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HomeMy WebLinkAbout110 Spring Creek Rd - 21109107002b APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. PERMIT APPLICATION FEE: $150.00 328-7311 PERCOLATION TEST FEE: $50.00 NAME OF OWNER: Randy Guerriero -y ADDRESS: l % %�i_� �t C° r P PHONE: NAME OF APPLICANT(if different from owner) : ADDRESS: A. e� .� S �> .�'�'1 ri PHONE 2 `9 DESIGN ENGINEER OF SYSTEM (if applicable): 4? g' r a ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: Licensed Installer (see attached list): YES NO ADDRESS: PHONE: C9a�S"�-_ PERMIT APPLICATION IS FOR: (L,,y New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Street/Rural Address: Cj / / {) 5-,ef Lot Size: ,r ,a S, Legal Description: BUILDINGS OR SERVICE TYPE (check applicable category): ( X Residential - Single Family ( ) Residential Quadplex ( ) Residential - Duplex ( ) Commercial (state usage) ( ) Residential - Triplex NUMBER OF PERSONS: Z 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 TYPE OF T­NDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( L 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 ( )� (14 Yels, .see attached walstewaten 4tow reduction methods) NOTE: The Enviunmentat Health 044icen may reduce the nequiAed abzonption aua upon appnovat o4 an adequate wa6tewateA 4tow reduction ptan.- SOURCE AND TYPE OF WATER SUPPLY: Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: 9 C��,�' If supplied by commun•ty water, giv me of supplier: SIGNATURE: L 1— DATE: Ze /___? • - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -/- - - - - - - - - - - INFORMATION BELOW TO -BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Pehcent Ground Slope Depth to Bedhock (pa 8' Pno bite Hote ) Depth to GnoundwateA Table SOIL PERCOLATION TEST RESULTS: 10 m p, Minutes peer. inch .cn Ho.-e 1. S r'e r , r . 0- 1 &0 Minuta pen .inch to Hote #2 �►� f f Z— Minutes peA inch to HoZe # 3 FINAL DISPOSAL By: ( ) Ab�sonpti.on Trench, Bed oA Pit ( ) EvapotAanspitation ( ) Above Ground DispeAzat ( ) Sand Fi teh ( ) Undehgnaund D.%spetusae ( ) WalsteWaten Pond ( 1 Other. d Amount Paid: 4' Receipt Numbers a 0 ( Date: NOTE: Site Plan must be attached to application. (Env. Health Department - Rev. 4-07-83)- EAGLE COUNTY To: Mr. Mark Trimble From: Environmental Health Office memorandum Subject: ISDS PERMIT #633 (Attached) File No.: Date: August 17, 1983 Enclosed is a copy of your ISDS Permit #633 for property located at 0110 Spring Creek Road in Gypsum. The information on the permit application indicates that the system will be owner installed. Therefore, you will be responsible for the installation of the system. This green copy of the ISDS Permit must be posted on the installation site. must call our office for final inspection before covering any p—+i- -F -1-t- installed system. We can be reached at 328-7311, ext. 238. If you have any questions, please contact our office. -- Lorraine Funke, Secretary Environmental Health Office Eagle County /if Enc. You EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE Name Date Routed Application No. Loc tion) 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 'REVIE14ED BY DATE Subdivision Regulations: Zoning Regulations: (o Recommend Approval: kin COMMENTS: BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: w COMMENTS: REVIEWED BY DATE: ENGINEER: Complies.with - Roads: Grading: Drainage: Recommend Approval: YES NO REVIEWED BY DATE COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: YES NO RKIEWED BY DATE 16 COMMENTS: OLE • PE4,11COL "TION TES T Fee: $ 50. 00 IPT)licption No. -1045 .11'ermit No. Owner: Randy Guerriero Le,,nl Description:. Type of Dwelling-: No. of Bedrooms: Date of Test: ,, 77 Denth of Holes: -Z Dian'ietex: A ZO 4 /V7 Tyne of Soil: Loc,vtion of Test Holes: Test hole xvas nreso,-%ed from: To: Time Dcte -Tim e Date 4/01/e� TP, IIE 11. 17ATER DEPTH I INCHES OF FALL RATE L . 1 2 I I I 1 2 3 1 2 2 3 2- 2-0 Percolation Rate: MPI, Site has been revievied- and tested for percolation. We IPPROWL CZDIS!PPROVAL DITE: di 1 V;'. 3"d e 0 11, 1? 