HomeMy WebLinkAbout4381 Brush Creek Rd - 210911200006EAGLE C`7NTY DEPARTMENT OF ENVIRONM['_irAL HEALTH
;r MUST BE POSTED ON LOCATION Box 811 6th & Broadway CALL FOR FINAL INSPECTION BEFORE
Eagle, Colorado 81631 COVERING INSTALLED SYSTEM
i
PERMITa 4"14 (this does not constitute
a building or use permit)
Owner ADAM' S RIB RANCH
System Location 4381 Brush Creek Road
Licensed UW=
* Conditional Construction approval is hereby granted for a 1,250 gallon
xx Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate inches in minutes sq. ft.
absorption area per bedroom
# of bedrooms 3 x sq. ft. minimum requirement
May we suggest
Date October 22, 1980 Inspector
FINAL APPROVAL OF SYSTEM:
REPAIR PERMIT TO
REPLACE SEPTIC
TANK ONLY
WILL CONTINUE TO USE
EXISTING LEACH FIELD
Erik W. 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. 10/22/80 INSTALLED AND COVERED WITHOUT
FINAL INSPECTION, according to owners
Adequate absorption (or dispersal) area. via phone 12/16/80.
ncm for Erik Edeen
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.
3.28 3. Section III, &tWequires 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
tenth
PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES
t 328-7311 949-5257 927-3823
ENVIRONMENTAL HEALTH
BOX 850
EAGLE, COLORADO 81631
PERMIT FEE = $75 PERCOLATION F� EE�`,�-6�
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
NAME OF OWNER:
ADDRESS: 44159
NAME OF APPLICANT (IF DIFFERENT FROM OWNER):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (IF APPLICABLE):
ADDRESS:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
ADDRESS:
NO . ,� -Z
PHONE:
PHONE:
PHONE:
PHONE:
PERMIT APPLICATION IS FOR: (`/) #^Jew Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County A_ Lot Size
City or Town, if within City or Town Limits
LEGAL DESCRIPTION:
STREET (RURAL) ADDR
IS SYSTEM DESIGNED
BUILDING ,OR SERVICE TYPE: (Check applicable category)
(�) Residential - Single-family dwelling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex
( ) Commercial - State usage
# Persons # Bedrooms _ 3
WASTE TYPES: (Check all applicable) If
( ) Commercial or Institutional ( ) Dwelling ( ) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher
( ) Other ( ) Automatic Masher
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( ) Creek or Stream
Give depth of all wells within 200 feet of the system:
If supplied by community water, give name of supplier:-k
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(vl) Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
( ) Vault Privy ( ) Composting Toilet ( ) Recycling, Potable Use
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use
( ) Greywater ( ) Other
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes ( 4 No
Signature
* * * * * * * * * * L_*' * * * * * * * * * * * *
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope:
Date
* * * * * * * *
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
Other
MnA00E CO000W ffih@m@Fgndum
To:
Subject:
Adam's Rib Ranch, Owner
Permit #474
From:
File No.:
Date:
Erik W. Edeen, Environmental Health
December 9, 1980
Please advise this office as to the date of installation of the septic tank for the Repair
Permit issued October 22, 1980 by the Environmental Health Office. The permit was issued
for the property located at 4381 Brush Creek Road.
You can reach my office at 328-7311, 949-5257, 949-5631, or 927-3823 or you may write
to Box 850, Eagle, Colorado 81631.
REPAIR PERMIT APPLICATION
FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
d
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:1�eal th hazard.
IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW SYSTEM SHALL BE INSTALLED,
COMPLYING WITH AL'_ CURRENT REGULATIONS. IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE
APPLICABLE.
DESCRIPTION OF PROBLEM/MALFUNCTION:
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: F03 a,,
DATE PRESENT SYSTEM WAS INSTALLED 9 6 y
PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: Civic
SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS:
c
a
0
� x `
W
U
$ o°
J
d
N0�,�,�
OWNER OF SYSTEM:
ADDRESS:
APPLICANT:
AnnRF�C-
DATE:
0474 Approximatly. 3. miles s
JOB NAME of Eagle, -4-3-� Brush Crk Rd
r.
,,.�T c �TB OB NO
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
Paul
011 00 - b 0 6` fly-x�
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 QQ NEW ENGL}ANR BUSINESS SERVICE, INC., G,ROTON, MA 01471 JOB FOLDER Printed in U.S.A.
•
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
PLEASE, -CALL F01� FINAL P. 0. Box 850 - 550 Broadway
INSPECTION BEFORE COVERING Eagle, Colorado 81631
ANY PORTION OF INSTALLLD SYSTEM N� 636
328-7311 or 949-5257 or 927-3823 PERMIT N0.
