HomeMy WebLinkAbout33933 Colorado River Rd - 168701300002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631
Telephone: 328-8755
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE.
Please call for final inspection before covering any portion of installed system.
PERMIT NO. 1 5 4 8
OWNER: Lee and Kate Robbins PHONE: _(970) 653-4312
MAILING ADDRESS: HCR 81 BOX 92 Olry: McCoy state: C0 ZIP: 80463
APPLICANT: Lee Robbins PHONE: (970) 653-4312
SYSTEM LOCATION: 33933 Colorado River Rd. TAX PARCEL NUMBER: 1687-013-00-002
LICENSED INSTALLER: Lee Robbins LICENSENO: 66-95
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS: 21
SQUARE FEET OF SEEPAGE BED 750 SQUARE FEET OF TRENCH BOTTOM. via+infiltrators as requested by owner
SPECIAL REQUIREMENTS: Install in serial distribution in trenches. Install inspection portals in
each trench, and a cleanout between the tank and the house. Ra1.e all trench surfaces,
e
stoc away. Ca 1 the County for final inspection rior to back -filling. If you ave any
questions about the installation please call our oyfice at 328-8755.
ENVIRONMENTAL HEALTH APPROVAL: DATE: November 22, 1995
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. 1973, AS AMENDED.
2. 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 BE A VIOLATION OF A
REQUIREMENT OF THE PERMIT AND CAUSE FOR BOTH LEGAL ACTION AND REVOCATION OF THE PERMIT.
3. CHAPTER IV, SECTION 4.03.29 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM TO BE LICENSED.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMPLIANCE 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: 756 SQUAREFEET. via 21 infiltrator units
INSTALLED SEPTIC TANK: 1500 GALLON _330 DEGREES 1119FEET FROM the c1eanout
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY x YES NO
COMPLIANCE WITH COUNTY/ STATE REQUIREMENTS: X YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED.
COMMENTS:
ENVIRONMENTAL HEALTH APPROVAL: �JGf j7(�/'/iC DATE: December 10,1997
ENVIRONMENTAL HEALTH APPROVAL: DATE:
(RE -INSPECTION IF NECESSARY)
APPLICANT / AGENT:
RETAIN WITH RECEIPT RECORDS
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT #
CHECK#
(Site Plan MUST be attached)
ISDS Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. O. BOX 179
EAGLE, CO 81631
328-8755/927-3823 (El Jebel)
**************************************************************************
* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
* *
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
**************************************************************************
PROPERTY OWNER:
MAILING ADDRESS: 141alz
APPLICANT/CONTACT PERSON*
MAILING ADDRESS: A/e/Z
M
M
PHONE: (}53 ``-
LICENSED ISDS CONTRACTOR: �O.OPHONE:
COMPANY/DBA: m ADDRESS: 3,73-
PERMIT APPLICATION IS FOR: (,/� New Installation ( ) Alteration ( ) Repair
***************************************************************************
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Building Permit #
(if known)
Legal Description: Subdivision:
Filing: —Block: Lot No.
Tax Parcel Number:
- ( f
3- -
G°
7 Lot Size:
Street Address: 7
(VZ,-16
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BUILDING TYPE: (Check applicable category)
("Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
TYPE OF WATER SUPPLY:
Well ( )
( ) Public Name
(Check applicable category)
Spring ( ) Surface
of Supplier:
Number
Number
Type _
of Bedrooms
of Bedrooms
*These systems re r sign by a Registered Professional Eng'neer
t.
SIGNATURE: Dater
TO BE COMPLETED BY THE COUNTY
AMOUNT PAID: RECEIPT
CHECKfec
#:
�1 6 ,.
#: DATE:
CASHIER:
ISDS PERMIT
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER:
LEGAL DESCRIPTION:_
MAILING ADDRESS:—
EA
TYPE OF DWELLING:
NUMBER OF
BEDROOMS
TEST HOLES PRE-SOAKED: YES
NO
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Time to drop last inch
(PERC RATE: MINIMUM SEPTIC TANK SIZE:
MINIMUM LEACH FIELD SIZE:
COMMENTS:
Vj L-14/1 _b, - � 411
PERC TEST 0
DATE:
Environmeh-tal Health officer
rev. 6/90ks
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67
14
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ISDS Permit # '�q Date
ISDS Final Inspection
Comrleteness Form
i �`v 0
i/ Tank is gal. Tank Material (- Ui,-1�4
Lr Tank is located /% q ft. and 530 "degrees from
(permanent landmark)
Tank is located ft. and degrees from
(permanent landmark)
Tank set level. tD Tank lids within 81, f finished grade.
V/'� Size of field %'5-D ft2 21 units lineal ft.
Technology-A77 7- -- s
V" Cleanout is installed in between tank and house(+ 1/100ft).
There is a 'IT"that goes down 14 inches in the inlet and
outlet of the tank.
Inlet and outlet is sealed with tar tape, rubber gasket etc.
Tank has two compartments with the larger compartment closest to the
house.
Measure distance and relative direction to field.
_ Depth of field" ft.
Soil interface raked. 4"t
i/ Inspection portals at the end of each trench.
_(/ Proper distance to setbacks.
i Chambers properly installed as per manufacturers specifications.
(Chambers latched, end plates properly installed, rocks removed from
trenches, etc.)
Other C�k
Inspection meets requirements.
Copy form to installer's file if recommendations for
improvement were suggested.
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Setbacks
Well Potable House Property Lake Dry Tank Drain -
Water Lines line Stream Gulch
Fed 100 25 20 10 50 25 10 10
Tank 50 10 5 10 50 10 * 10
JuM
SHEET NO. OF
CALCULATEDBY DATE
CHECKED BY DATE
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33933 Colorado River Rd.
:JOB NAMEMcCoy, CO ROBBINS
JOB 'NO
JOB LOCATION
BILL TO
DATE STARTED
'
DATE COMPLETED
DATE BILLED
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JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 �® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER Printed in U.S.A
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