1-, . S. ElIvil'onnient'-J 1JOL: it 11 coulay m „OZ,21000s pY ;y- 1N_7N3SV3 41/7/l/I 61Nd OVOtl v I o b9'SIZ M;92.99"Co ,-A 00Oil Hi8ON I - ,09 Qs aQ Y I Q-A � I I z Z Q W J w W < I�w � � I g I` a -It I z NCM M to M Q p W Ln w °o W Q I W 3 o 0 o v o N w OD -o O o ( o L LO 0 O ° 0) � I W 0) co I j z I 0 (� O Ck I _ �Q� J V-1 2 109.92-Z LO onOA/ 6L'8Z� v r uJ — � n .JOB NAME: --•ter-....v:--_,-:�--�,.�,�,z�- ,:,�,.-._ � v , JOB LOCATIONnj r " BILL TO DATE STARTED DATE COMPLETED DATE BILLED �SVQs Wilk favopO' 2111 -- 0q I- co 2 CoheK1' tt, mar d Fact L ATC©mmn .a-� fie? LL. C JOB Nla I 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 Printed in U.SA JOB FOLDER INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT N® 0779 P.O. Box 850 - 550 Broadway Eagle, Colorado 81631 Telephone: 328-7311 or 949-5257 or 927-3823 YELLOW COPY OF PERMIT MUST PLEASE CALL FOR FINAL INSPECTION BEFORE BE POSTED AT INSTALLATION SITE COVERING ANY PORTION OF INSTALLED SYSTEM Owner: Randy Guerri ero 476-2417 Telephone: Address: 1859 Meadow Rdg. Rd. - Vail, CO 81657 System Location:_ 0110 Spring Creek Road / Parcel A, Spri"ng Creek Park Licensed Installer:_ Hynnon Excavating License Number: Conditional installation approval is hereby granted for the following: Minimum requirements: 1000 Gallon Septic Tank or - Aerated Treatment unit Absorption area of dispersal area computed as follows: Percolation rate: 1 Inch in 5 Minutes Absorption area per bedroom 200 Sq. Ft. Number of Bedrooms 3 X 200 Sq. Ft. minimum requirement per bedroom equals 600 Total Sq. Ft..minimum requirement Special Requirements: 100 lineal feet of SB2 Date: April 29, 1987 Environmental Health Officer: Eri k Edeen 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 III, 3.21 requires any person wbo 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 system is approved prior to covering any portion of the system. INSTALLED ABSORPTION OR DISPERSAL AREA: ®7 SQ. FT. INSTALLED SEPTIC TANK: 1000 GALLONS;DEGREES; FEET DESIGN ENGINEER OF SYSTEM: Hynoon Excavating INSTALLER OF SYSTEM: Hynoon Excavating SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR AERATED ACCESS PORTS ABOVE GRADE: PROPER MATERIALS AND ASSEMBLY: COMPLIANCE WITH PERMIT REQUIREMENTS: PHONE:. YES NO YES_ NO YES_ NO COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES 4 NO COMMENTS: (Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) 066 DATE (Final Approval) 4/2�3/$7 ENVIRONMENTAL HEALTH OFFICER: Erik Edeen DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER: RETAIN WITH RECEIPT RECORDS PERMIT Name of Applicant: Randy Guerri ero Name of Owner: Same Amount Paid: $200.00 Receipt Number: 3007 Date: 4 15 87 Cashier: Earl ene Hueni nk White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner APP ICA77"' FOR .r• AL SF*SAG DTc-,,.c L :C- 7r.^•.rT \ PERMIT APPLICATI TON FEE: I:EALTii OFFICE - EAGLE CC-U::T�' P.O. 3O:•: 350 Eagle, Colorado 81631 No. 5/C/1y 3 8150.00 328-7311 PFRCOLITIO`: TEST F=.,. 550.00 NAME OF OLdNER:jZ�%/�`�_��yiei-s�le�L ADDRESS: NA.NIE OF APPLICANT (if different from owner): ADDRESS: DESIGN ENGINEER OF SYSTDI (if applicable): ADDRESS: Prn;,vw i:.;;..,;:,,1L.� INKALL•'1TION OF SYSTE_I: Licensed Installer (see attached list): YES - ADDRESS: PER`fIT APPLICATION IS FOR: (p,�) New Installation LOCATION OF PROPOSED INDIVIDUAL SE'•'AGE DT�POSAL SYST-_H- Street/Rural Address: Q//D G'. Lot Size: Ik j Legal Description: BUILDING OR SERVICE TYPE (check applicable cate^orv) Residential - Single Family ( ) ( ) Residential - Duplex ( ) ( ) Residential - Tr_nlex IL PIIO::E: ',(/� C;4// 17 - PHONE: PHO"E: NO PM E: Alteration ( ) Repair Residential QuadDlev Co.:-ercial (state usacre) NUMBER OF PERSONS: a --y NL77IBER OF BEDROOMS: C;'�'-3 WASTE TYPES (check applicable categories): ( ) Co«.mercial or Institutional (X.) ( ) Non -Domestic Wastes ( ) (>e_*) Garbage Disposal 00 Automatic Washer ) ( ) Other TYPE OF MM"IVIDUAL SE? -.AG-- DISPOSAL SYS=•I PROPOSED: (X) Septic Tank ( ) Composting Toilet ( ) ( ) Vault Privy ( ) Greywater ( ) ( ) Pit Privy ( ) Aeration Plant ( ) ( ) Other ( ) WILL EFFLUENT BE DISCHARGED DIRECTT.