OWNER: ADAMS RIB RANCH
SYSTEM LOCATION: 4381 Brush Creek Rd.
LICENSED INSTALLER: Les Frimml-
PERMIT MUST BE POSTED
AT INSTALLATION SITE
ADDRESS: 4381 Brush!i Creek Road
LICENSE NUMBER:
**CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following:
MINIMUM REQUIREMENTS:` gallon septic tank or aerated treatment unit.
Absorption area or dispersal area computed as follows:
PERCOLATION RATE: 1 inch in 20 minutes.
Absorption Area per Bedroom 288 sq. ft. `l�v�lc �c1c��i�SftSeJ/VA�
No. of Bedrooms x sq. ft. minimum requirement per bedroom
600 total sq. ft. minimum requirement.
SPECIAL REQUIREMENTS: Fence or blockade the drain field area so the area does
not become compacted due to traffic
DATE: 8 31 83 INSPECTOR: Sid Fox
**CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage
Disposal System Regulations, adopted pursuant to authority granted in 25-10-104,
C.R.S. 1973, as amended.
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 structure not approved by the building and zoning departments 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, 3.21 requires any person who constructs, alters, or installs an
individual sewage disposal system to be licensed according to the Regulations.
FINAL APPROVAL OF SYSTEM: No system shall be deemed to be in compliance with the Eagle
County Individual Sewage Disposal System Regulations until the installed system is
approved prior to covering any part.
Installed Absorption or Dispersal Area: CICO sq. ft.
Installed Septic Tank: _
Design Engineer of System:
Installer of System:
gallons. Degrees: ' D Feet: 5®
Phone:
Septic tank cleanout to within 12" of final grade or 6 o
aerated access ports above grade? Yes No
Proper materials and assembly? Yes No
Compliance with permit requirements? Yes No G °
Compliance with County/State regulations requirements? Yes No
COMMENTS:
(Any item checked "No" requires correction before final approval of system is made.
Arrange a re -inspection when work is completed
DATE: o INSPECTOR:
RE-INSPECTIO DA E: INSPECTOR:
APPLIC1-A7IO:: FOR I`:Di`: IDUAL 9--.'AGE DISPOSAL SYSTEM PER_` T7
E`.'V'TRO MENTAL HEALTH OFFICE - EAGLE COUNTY
P.O. Box 850
+ Eagle, Colorado 81631 No.
PEMIT.:VPLICATION FEE: S150.00 328- 311 PERCOL:ITION TEST FEE: $50.00
NME OF OWNER: Adam's Rib Ranch Corporation
ADDRESS: 4381 Brush Creek Rd. PHONE: 328-7751
NkME OF APPLICI\?T (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (if applicable):
PHONE:
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: Fri'mml FxravatinT, Lnc
Licensed Installer (see attached list): YES X NO
ADDRESS: BOX 616, Eagle, CO PHONE: 3 8-7 7
PER.tifIT APPLICATION IS FOR: (X ) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Street/Rural Address: 4Jbi bruSTIC-r-e-e-FIR-d.
Lot Size:
Legal Description:
BUILDING OR SERVICE TYPE (check applicable category):
( ) Residential - Single Family ( ) Residential - Quadplex
( ) Residential - Duplex ( ) Commercial (state usage)
( ) Residential - Triplex V Seasonal bunk house
NTTyfRER OF PERSONS: NUMBER OF REDROOMS:
WASTE TYPES (check applicable categories):
(
)
Commercial or Institutional
( )
Dwelling
(
)
Non -Domestic Wastes
Transient Use
(
)
Garbage Disposal
( )
Dishwasher
(
)
Automatic Washer
( )
Spa Tub
(
)
Other
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
Septic Tank
( ) Composting Toilet
(
)
Incineration Toilet
(
)
Vault Privy
( ) Greywater
(
)
Chemical Toilet
(
)
Pit Privy
( ) Aeration Plant
(
)
Recycling, Potable 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 ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( �)
(I 6 yeas, see attached walsteavate)t {.Cow Aeducti.on methods)
NOTE: The Env.itc.onmentae. Health 066i.celr. may reduce the requited absotption area upon
apptovat o6 an adequate wastewatet 6.Cow Aeducti.on ptan.-
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier: Town of Eagle
SIGNATURE: f/ `2 DATE: Z�S
INFORMATION BELOW TO BE FILLED OU BV ENVIROMAJENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAcent GAound Scope rLA
