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HomeMy WebLinkAbout4076 Ennen Ave - 219724308002.i'I' MUST BE POSTED EAGLE �1NTY DEPARTMENT OF ENVIRONM'—)TAL HEALTH
P sd b50 Box:Pyr 6th & Broadway
CALL FOR FINAL INSPECTION
Eagle, Colorado 81631 BEFORE COVERING ANY PORTION
OF INSTALLED SYSTEM
PERMIT0 45� (this does not constitute
• a building or use permit)
Owner PAUL ICKES & JANET TERRY
System Location FULFORD: BLOCK 7: LOTS 5, 6, 7, and 8
Licensed1�f1RiTrTsmnr.r.Fu.
* Conditional Construction approval is hereby granted for a gallon
Septic Tank or Aerated treatment unit. MINIMUM REQUIREMENT:
Absorption area (or dispersal area) computed as follows: 1,000 gal. holding tank
Perc rate inches in minutes sq. ft.
absorption area per bedroom
# of bedrooms 4 x sq. ft. minimum requirement
May we suggest
Date August 26, 1980 Inspector
FINAL APPROVAL OF SYSTEM:
Erik W.
fo
V
Edeen
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.
No final given. The system
Adequate absorption (or dispersal) area. (Bud Eaton dug the hole, Jack
Riggan put in the tank.) was
Adequate compliance with permit requirements. installed in September 1980.
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, 3.28requires 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.
--rk- PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND
FEES
949-5257
927-3823
Zz
� ENVIRONMENTAL HEALTH
BOX 85
BOX 850
o
PP1 FEP-
- --
--� EAGLE, COLORADO 81631
PERMIT FEE $75
PERCOLATION TEST FEE = $50
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM
PERMIT
NO. A201
J
NAME OF OWNER: G+'/C
-A A-11
ADDRESS:
, . .3,(i ,
PHONE: 3�11
NAME OF APPLICANT
(IF DIFFERENT FROM OWNER):
ADDRESS:
PHONE:
DESIGN ENGINEER OF
f
SYSTEM (IF APPLICABLE):'lT
ADDRESS:
PHONE:
PERSON RESPONSIBLE
FOR INSTALLATION OF SYSTEM:
ADDRESS:
PHONE:
ReEa►OVE4
PERMIT APPLICATION
IS FOR: ( ) New Installation ( ) Alteration
(X) ,Iee
�h
LOCATION OF PROPOSED
FACILITY: County
Lot Size /3R7T-1 � —kvy
City or Town,
if within City or Town Limits
LEGAL DESCRIPTION:
7Z a
STREET ( RURAL) ADDRESS: �,,, Z �,
IS SYSTEM DESIGIJED FOR LESS THAN 2,000 GALLONS PER DAY? ( ) Yes (, ) No .
NOT AiPPUCABU
BUILDING OR SERVICE TYPE: (Check applicable cegory)
j000 Gq � privy ��di�y, y
G"A81)v (,�50)WMer vSe)
O Residential - Single-family welling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex
( ) Commercial - State usage
# Persons ?,b/y:5 # Bedrooms
WASTE TYPES: (.Check all applicable)
( ) Commercial or Institutional ( ) Dwelling ( ) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher
( ) Other A1VM y U)A.57E ®IIJLy ( ) Automatic Masher
oE ���LY: ( ) Well �x{ Creek BOpy
SOURCE AND TYPE OF WAT
.7.. R„k P( ) Spring Creek or Stream
Give depth of all wells within 200 feet of the system:
If supplied by community water, give name of supplier:
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( ) Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
Vault Priv ( ) Composting Toilet ( ) Recycling, Potable Use
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use
( ) Greywater, , ( ) Other
l!i�99GiD G/qL Flbor664sS 11qId1,vq : Urra,p t��
WILL EFFEUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes (�J
No
Signature s-1 l , C k, ��� �,;� aJL
Date k
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope: x1
Depth to Bedrock (per 8' Profile Hole): Depth to Groundwater Table:
SOIL PERCOLATION TEST RESULTS: Minutes per,inch in Hole No. 1
Minutes per inch in Hole No. 2
Minutes per inch in Hole No. 3
FINAL DISPOSAL BY: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( Underground Dispersal ( ) Wastewater Pond
REPAIR PERMIT APPLICATION
FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
A permit fee of $75. shall be charged for alteration, enlargement, or any repair
involving alteration of an existing sewage disposal system. This fee is authorized
by Eagle County Individual Sewage Disposal System Regulations adopted and effective
March 27, 1980.
For minor repairs of less than $100 for maintenance of the individual sewage
disposal system, no fee shall be required.
A percolation test fee of $50 shall be charged for all new leach fields on repair
permits. Percolation testing may be waived at the -.discretion of the Environmental
Health Officer on certain repair cases where prompt action must be taken to prevent
a ItLeal th hazard.
IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW SYSTEM SHALL BE INSTALLED,
COMPLYING WITH ALL CURRENT REGULATIONS. IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE
APPLICABLE.
DESCRIPTION OF PROBLEM/MALFUNCTION:
_1s //7 1-2e(fd (Of Ro pOIrs
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE:
DATE PRESENT SYSTEM WAS INSTALLED ?
