HomeMy WebLinkAbout9 Colorado River Rd - 000000000000EAC COUNTY DEPARTMENT OF ENVIF 'MENTAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT (this does not constitute
a building or use permit)
Owner
System Location
Licensed Contractor
* Conditional Construction approval is hereby granted fora _ gallon
Septic Tank or _ Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate — inches in minutes s q. ft.
absorption area per bedroom
# of bedrooms X -,
sq. ft. minimum requirement
May we suggest
Date Inspector
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved to covering any part.
kle�
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Pw`ner materials and assembly.
/Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations; requirements.
Date Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973
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 structures not approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the permit.
3. Section 111, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or
both.
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~ \ ENVIRONMENTAL HEAL I
~ PI�BOX 8ll
PERMIT NO. EAGLE'COLORADO 81831
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ��0, �����
�� ° �u^x w
Nome of Owner:
Address of Owner:
Is facility within boundaries o; o city/town or sanitation district?
Distance to nearest sewer system:
Location of Proposed System:
Legal Discrption:
Type of Structure: Single Family Dwelling ( ) Other: No. Bedrooms
VVotex Supply: Private Well (X ) Location: Distance From leach fie|6:_---___—___
SioeofLo+:Public Water Supply:
An appropriate o|ct plan must accompany site inspection for this application showing required information. (See
onocke6 sheet.) The individual sewage disposal system will be constructed and installed in orcon6onoe with the
regulations governing individual sewage systems within Eagle County, and shall comply with House 8i|/ 7553 [RS
66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be
obtained at the Eagle County »oni:orion'o office.
Apppynmnnemm for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone
3D8-77Y8between 8:38and 9:ODAK8]Refer hopermit number. @oapproval will 6egiven mnany system without final
inspection.
The undersigned acknowledges that the above information is true and that false information will invo/i6oha the
application or subsequent permit.
S|GNATUREOFAPPL|[ANT:' Date:
� /\/omapplication becomes invalid 6months from above dota.>
HEALTH DEPARTMENT USE ONLY
Percolation Information:Permit No.
Tank Capacity: gal. (minimum) FeeReceipt-_
Absorption Area: Sq. ft. (minimum) File:
APPLICATION IS: APPROVED DENIED
The above individual ooy,oge disposal system was installed by
"*,ate: Sanitarian:
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91
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ry ` Cy
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a
Px:' _'�'OT T 10 14 TEST AND SITE INSPECTION e 0
W IA .00
PE-UlIT 1,.0.
Street Address or Legal
Description:
T'y,pe OJ_E Dwelling:
of D-r'
DO MOT ;I IT BE' 0--T
THIS LINE
Date of Test:
f
./11thole: Diaiacter:_.LType
of soil:
Location of Test Hole:
Test hole was presoaked
-7Z
from:
z 2
To:
(Time)---,-
(Time)
Date:
)LI
-2
T.TATr :� 7PT[I
IUCHT71S OF F�IITJ,
3
2 3
2 3
2
71
2-57
Mi
711n)
TS_�f
21
c
2- L,
Percolation Rate:
-ze 221
Site has been reviewed and tested for percolation rate,
We recommend: APPZOVAL DISz.V-PPL-,,OWL Date:
NOTE- Plot plan showinc boundary lines, location of Proposed . building or buildings
and system
design of septic , must be submitted
I-> I Lt,-;d lyftl Api lication for Permit to Construct.
The back of this form may be used to show plot plan and desi-n of system.
14 k7
r1d4 By:
S a n i t a ria an
i
P. O. Box 8 11
Telephone (303). 3200-7718 Fa -le, Color . ado 81631
(4,5
Z3 75
0010-0034 Sweetwater Route
JOB NAME — Stephens
WENEMEEMEEMEEM
JOB NO.
JOB FOLDER Product 277 ®@ NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Printed In U.S.A.
