HomeMy WebLinkAbout781 Lake Creek Rd - 000000000000 - 0383IS VOIDEAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT MUST BE POSTED ON PROPERTY PLEASE CALL FOR FINAL INSPECTION
PERMIT No 383 (this does not constitute
a building or use permit)
Owner
System Location
FRED GREEN
0871 Lake Creek Road (Lake Creek Ranch)
Licensed Qo1nbrxg<Wr Instal IPr�
* Conditional Construction approval is hereby granted for a
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate XKX 1 inches in 00' 20 minutes
absorption area per bedroom
# of bedrooms 3 x ft. mi , i
May we
Date
FINAL APPROkAL�OF SYSTEM: i
um re
pector
gallon
REPAIR PERMIT ONLY:
No systeO s II be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approv6grior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
Adequ"mpliance 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 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.
............................................................................................................................
P ermit N O
CHARGES
game of.Appl'
Percolation Test $50.00
(includes final inspection) Amount Pai
Permit Processing Fee $25.00
Da Pai
Check (no cash) Lshief'/
383
Money Order _
I%
ALL CHECKS ARE TO BE MADE PAYABLE TO EAGLE COUNTY
Eagle Cty. — White Copy Applicant — Green Copy Dept. — Pinx Copy
0383 VOID
JOB NAME _ JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST
SUMMARY
TOTAL SELLING
PRICE
TOTAL MATERIAL
V 0 I D
PERMIT # 383
OWNER: Fred Green
LOCATION: 087,1 Lake Creek Road
)ST
FIT
STS
LICE
FIT
JOB FOLDER Product 278 Vic@ NEW ENGLAND BUSINESS SERVICE, INC.. GRO Printed in U.S.A.