PERMIT NUMBER FOR ORIG_,INAL SYSTEM, IF A. PERMIT WAS ISSUED BY THIS DEPARTMENT:
SITE PLAN BELOW SH0IEJit
ING PRESENT SYSTEM COMPONENTS:
OWNER OF SYSTEM:
ADDRESS:
APPLICANT:
ADDRESS:
DATE:
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number: 3294
P. 0. BOX 179
EAGLE, COLORADO 81631
949-5257 Vail 328-7311 Eagle 927-3823 Basalt
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00'
Paul and Carol Ickes 53'Lakewood Lane Council Bluffs, IA 51501
NAME OF OWNER: Lee and Jan Terry 9706_Hartman Omaha, NE 6232
MAILING ADDRESS: PHONE: Carol Ickes 1-800-228-9532
NAME OF APPLICANT (If different from owner): Jack Riggan (agent)
ADDRESS: Post Office Box 668 Eagle. CO 81631 _ _ PHONE:
DESIGN ENGINEER OF SYSTEM (If applicable):
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF
LICENSED INSTALLER: ( ) YES
ADDRESS:
SYSTEM:
( ) NO
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address: 1st and Main Streets - Fulfc
Parcel Number: Lot S
Legal Description:
PHONE:
ALTERATION
ze:
( ) REPAIR
'd _oc
BUILDING OR SERVICE TYPE (Check applicable category):
Residential- Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential - Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS:
WASTE TYPES Check applicable categories
Commercial or Institutional ( ) Dwelling
( ) Non -Domestic Wastes ( ) Transient Use
{ ) Garbage Disposal ( ) Dishwasher
( ) Automatic Washer ( ) Spa Tub
( ) Other (Specify):
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
Septic Tank Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( ) Greywater ( ) Chemical Toilet
( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Portable Use
( ) Other ( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: ( ) YES ( ) NO
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: ( ) YES ( ) NO
WATER CONSERVATION PLAN: ( ) YES ( ) NO
NOTE: The Environmental Health Office may reduce the required absorption area upon
approval of an adequate water conservation plan.
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( )
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier:
SIGNATURE:
DATE:
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
Creek/Stream
GROUND CONDITIONS: Percent ground slope
Depth to Bedrock (Per 8' profile hole
Depth to Groundwater table
SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole #1
Minutes per inch in Hole #2
Minutes per inch in Hole #3
FINAL DISPOSAL BY:
Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( ) Under Ground Dispersal ( ) Wastewater Pond
( ) Other
AMOUNT PAID: RECEIPT NUMBER DATE:
CHECK NUMBER CASHTFR-
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER".
"I L�
(Environmental Health Dept. Rev. 4/88) l i
e
EAGLE COUNTY ENVIRONMENTAL HEALTH
ROUTE FORM
Q 1 •- /ham fa NAME
DATE REFERRED APPLICATION NO.
' :.. LOCATION
Y
Please review the attached application and return it and this completed form
to the Environmental Health Office.,
PLA_nNIN Complies with:
Subdivision Regulations.
Zoning Regulations
' � c -53
Recommend Approval
Comments:'
BUILDING Set Backs
tl/ S it e
Other
Recommend Approval
Comments:.
ENGINEER (not always necessary)
_-Roads
Grading
Drainage
Recommend Ap
Comments:
s N Reviewed By
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
October 26, 1989
Jack Riggan
Box 668
Eagle, CO 81621
RE: Building Permit 3917; Terry Ickes, Fulford, CO
Mr. Riggan:
This letter is to inquire about the status of the septic system
at the above referenced project. our records indicate that a
final inspection was never done on this system.
Please contact us at 328-8311, Ext. 530 if you have any further
questions. i7� EIVP;.
..
sincer
OV 2 2 V� .1
" OLE COUL -
Ra d P. Mer
En ronmental Hea h Officer
AIX i r�S�ee-�,`or� wry r ;nn y
�s -�� �` w l �1 �. r "� l 30 -,311 /mot �J�
ae1.. 4o vise}--
RPm/tmt �o,, -k�a- 51?
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, 4- ; i s fe e d 4,ee~- 41 / ow' U-) e-4r-- IL he. WA-9 n e-- li.n lock_ 4-k�e,
it
vq - k Ltse Since 1
W o w I d. iti'� � a.. Ua , / w-6 l e, Cp k S,`+C j, `Th � 5 Y S-be*.../
S G��. � �►^-e�0�.�.�-- hem, �e'? C��1.�G�Ces
PeAmi /Y- /iv /98/- s ve ofi the ,ri.esy
u hk'ehe 2 �hin�%<-- buAtea /a l�oo Owl-
Qu.r.Go I p, _
Board of County Commissioners Assessor Clerk and Recorder Sheriff "1'reas re$ -
P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 4795 /SO /
Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631
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0457 Lots 5,:6, 7, 8 Blk 7, . e ?
Fulford ICKES'� uj 1
NAMEt - _
Parcel # 219724308002
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
20 i�
G&-1 J
�s
AVL
r
-
JOB COST SUMMARY
_.
TOTAL SELLING PRICE
-File
v
2 Jl�m
_
-
PERMIT #457
7� '�
,�e-t -Perry
OWNER:
��
Fulford
- - -
Lots 5 �6 °�'g
EOCATION: Block 7
.:
tank
Jack Ri ggan al 1 ons hol ding INSTALLER: 1,000 gallons
TANK:
SIZE OF summer
pWELLING: Cabin
N/A
-
- -.
PERC RATE:
r�
�As:g"' }
� /f Vf\
U"' c� G�F inspection made•
No final _
-- Printed in U-SA.
•