No preview available
HomeMy WebLinkAbout1299 Lake Creek Rd - 210507401003EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED INSPECTION BEFORE COVERING Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTION OF INSTALLED SYSTEM 328-7311 or 949-5257 or 927-3823 PERMIT NO. N a 619 OWNER: Stephen D. Warren ADDRESS: 1299 Lake Creek Road - P.O. Box 746 SYSTEM LOCATION: Vail, CO 77A9 T.aka C'raak RnaA - Ent 3 - Taka ("rank S'nhrliviC;n„ LICENSED INSTALLER: B & B Excavating/Owner (advice from J. Kemp) LICENSE NUMBER: **CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following: MINIMUM REQUIREMENTS: l,000 gallon septic tank or aerated treatment unit. Absorption area or dispersal area computed as follows: PERCOLATION RATE: one inch in 20 minutes. Absorption Area per Bedroom No. of Bedrooms _ 3 x 800 total sq. SPECIAL REQUIREMENTS: 275 sq. ft. 275 sq. ft. minimum requirement per bedroom ft. minimum requirement. E1l k� DATE: 6102183 INSPECTOR: Sid Fox w **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: j O 9y sq. ft. Installed Septic Tank: , 000 gallons. Degrees: a 'K0 Feet: / Z Design Engineer of System: Installer of System: ( 7 Phone: Septic tank cleanout to within 12" of final grade or aerated access ports above grade? Yes _7�— No Proper materials and assembly? Yes No Compliance with permit requirements? Yes x No Compliance with County/State regulations requirements? Yes CR'0.511r, eje Vc:� COMMENTS: (` 1A �4 L No <✓C�' (Any item checked "No" requires rrection before final approval of system is made. Arrange a re -inspection when work is completed.) DATE: �0-0_ff 3 INSPECTOR: 5-1 RE -INSPECTION DATE: TNSPFrrnR- COLORADO STATE DEPARTMENT OF PUBLIC HEALTH at oil o Con ro 1 Commission /16--c E 4 E l l th nue 3 Z� _ 77/ D Co o 0220 ► f APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS Applicant (Owner) : 6 elz 0ne!�- Mai l Address: I X„ �( Z i 1/�- ('� C i ty Phone :6` / A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: (Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, soil profiles in test holes.) 1. Location of Facility: County_ —1LZ:E (,,fit —City or Town Lrn,Fe c, e�� sub Legal Description _Lot size: 2. Type of area and facility - Number of persons to be served: Subdivision Motel Restaurant Trailer Court Other: __ — - — - --- -- 3. Source of domestic water: Public(name): _ Private: Well Depth Other Depth to First Ground Water Table 4. Is facility within boundaries of City or Sanitation District:_ � ijo If so, name: 5. Distance to nearest sewer system: L S Have negotiations been attempted with owner to connect: If rejected, give reason: 7`I —�- 6. Rate of absorption in test holes in minutes per inch of drop in water level after - holes have been soaked for 24 hours > 7. Name, address & telephone of person who made soil absorption tests: 8. Name, address & telephone of person responsible for design of the system: 9. Est. bid opening date: Est. Completion date: Est. Project Cost: Date:c;— ' Signature of Owner APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. �a PERMIT APPLICATION FEE: $150.00 328-7311 PERCOLATION TEST FEE: $50.00 NAME OF OWNER: S r /� ADDRESS: /.2 /?b. �j Cl cL PHONE: NAME OF APPLICANT (if different from owner): P ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: Licensed Installer (see attached list) : YES W '�•'a�:-�i'IICAI L ADDRESS: PHONE: ©m Ti0'_ PERMIT APPLICATION IS FOR: O New Installation LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL S S Street/Rural Address: / �1( ;re Lot Size: Q l Legal Description: BUILDING OR SERVICE TYPE (check apRlicable category): (xf Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( v)- Garbage Disposal ( t,-Y Automatic Washer ( ) Other TYPE OF 1NDTVTDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( ) Alteration ( ) Repair ( ) Residential - Quadplex ( ) Commercial (state usage) NUMBER OF BEDROOMS: U (V<�Dwelling ( ) Transient Use ( ) Dishwasher ( ) Spa Tub ( 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 (>d �J IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO ( ) WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( ) (If yet, see attached waztewatet 6tow neduction methods) NOTE: The Envitonmentat HeaP,th 04iicetr. may reduce the negu,iAed ab�sonpti.on a/,cea upon appnova2 o{ an adequate walstewaten 6tow tc.educti.on plan. SOURCE AND TYPE OF WATER