No preview available
HomeMy WebLinkAbout1287 Lake Creek Rd - 210507401002EAGLE( "LINTY DEPARTMENT OF ENVIROWF—ITAL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 Owner Victor Gallina System Location PERMIT 4 (this does not constitute NO • a building or use permit) Lot 2 Lake Creek Subdivision Licensed Contractor Victor Gallina * Conditional Construction approval is hereby granted fora 1000 gallon X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 14 minutes 600 absorption area per bedroom 200 sq. ft. # of bedrooms 3 x 200 sq. ft. minimum requirement May we suggest a minimum of 600 sq. ft. leach field. Date March 25, 1976 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 prior to covering any part. .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. Date Inspector az 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. c ENVIRONMENTAL HEALTH' P.O. BOX 811 PERMIT NO. EAGLE, COLORADO 81631 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Name of Owner: j�e `�14r ru 1 -1 rl Phone: Address of Owner: 8r��� Is facility within boundaries of a city/town or sanitation district? Distance to nearest sewer system: ZO ^7, *-`S / PO A PERMIT FEE $25.00 N° 248 Location of Proposed System: / Legal Discription: b��f'� �� it ,fi -,, at`a e Type of Structure: Single Family Dwe/lhn� ( ) Other: No. Bedrooms Water Supply: Private Well (�/ ) Location: Distance From leach field: Size of Lot: Public Water Supply: An appropriate plate_ t_plan �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 above information is true and that false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICANT: Date: (This application becomes invalid 6 months from above date.) HEALTH DEPARTMENT USE ONLY Percolation Information: / �'7� 7G: � -t�� Permit No. Tank Capacity: / 000 gal. (minimum) Fee Receipt: Absorption Area: �00 sr� Sq. ft. (minimum).11J &JtL&) File: REMARKS: /19 APPLICATION IS: APPROVED ( ) DENIED 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: ,of APPROVED, Date........... ... . .............. . ......... — -- - - ------ Perm it # Insp- --------------------- --------- ................. ­COLORADO .... EAGLE COUNTY, PV 0074-Lot 2 Lake Creek Subdivision llina JOB NAME —GaJOB NO . .InR LOCATInN BILL TO DATE STARTED DATE COMPLETED DATE BILLED Z y-ie/Z�GL 2-l(c C, PERMIT # 74 l �< 'i JOB COST SUMMARY OWNER: Victor Gallina TOTAL SELLING PRICE LOCATION: Lot 2 - Lake Creek Subdivision TOTAL MATERIAL INSTALLER: Victor Gal l i na ! TOTAL LABOR SIZE OF'TANK: 1,000 gallons DWELLING: single family - 3 bedrooms x 200 sq.ft. INSURANCE PERC RATE: one inch/14 minutes (600 sq.ft.) SALES TAX suggest a minimum of 600 sq. ft. leach field ooa 7 MISC. COSTS Finalized: 4-15-76 t By: Erik Edeen 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.