HomeMy WebLinkAboutBlk 19, Lot 10,11 - 219723413004EAGLE `UNTY DEPARTMENT OF ENVIRON' 'ITAL 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
absorption area per bedroom
# of bedrooms x
May we suggest
Date
FINAL APPROVAL OF SYSTEM:
s q. ft.
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 prior to covering any part.
Date
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
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 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.
ENVIRONMENTAL HEALTH
PERMIT NO.
APPLI
Name of Owner:
Address of Owner:
P.O. BOX 811
EAGLE, COLORADO 81631 PERMIT FEE $25.00
TION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT n 9
iCli.�`7"�,r,r,•
►ek- 41'=0 1 a q wQ Al Phone: g2- 7 - 7
Rj
r4 .
Is facility within boundaries of a city/town or sanitation district?
Distance to nearest sewer system: 11f /
llq
Location of Proposed System:: - `A-C �i=�2 C/ �ey 'tL2
Legal Discription: 1✓ 0 T S ol- '" // ��D c
Type of Structure: Single Family Dwelling (x) Other: 1**'� 61y No. Bedrooms
Water Supply: Private Well ( ) Location: Distance From leach field:
Size of Lot:--' � ` %� �� '� Public Water Supply: Ze_ %
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 persor.reAsponsible for design of system:
�. . c".ram c. S V E ' 1 ✓+�' . t�Ze
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit:
SIGNATURE OF APPLICANT. -'- r Date: tt �'
(This ap lication becomes invalid b months from above date.)
Percolation Information
Tank Capacity:
Absorption Area:
REMARKS:
HEALTH DEPARTMENT USE ONLY
gal. (minimum)
Sq. ft. (minimum)
Permit No.
Fee Receipt:
File:
APPLICATION IS: APPROVED (l/� DENIED ( ) � %;S
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:
0034- Lots 10-11 Block 19 Fulford D
JOB NAME— Riggian — 1 1a Q-C� >_ I .�3 `� 1 3 Ua L4
• �i
JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
PERMIT # 34 c'V�
(�o
OWNER: Jack W. Riggian'Lore -��I-N.
LOCATION: Lots 10, 11 - Block 19 - Fulford
INSTALLER: Owner
SIZE OF TANK: 1,200 gallon (sealed vault)
DWELLING: Cabin
PERC RATE: N/A
r� �[
(suggest a minimum 1,200 gallon, fiberglass
(50' x 1251)
sealed vault)
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
Finalized: Not listed )LDER Printed in US.A
Application 8-06-75