Depth to Bedtto ek ( pet 8' Ptto jit e Hote)
Depth to GtoundwateA Table � egr
SOIL PERCOLATION TEST RESULTS: MtdEtta pets inch in Hot 7 1
Dt4j9X Minutes pets inch to Hote # 2
X- nu to peA .inch. to Hote # 3
FINAL DISPOSAL By:
(� Absotption TAeneh, Bed oA Pit ( ) Evapott ansp.ilta#,i,on
( ) Above GAound D.&speuat ( ) Sand FitteA
( ) Unde,'tg-tound DZspe,tSaZ ( ) Was.tetvatet Pond
( ) OtheA
Amount Paid: -2.-00 Recc,i.p-t Number Date:
{
o ajo ®,a
(Env. Health Department - Rev. 4-07-83)
JOB NAME,
� °.f t1� jlw
rD
JOB .wv
TION
_L TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL7/7
TOTAL LABOR
INSURANCE
PERMIT NO. 636 _ _ _ _._
SALES TAX
OWNER: Adams Rib Ranch (Bob Young)
4381 Brush Creek - Eagle MISC. COSTS
LOCATION: 4381 Brush Creek Road
SIZE OF TANK: 1,000 gallons - Degrees: 250 - 40 feet
INSTALLER: Les Frimml
DWELLING: bunk house/SEASONAL
PERC RATE: one inch/20 minutes 900 sq.ft. absorption area
Finalized: 10/5/83
BY; Sid Fox
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
)ER Printed in U.S.A.
I.
-.�-
'_ •ems: ,�� _. �� - ..NOW
• XF
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927-3823
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1122
Please call for final inspection before covering any portion of installed system.
OWNER:
PHONE:
MAILING ADDRESS:
AGENT: PHONE:
SYSTEM LOCATION:
LICENSED INSTALLER: LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS:
ENVIRONMENTAL HEALTH OFFICER: DATE:
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM
REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED IN 25.10-104, C.R.S. 1973, AS AMENDED.
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 STRUCTURE NOT APPROVED BY THE ZONING AND
BUILDING DEPARTMENTS SHALL AUTOMATICALLY BE A VIOLATION OF A REQUIREMENT OF THE PERMIT AND CAUSE FOR BOTH
LEGAL ACTION AND REVOCATION OF THE PERMIT.
3. SECTION Ill, 3.21 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM
TO BE LICENSED ACCORDING TO THE REGULATIONS.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE WITH THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS UNTIL THE SYSTEM IS APPROVED
PRIOR TO COVERING ANY PORTION OF THE SYSTEM.
INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET.
INSTALLED SEPTIC TANK: GALLONS DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALS ANDASSEMBLY YES NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED.
COMMENTS:
ENVIRONMENTAL HEALTH OFFICER: DATE:
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
�0 �o x 70 3
ISDS Permit #
Building Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8730/927-3823(Basalt)
PERMIT APPLICATION FEE t�40-Alo Fee PERCOLATION TEST FEE $125.00
PROPERTY OWNER: /0/,yWS
MAILING ADDRESS: ' ) /, PHONE: 328 - 3Z
APPLICANT/CONTACT PERSON: PHONE:
LICENSED SYSTEMS CONTRACTOR:
ADDRESS: OgpB PHONE:
******vc**v **_**mow**lk-*****vc***********************************sr******vr*vc****
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION (X) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: -
Parcel Number: Lot size:
Physical Address:
BUILDING TYPE: --(Check applicable category)
(Residential / Single Family Number of Bedrooms
( )--Residential / Multi -Family* Number of Bedrooms
( ) Commercial / Industrial* Type
HOT TUB _ Yes ( ) No
WATER CONSERVATION PLAN: Yes ( ) No { )
TYPE OF WATER SUPPLY: Well( Spring ( ) Surface ( )
Public ( ) Name of Supplier:
Give depth of all wells within 200 feet of system: 11nc%no�✓ M
*These systems require design by a Registered Professional Engineer
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
SIGNATURE:
AMOUNT
PAID: i✓ RECEIPT#(
CHECK #
TIME LOG
Travel Perc Final
DATE:
*************************
DATE:
CASHIER:
W // I,/ S/" / /mod/ /U/17'/A",41
�jl or,7
,2 iV- G� o/G31
32-S-- 2-32
are ro,�
1122-92 TxPrcl#
JOB NAME 019 �_--__ T =e 451'6YL,4, 6 PP4 P. .
—Adams Rib Ranch +' e� u;
JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 ®, NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 ®B FOLDER Printed in U.S.A.
4'