`i TN:Tn ?7aT^RG nr TUF c^•A•rT. Dwelling Transient Use Dishwasher Spa Tub Incineration Toilet Chemical Toilet Recyclin„ Potable Use Recycling, Other Use IS SYSTEH DESIGNED FOR LESS THAN 2,000 GALLONS PER D.iY: YES (•) NO ( 1%.0� WASTE:•fATER FLOWREDUCTION PLAN: YES ( ) NO(� (I S Yes, see attached tt;a+s.tex Lte•t SZc•tu teduct. cn mth eods ) NOTE: The Heae 'LI'i USS.Lc&L mat( «educe the •teruLi .-d ab.se%tptLon area upon app+tovaZ o S a;i adequate icas.i "Ca t2t SZcu, .teducti o,z pZa;z. SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) Spring ( ) Creek/Stream Give depth of all wells within_200 feet of system: ,ean1( If supplied by communyy water, give name of supplier: Ci YES ( ) NO SIGNATUREDAT�E. ------ /—---------^--------- --- - - - --- - - INFORMATION BELOW TO BE FILLED OUT BY ENVIRON,'.fJFFAL HEALTH OFFICER: GROUND CONDITIONS: Pewee;tit G.touizd SZope r Depth to BecGtoCh (pew 8' P+to SZ2e Hole) 27„„7 Depth ,to Gnourzd ca to t Table _ > C, v SOIL PERCOLATION TEST RESULTS:_ Is— ,{.uzuU- pe/t ,(.iicjz in Hoxe P S 1tf j1u tcs pen inch .to Ho.�e # 2 e S n, i i:u tuS pe%, iiick -tG Hole. # 3 FINAL DISPOSAL BY: ( ) Abso.tp.tco;l Tnencli, Bed o.t Pit ( ) Evapo.tta;tsPiAatcon ( ) Above G,%ewid DZs pe+-usa L' ( ) Sand F.t Oct IL ( ) Undo, gLowid DispnsaC ( ) (Vastcratct Pond ( O.thvL /00 ` ESQ .ii� �4'/7. , Amoumt Paid: ' `} ,.�', �(f RCCC(.;?t NCUabG'L ��'C�, +� DCti.°: - - - - - - - - - - - - - - - - - - - -� - r,'- - - l- - - - - - - - - - - - - - - - - - NOTE: Site Plan must be attached to'application. (Env. Health Departrnent - Rev. 4-07-83) PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $50.00 ISDS APPLICATION NO. 30�� o0 01-4 OWNER: LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DWELLING: >ii, 5� NUMBER OF BEDROOMS: �� DATE OF PERCOLATION TEST: l�/'� 7 TYPE OF SOIL• 5e't, TEST HOLES PRE-SOAKED: YES C/ NO TIME +� WATER DEPTH II INCHES OF FALL 1 2 3 RATE 1 2 3 1 2 3 1 2 Z s 3 s' PERCOLATION RATE: C am►-�,-1 '`'7 0✓� RECOMMENDED MINIMUM SEPTIC TANK SIZE: I RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:(/) SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Environmental Health Officer COMMENTS: /0/1) ell / Rev. 5/31/84 Date EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE ��GC:(JLZ.C2CY Name) _ Date uted eL-L.9 - 4n >q �� %�G�3jv3 D/h -,n/ App i i cation 14o Location Please rev.ie;v 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 'RFVTF!•!Fn RY nnTr Subdivision Regulations: { Zoning Regulations: Recommend Approval: %: C01.1h,E,dTS : BUILDING: Complies with - YES I NO REVIE!•!ED BY DATE Building Permit Applied For: I Building Permit Issued: I l/ Recommend Approval: I COMMENTS: ,ENGINEER: Complies with - YES NO I REVIEI.IED BY DATE Roads: Grading: Drainage: Recommend Approval: COMMENTS: EN11IROB1,'1Ei1TAL HEALTH: Complies with - YES NO REVIE14ED BY DATE Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recomend Approval: COi•?PIENTS: �r EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 Date: April 30, 1987 Randy Guerriero 1859 Meadow Ridge Rd. Vail, CO 81657 RE: Final of ISDS Permit # 779 This letter is to inform you that the above referenced ISDS Permit has been inspected and finalized. Enclosed is a copy to retain for your records. If you have any questions regarding this permit, please contact the Eagle County Environmental Health Office, P.O. Box 179, Eagle, Colorado 81631. Phone: (303) 328-7311, Ext. 227. Sincerely, Eagle County Community Development Environmental Health Office /gP Board of County Commissioners Assessor Clerk and Recorder Sheriff Treasurer P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 479 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 0779 Gurriero Parcel A 0110 ,JOB Nj Spring Creek Rd ,IOB LOCATION BILL TO DATE STARTED DATE COMPLETED ATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR PERMIT #779 INSURANCE SALES TAX OWNER: Randy Guerriero - -- MISC. COSTS LOCATION: Parcel A - Spring Creek Park 0110 Spring Creek Road INSTALLER: Hynoon Excavating SIZE OF TANK: 1000 gl. DWELLING: 3 bdrm MH TOTAL JOB COST PERC RATE: 1 inch in 5 minutes ABSORPTION AREA: 100' SB2 GROSS PROFIT LESS OVERHEAD COSTS FINALIZED: 04/23/87 BY: Erik Edeen Rio OF SELLING PRICE NET PROFIT ,DER Minted in U.S.A.