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Home My WebLink About781 Lake Creek Rd - 210507101001 - 0384ISt .. EAGLL� ,!OUNTY DEPARTMENT OF ENVIROP�')NTAL HEALTH PERMIT MUST BE pQSTED ON PRQPERTY Box 811 bth &Broadway Eagle, Colorado 81631 PLEASE CALL FOR FINAL INSPECTION PERMIT N® 384 (this does not constitute a building or use permit) Owner FRED GREEN System Location 0781 Lake Creek Road (Lake Creek Ranch) Licensed f g0UAtk X Installer - Conditional Construction approval is hereby granted fora 1,000 gallon xx Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: REPAIR PERMIT: Minimum 1,000 gallon Perc rate 1 inches in 20 minutes 750 sq. ft. two -compartment septic tank with absorption area per bedroom minimum 200 sq. ft. 600 sq. ft. minimum leach field. # of bedrooms 3 x 200 sq. ft, minimum requirement (Owner has advised will May we suggest install 750 sq. ft. leach field.) Date August 22, 1979 Inspector Erik W. Edeen 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. Ade ompliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date Inspector —ira 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. ` ENVIRONT4ENTAL HEALTH ` 1PER.COLA.'3 TEST FEE. BOX 850 P a e MIT FEE $50.00 EAGLE, COLORADO 81631 825.00 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. NAME OF OWNER.: frePHONE C%Z_ ADDRESS: NAVE, OF APPLICANT: �� (�cE'.y PHONE ADDRESS: / �S/_�� DESIGN ENGR.. FOR SEPTIC g� (if necessary): ADDRESS: PHONE LICENSED INSTALLER: PHONE ADDRESS: IS PERMIT FOR: ( ) New Installation ( ) Alteration (i Repair LOCATION OF PROPOSED FACILITY: County Eli&L L Lot Size City or Town, if within City or Town Limits LEGAL DESCRIPTION: WASTES TYPE: () Dwelling ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( ) Transient Use ( ) Other IS SYSTEM DESIGNED FOR 2,000 GALLONS PER. DAY OR LESS? ( yes ( ) no BUILDING OR SERVICE TYPE:jaber of Persons Nzber of Bedrooms OQ Garbage Grinder ( Automatic Washer ( ) Dishwasher SOURCE AND TYPE OF WATER SUPPLY: (X) Well ( ) Spring ( )Stream or Creek Give depth of all wells within 180 feet of system: If supplied by community water, give name of supplier: GROUND CONDITIONS: Percent Ground Slope: L— Depth to Bedrock: > 6-0 Depth to Groundwater Table: — 130 TYPE OF INDIVIDUAL SETRAGE DISPOSAL SYSTEM PROPOSED: Septic Tank ( ) Aeration Plant ( ) Chemical Toilet ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, Potable Use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greywater ( ) Other SOIL PERCOLATION TEST RESULTS: 2 Minutes per inch in Hole No. 1 2 p Minutes per inch in Hole No. 2 zp Minutes per inch in Hole No. 3 i'' i'i ii is * i'i a Ji i'i i'i * :i J i'i is is ii is * it IMPORTANT I I I APPOINTMENT FOR. FINAL INSPECTION MUST BE MADE PRIOR TO COVERING BY CONTACTING THE INSPECTING ENVIRONITENTAL HEALTH OFFICER. REFER. TO PERMIT NUMBER.. NO APPROVAL WILL BE GIVEN ON ANY SYSTEM T47ITHOUT FINAL INSPECTION. TOLL -FREE NUMBERS 328-7311, Ext. 949-5257, Ext. 927-3823, Ext. 238 (Eagle area) 238 (Vail area) 238 (Basalt area) (OVER) FINAL DISPOSAL BY: ( Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Above Ground Dispersal ( ) Sand Filter ( ) Underground Dispersal ( ) Wastewater Pond ( ) Other WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? SITE (PLOT) PLAN: Include location of wells, springs, potable water supply lines, subsoil drains, lake water course, streams, dry gulches. Show location of proposed system by direction. Show distance of proposed system from dwellings and other fixed reference objects. Please indicate scale of reference, if'any. Attach additioa a es if necessary to give complete information. SIGNATURE DATE i 1 D a PERCOLATION TEST FEE: $50 APPLICATION NO. OWNER: LEGAL DESCRIPTION:�� RURAL ADDRESS: TYPE OF DWELLING: # OF BEDROOMS: DATE OF TEST: 17 r TEST HOLES PRESOAKED: YES NO TYPE OF SOIL: �� /-✓] TIME WATER DEPTH INCHES OF FALL RATE 1 2 3 1 2 3 1 2 3 1 2 3 20 PERCOLATION RATE: TANK SIZE: SQUARE FOOTAGE PER BEDROOM: 1L717 LEACH FIELD SIZE Site has been reviewed and tested for percolation rate. We recommend: APPROVAL DISAPPROVAL DATE: �j — �� <" � — EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICER ' _ r DATE REFERRED EAGLE COUNTY ENVIRONMENTAL HEALTH ROUTE FORM NAME �Gey67 LOCATION PLICATION NO. Please review the attached application and return it and this completed form to the Environmental Health Office. PLANNING— Complies with: _ Yew N Subdivision Regulations Zoning Regulations Recommend Approval Comments: -BUILDING• Other._ Comments: Set Backs Site Access Reviewed By yi:` j 'Cl Recommend ApprovalJG ell ,ENGINEER• (not always necessary) Roads Grading Drainage Recommend Approval Comments: 0384 Lk Crk Ranch, , \r �I JOB NAME. _ 0781 Lk Crk Rd. � ' ,� (� i JOB NO. ' A T Green JOB LOCATInN BILL TO DATE STARTED DATE COMPLETED DATE BILLED °d EA X �0 �� 1 Z- 104 e lr_a'L� e, t _V JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL PERMIT # 384 TOTAL LABOR INSURANCE SALES TAX OWNER: Fred urea LOCATION:.=.V81 Lake Creek Road -Lake Creek Ranch REPAIR PERMIT _ INSTALLER: ? SIZE OF TANK: 1,000 gallons two -compartment tank DWELLING: residential 3 bedrooms x 200 sq.ft. PERC RATE: one inch/20 minutes (750 sq.ft.) Finalized: 12-7-79 By: Erik Edeen co RECEIPT Received From_ Address - For_ ACCOUNT AMT OF ACCOUNT ; AMT. PAID BALANCE DUE HOWPAID CASH 0 �! .4 — " ears 4) ----7 --