HomeMy WebLinkAboutLake Creek Rd Seele - 000000000000 - 0029EAGLE INTY DEPARTMENT OF ENVIRONMI 'TAL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 PERMIT Owner System Location Licensed Contractor * Conditional Construction approval is hereby granted for a 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 May we suggest Date FINAL APPROVAL OF SYSTEM: sq. ft. minimum requirement Inspector gallon (this does not constitute a building or use permit) No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved pri to covering any part. Se is Tank cleanout to within 12" of final grade or aerated access ports above grade. oper materials and assembly. dequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date 4�5, Inspector �jL�,K/ 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 III, 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. PERMIT NO. Name of Owner: Address of Owner: ENVIRONMENTAL HEALTH P.O. BOX 811 EAGLE, COLORADO 81631 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 5 1Q (Z - Phone: (q 3 x--.�- .� V i � Is facility within boundaries of a city/town or sanitation district? Distance to nearest sewer system: U LA- k,4" �,� 'I., 0 Location of Proposed System: Legal Discription: r PERMIT FEE $25.00 Type of Structure: Single Family Dwelling ( /) Other: / No. Bedrooms Water Supply: Private Well Location: '� ' � +mot ^ fi %fit' C', e6istance From leach field: F'P Size of Lot: Z Z,0 l `L �'dr. Public Water Supply: 41-0 yl to An appropriate plat plan must accompany site inspection for this application showing required information. (See attached sheet.) The individual sewage disposal system will be constructed and installed in accordance with the regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS 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 sanitarian's office. Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone 328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final inspection. Name, address, and telephone of person responsible for design of system: The undersigned acknowledges that the abg a information is true and that false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICA oe Date: Z q 7S' h (T /s application becorniWinvalio months from above date.) x HEALTH DEPARTMENT USE ONLY Percolation Information: Tank Capacity: gal. (minimum) Absorption Area:. Sq. ft. (minimum) REMARKS: APPLICATION IS: APPROVED ( ) DENIED Permit No. - Fee Receipt: File: The above individual sewage disposal system was installed by. AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. Date: Sanitarian: rF t'i:.vl�i._'.•tl:?:'V TEST c!lhr� S_ i'Ti. j� �� n //U . C., i .,treet Address or Le -al Description: T v e O _ L{`••i`l l =Il:` /%/�ltl. - . DO ITolf 1'12±TE D1:1 C).; T tIS 1:iII'L-- i> Date of Test:-2—/-7 Dept!, of bole: -, Diamete-r: /Z. Type of Location of Test Hole: � Test hole Baas presoakeu fro�I:7 ` o� To: rZ { 00 {Tine (Date). Date: 7__)(`' S- =� 1- t r 1 ! 2 3 �, 1 2 3 ! 1 12 1 3 1- 2 3 _ 2_' �2, ; zg 12 lz 12 20 J/O Percolation Rate: Site has been reviewed and tested for percolation rate. We reco end: A_ P ZOVAL { DT_S.kPPR01,7_A_L { ) Date. !:.70TE Plot 7lap- s1?owi — boundary lines, locc do Of pi: QPQ S"d bt?lldi_n" or 1?1111di'il^'' and desiSm of septic systc^ must be su1:c,.lttCC!: 17"!t'i? kiZ)1C%:tiOn for Permit t0 Construct. The back, Of tPis form may be used 1-0 S110TJ plot `plan and de-si-ii Of systE',n. Telephone (303) 328-7710 By: Sanitar ia n P. 0. Eagle, Colorado i1631 4 rCj� r -p 4� 14 C41'� 1+144ol, CA IrC4 tad 4 K R- X-A 4e Coe,* o6t.� well JOB NAME 0029-Lake Creek Road Edwards Seele ©d OIC-7 JOB NO, JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED Co V PERMIT # =— E W• Seeley Jr- (l60 acres) OWNER• k Road -Edwards _aye Cree �pCATION: JOB COST SUMMARY X 40p sq• ft• er dro m ft•) A ANK wn l (m sq e sin TOTAL SELLING PRICE INST am y es oFER 1 SIZE Sing 15 m inch) TOTAL MATERIAL pWRCE pTE: one PE field) TOTAL LABOR of leach °f 4p0 sq f t INSURANCE (sugge st a minimum Erik Ed een By� SALES TAX g-15-75 MISC. COSTS final iZed• TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT JOB FOLDER Product 277 ®O NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Printed in U.S.A.