HomeMy WebLinkAbout34 Whiskey Ridge - 210518305001 - 0586IS.f 1
EAGLE 000NTY D.EPARTMENT;OF ENVIRONMENTAL HEALTH
DI LncG ni.� rno" rrnini P. 0; BO:' 850. -' 550 ;Broadway
SYSTEM :LOCAT,,l,0
**CONDITIONAL`>
MINIMUM
Absorp,ti
P'ERC°OLA�T
Absorptr%
o`f 'B
_ 7
DATE.
t
Lout to within 1211 of fi "al
irts above grade? Yes
and assembly? Yes
.. sq.; "ft.
is,,
;. Phone:•
rrements? Yes No
Of system is, made:'
. a T 1. —i.•.L �A1 `
EAGLE, C0L0?I;CO E1631
PE„O; IT I EE = $1 7-13 PE=CCLT;G;; TEST FcE = SSO
APPLICATION FOR 1LIIDIV1DUr1 SE'-:f.rE DISPOSiiL SYSTE'•! PER!il T
NAME *OF 01•11,11ER: A c /XCL
ADDRESS: �� X G E�wcc �-C(s �!/Oi �j'fG 0;
NAME: OF APPLICANT (IF DI FFE^E;lT FROM ONNER) :
ADr,RESS: PHONE:
GE.SIGN ENGINEER OF SYSTEM (IF APPLICABLE):
ADDRESS: PHONE:
-PERSON! RESPONSIBLE FOR INSTALLATION OF SYSTEi•1.: �Jyf'�s�y �zrSr(
.ADDRESS: PHONE:
PPRIIIT APPLICATION IS FOR: ( } New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County 6- L Lot Size
City or Town, if within City or Town Limits
LEGAL DESCRIPTION: Z"r,4 75p/c) 12 i—i,-
STREET (RURAL) ADDRESS: $',j./
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? (Ekes ( ) No
BUILDING OR SERVICE TYPE: (Check applicable category)
( residential - Single-family dwelling ( ) Residential - Triplex
Residential -Duplex ( ) Residential Quadplex
( ) Commercial - State usage
Persons - Bedrooms
WASTE TYPES: (Check all applicable)
( ) Commercial or Institutional ( Dwelling Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use (X) Dishwasher
( ) Other Automatic Idasher
,SOURCE AND TYPE OF WATER SUPPLY: ( X) 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:
=.TYPE OF INDIVIDUAL SEWAGE bISPOSA.L SYSTEi I PROPOSED:
O Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
f . ,. i .. T .. i __ . .
t� 1,
}' .9 alal 1. PY•IYy .� L._lr�:i?1,i 11J iUt 1.<, t Ti=-�/t-1 lita, 1 i-tau �C
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use
( ) Greywater ( ) Other
WILL EFFLU iI E DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes No
`Signature Date
_.. _* * * * * * * * * * * * k * * * * is * * it * * * * * * * * * * - -• .
INFORMATION BELOW TO BE FILLED OUT BY ENVIRnjj[1E.NTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope:
Depth to Bedrock (per 8' Profile Hole): Depth to rirounc;,..jater Table
SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole No. 1
P1inotes per inch in Hole No. 2
!1inutes per inch in Hole No. 3
FINAL DISPCS"L oY: ( Absorption Trench, Ced or Pit ( ) Eva 'otranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( ) Un:erground Dispersal ( ) :!aste%-iater Pond
( j 0 t'ne r
REPAIR PERMIT APPLICATION
FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
A /:^v
A permit fee of S. 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,. ealth 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:
r
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: ,p,J-e5U
c> C ¢w\all - +"ev, c
DATE PRESENT SYSTEM WAS INSTALLED
PERMIT NUMBER FOR ORIGINAL SYSTEM, IFA PERMIT WAS ISSUED BY THIS DEPARTMENT:
SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS:
OWNER OF SYSTEM:
ADDRESS:
APPLICANT:
ADDRESS:
DATE:
EAGLE COUNTY memorandum
To:
Subject:
Dan Williams
INDIVIDUAL SEWAGE DISPOSAL SYSTEM REPAIR PERMIT #586
From:
File No.:
Date
Environmental Health Office
I September 29, 1982
Enclosed please find.your Individual Sewage Disposal System Repair Permit #586 for
property located at 1035 West Lake Creek Road. The information on the permit appli-
cation shows that the system will be agent (Ed Dreager) installed; therefore, Mr. Dreager
is responsible for the installation/repair of the system.
The permit must be posted on the installation/repair site.
our office for final inspection before covering any portion
can be reached at 328-7311, extension 238.
If you have any questions, please contact us.
-- Lorraine Funke, Secretary
Environmental Health Office
Eagle County
/lf
Enc.
The installer must call
of t
JOB �1AMI
0586
West
Williams Lot 124 1035
Lake Creek
J1Ky ' �
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JOB FOLDER Product278 Qe NEW ENGLAND BUSINESS SERVICE, INC GROTON, MA 01471 Printed in U.SA
JOB FOLDER
