HomeMy WebLinkAbout377 Pilgrim Dr ADU - 210519303007 - 0932ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927.3823
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 932
Please call for final inspection before covering any portion of installed system.
OWNER: Gary Bossow PHONE: 476-4880
MAILINGADDRESS: Drawer I %I 1 Vail, C.D 81658
AGENT: PHONE:
SYSTEM LOCATION: Lot 4 Pilgrim Downs; 2nd Unit$ Only LICENSED INSTALLER: Owner LICENSE NO.
DESIGN ENGINEER OFSYSTEM'
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TREN H eOTTOM.
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SPECIAL REQUIREMENTS: f�Q/1 �) �✓ � V /%��� l
ENVIRONMENTAL HEALTH OFFICER: DATE:
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM
REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED IN 25-10-104, C.R.S. 1973, AS AMENDED.
Z THIS PERMIT IS VALID ONLY FOR CONNECTION TO STRUCTURES WHICH HAVE FULLY COMPLIED WITH COUNTY ZONING AND
BUILDING REQUIREMENTS. CONNECTION TO OR USE WITH ANY DWELLING OR STRUCTURE NOT APPROVED BY THE ZONING AND
BUILDING DEPARTMENTS SHALL AUTOMATICALLY BEA VIOLATION OF A REQUIREMENT OF THE PERMIT AND CAUSE FOR BOTH
LEGAL ACTION AND REVOCATION OF THE PERMIT.
3. SECTION 111, 3.21 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM
TO BE LICENSED ACCORDING TO THE REGULATIONS.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE WITH THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS UNTIL THE SYSTEM IS APPROVED
PRIOR TO COVERING ANY PORTION OF THE SYSTEM.
INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET.
INSTALLED SEPTIC TANK: ODO GALLONS DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN S" OF FINAL GRADE, OR:
PROPER MATERIALS AND ASSEMBLY — YES NO
COMPLIANCE WITH COUNTYISTATE REGULATION REQUIREMENTS: ./Y• YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED.
COMMENTS:=�+f
ENVIRONMENTAL HEALTH OFFICER: i' h• -�"`S• DATE:
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE4NSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANTIAGENT:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
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