%~��y F•. T1TT1 / , Phone 'hi/ Legal D `r.ripS, ,n ____21(4- 1 - -` '- . ', 7'`•.. -'._ ir'ts.t...* its .4 („... i ell .- -at: �(P!Direction _ ea r„,..L- ,),Ate•,Y:r- Z' .it .-- 9- .'...c. -...e.._.-.-x . _.c. -- _ - --/- -- ,..� , -a . , General information Septic Tank — -- - 1 . Liquid Capacity 2. No. of Bedrooms -_ - - -- .._- _ . ___ ____- •-- 2. Dimension; _. . �w_ /74- it __ _ D 3. No. of Baths ----- .._ -- -- — - — —'_ :3. Material `_c '''nee -- 4 . Easement Drain ____.4%--&-a-------- ._ _______ 4. Type Inlet __ �. ____. --� 5. Automat is Dishwasher _ -�.j•z. • Type Outlet __ 6. Garbage Disposal _._�. - --Le --___�_� ^___._- 7. Automatis Laundry yea___.•••••........ey Seco dory �`reatment 8- Size of Lot _ ,�.- l.,, .„4,„ ic.are 9. Type of Soil —. .4‘*# .444.-4,--0...ate/ ,acr .._ ..� —�' -- — _ _ - Field _-U C-.1..._._ ..--- '/ /1 -- " / 10. Percolation Test //J �'Ut.- • �` ' I1 . Water Supply _ 7 fl.. , •'. 1 . No. of distribution lines i ? llot Grade _ . - ---- -- __ - -- -- -- 2. Trench : Width__ - - ._ Length ._._ --- ----- 13. Water Table Depth _-- - -_ . ._ — _._.____ . _-- '__ —'- .- - 3. Type Filler Material __ .— - — ': 1 , ether 4. Depth of Filler Material _____ ____ __ _. _ 5. Gravel Size 6. Type 'file _ . -- .... _ _ ----- . - ---- --- .-------- ---. ..--_7. Depth ofc 'o' r . - -- - - - - .. - -- . - .. • The Perim ! i .: :'. r . i'c' ;:-,;tin in till force iii-id effect for :•:i.: ( (i ) months from ( (sill.', until revoked for non-compliance. TH.: •• ''• til ' ni w; ll bo constructed in accordance with t he. above specifications and regulations governing non- !111U1it•iEi;; : ,-• •,Valite disposal systems , in accordance with Regulation No. 1 of the Weld County Health De- ti:ti•tr.1ci; t . Owner c•�innot. transfer permit. �� s Owner : I. . _I_,•- �. _.x.1X.-r.1 ._..---- •f -r•.'�_�,44. :-'_ 2 rI .}-- . .. - -- - ' - _,I_ _ Applicant : The plans and specifications as shown are approved, pending payment of prinit fee. • Sanitarian : c - '- / ,l 4. --�- - v -- - — - - t r _x__ -- - •-_J t ; The al %C; 1'E' sv;,tem inspected and found to comply with the plan and description . Installed by � '� ` Date :- . i Sanitarian : r i PERMIT l•'E E $. • Ii ' - ' et.: -�-- , , _, ` __,.....� . __ ---- - Date _ ---- .. .ease u:-c, reverse side- for Plot Plan or use separate sheet of paper. 2010-0118 ..MO •t(flm S .V r• Hello