SUPPLY: Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If supplied by co it wa e gi me of supplier: SIGNATURE: DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: PetLcent Gtr.ound Stope ��O OAA Depth to Bedewck ( pen 8' Pno 4.i to Hote) Depth to Gnoundwatetc Table SOIL PERCOLATION TEST RESULTS:, Minuta pen inch in Hote #1 �� M� nu ens pen inch o Ho 2e 02 �j r :T Minutes pen inch to Hote # 3 FINAL DISPOSAL BY: (� ) Absonpti.on Tnench, Bed Pit on ( ) EvapotAaopivatc:on 2 1 I ( ) Above Gtound Dispeuat ( ) Sand Fif_ten ( ) Undengnound Di6peAza2 ( ) wa tailaten Pond ( ) OthuL Amount Paid: ISO .Q D Receipt Numbers `�l'b Date: & - O ;k • b l NOTE: Site Plan must be attached to application. (Env. Health Department - Rev. 4-07-83) Page 2 B. COMMENTS OF LOCAL GOVERNMENT AND SIGNATURES: Check one: Q Mayor or City Manager County) ElCounty Commissioners Comments: /� Si za: ealth Department (City or Signature & Title '6- Note: The applicant must obtain the comments and signature of at least one of the above. C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: D. ACTION BY COLORADO WATER POLLUTION CONTROL COMMISSION: WP-10(Rev.11-68-100) REPAIR PERMIT APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS h A permit fee of $150.00 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 $100.00 for maintenance of the individual sewage disposal system, no fee shall be required. A percolation test fee of $50.00 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 health 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: TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: DATE I ESEPyT SYSTEM WAS INSTALLED: PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: # SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS: 5 - _..., 9 _ _, l f-----i_. jr�� s 6 p r e C OWNER OF SYSTEM: ADDRESS: APPLICANT: ADDRESS: DATE: r%uu I C r V M111 EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE Name Date Routed Application No. Location Please review the attached Individual Sewage Disposal System Permit Application and return it with this completed form to the Environmental Health Office._ PLANNING: Complies with - YES NO R V 14n BY DATE Subdivision Regulations: Zoning Regulations: Recommend Approval: COMMENTS: BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: JMJWN 1 1 REVIEWED BY1� ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: YES NO REVIIEDIED BY DATE I n H fi /1. COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: YES NO REVIEWED BY DATE COMMENTS: -" --- --- - 13 5 0 -- _ 216 0' 32 S . 0 'CO )5 2 f N.3:°43' 10"E. c, 1:013 76.42 a. ) � o O. j of ,? / r, o oe { 002 275, 05_ 'S 003 1.002 Lof / z 1� 004 of fv 006 Of 007 S 6 0E I .0-io a. �of 6 6` 4J� O BOU1NDARi, LAKE CREEK SUBDIVISION, Isf filing �v `I O01 U/ v EAGLE COUNTY memorandum To: 0 Dr. Stephen Warren Subject: ENCLOSED ISDS PERMIT #619 From: File No.: Date Environmental Health Offic June 9, 1983 Enclosed is your individual sewage disposal system Permit #619 for property located at 1299 Lake Creek Road (Lot 3 - Lake Creek Subdivision). The information on the permit application indicates that the system will be owner /agent installed. Therefore, you will be responsible for the installation of the system. The permit (green copy) must be posted on the installation site. The installer/owner must call our office for final inspection before covering any portion of the installed system. We can be reached at 328-7311 or 949-5257, extension 238, If you have any questions, please contact us. -- Lorraine Funke, Secretary Environmental Health Office Eagle County /if Enc. AVV/ z941-kC� z Date �— Recoived ByIns�ucted By Scope ES:MFD:57 (5-75-10) 0619 Warren Lot 3 Lake Creek _ JOB NAMESub. 12-9�- I ke Creek Road 9L&i0 ,�%,C � J019 NO. L2 JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED UaeA C, ass i lk� a I a��es Raj `4' scwv1'g T6 1181 V r�� JMMARY 'CE PERMIT # 619 -� G1� 'e "s ,Gi0- �_ t OWNER: -5,�..yy1� GO `3 LOCATION: ±2�9�' Lae Creek Road - Lot Lake Creek Subdivision INSTALLER: B & B Excavating (J. Kemp) _ 1,000 gallons Degrees: 2800 Feet: 15 SIZE OF TANK: DWELLING: Single family - 3 bedrooms x 275 sq.ft. PERC RATE: one inch/20 minutes (800 sq.ft.) 3T Finalized: 6-17-83 by: Sidney Fox — IT V/—crcntAD COSTS _ % OF SELLING PRICE NET PROFIT .JOB FOLDER Product..278 �® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER printed in U.S.A.