HomeMy WebLinkAbout455 Meadow Rd - 210507401021 - 0787ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMITS 0787
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: George Shaeffer Telephone: 827-5685
Address: P • 0. Box 373, Vail, CO
System Location: Lot 2, Block 4, Lake Creek Meadows
Licensed Installer: License Number:
Conditional installation approval is hereby granted for the following:
Minimum requirements: ] LO Gallon Septic Tank or Aerated Treatment unit
Absorption area of dispersal area computed as follows:
Percolation rate: 5 Inch in 8 Minutes
Absorption area per bedroom Sq. Ft.
Number of Bedrooms_X 200 Sq. Ft. minimum requirement per bedroom -
equals 800 Total Sq. Ft. minimum requirement or 140 1 i neal feet SB2
Special Requirements:
Date: ?� �'�� % F.nvirnn�nantal Nvalth flff;�Ar• . /L-y
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 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 system is approved prior to covering any portion of the system.
INSTALLED ABSORPTION OR DISPERSAL AREA: SQ. FT.
INSTALLED SEPTIC TANK: �L 0 GALLONS; DEGREES;' 60 / FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE: YES— - NO
PROPER MATERIALS AND ASSEMBLY: YES _�[_ NO
COMPLIANCE WITH PERMIT REQUIREMENTS: YES ✓ NO
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO
COMMENTS:�z' ✓?�� %•
(Any item checked NO requires correction before final approval of system is made. Arrange a e-inspection when
work is completed.) r .
DATE (Final Approval)/ `�c(i _ � ENVIRONMENTAL HEALTH OFFICER: t
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: George Shaeffer Name of Owner: Same
Amount Paid: 200.00 Receipt Number: 3222 Date: 6-8-87 Cashier:
Check #7731
E. Huenink
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
rlf- ��e Co
O. ..-\L ` E';:\C; DTc,..cZ %L
ENVIRO" IENTAL HSALTii 0F7TC7 - EAGLE' Cl'C;:;`'
.` P.O. 3 u x S 3 0
F i Eagle, Colorado 81631
PER:-IIT APPT.ICATION FEE: �150,00 328-7317 PFRCOT-MO': TEST F=F: 5�0.00
NAME OF OWNER:(��nhri',O�' �lli�tD-�fP�n
ADDRESS:
NA.`IE OF APPLICA_%T (if different from owner) :
ADDRESS:
DESIGN ENGINEER OF SYSTE.`i (if applicable):
ADDRESS:
Prtc;,viv Lci:ii Vi.J1UiJL c� �; INS-ZALL:NTION OF SYSTE`I:
l- l�//jeltkA PIIO':E: O�7
PHONE:
PHO:E :
Licensed Installer (see attached list), YES- NO
ADDRESS:
- PHONE:
PER`1IT APPLICATION IS FOR: (-) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED T�MTVTMTAT c,t'Ar nTc'?0c3T crcT�•.f.
0LreeLiccurai Address:
Lot Size:
Legal Description:
BUILDING OR SERVICE TYPE (check applicable cate,o
( ) Residential - Single Family
O Residential - Duplex
( ) Residential - Tr_olex
NUMBER OF PERSONS:
WASTE TYPES (check apolicable categories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
()() Garbage Disposal
( ,) Automatic [dasher
( ) Other
HYPE OF INDIVIDUAL SE[:AGE DISPOSAL SYSTE•[ PROPOSED:
(x) Septic Tank ( ) Composting Toilet
( ) Vault Privy ( ) Greywater
( ) Pit Privy ( ) Aeration Plant
( ) Other
( ) Residential - Quadolex
( ) Co.--::ercial (state usage)
RTYBER OF BEDROOMS:
(x) Dwelling
( ) Transient Use
(�) Dishwasher
(�C) Spa Tub
( ) Incineration Toilet
( ) Chemical Toilet
( ) Recycling, Potable Use
( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO ['AT='RS OF THE STATE: YES ( ) NO (x )
IS SYSTE:I DESIGNED FOR LESS 7HAN 2,000 GALLONS PER DAY: YES ( NO ('
WASTE -7ATER FLOW REDUCTION' PLAN: YES ( ) NO ( )
(1 S Ya, see at --ached LL2s i elC2te S.Zcw ,LedLtCtCC';t rne.tfLcds )
NOTE: The EnvZ1Lo;uner7.taZ Heae-vi Oa�.Lee%L may reduce .t�Le-'Lequ,,ted ab.se;Lpti.cn C,tea upon
appnovaZ oS an adCgjuate teas.t,:xat- _6&w ,'Leductton pi-a;t.
SOURCE AND TYPE OF [d UPPLY: ) I1 ( ) Spring ()O Creek/Stream
Give depth of a wel w' hi 0 "e of system:
If supplied by o<< at r C' me of supplier:
SIGNATURE:
------ ----- -------------DATE_-- ---
INFORMATION BELOW TO BE FILLED O T BY ENVIRON,'fENTAL HEALTH OFFICER:
GROUND CONDITIONS: Peac--nt G,tou►td Slope
r Dep i;t ,to Bedto ch (pea 8' Pto S tee Hote )
Depth to Gaounc�c'catet Tabte
SOIL PERCOLATION TEST RESULTS: M-crtu,t'ca pet .cILC_;L •crt Hoze K 1
tt(-LruLtes pen ineh .to Hote # 2
iU11L' utt✓s pe,L i,LCIL to Ho.l?e #3
FINAL DISPOSAL BY:
( J Abwtpt�o;l Tte,tch, Bed on Pit ( ) Evapo.ttanspvLation
( Above Gacund D.i.,s pe zsa.L" ( ) Sand FiUct
( J UndetJ•toctnd Vispnsae ( ) (Vas-texatct Pond
Arnuu;Lt Paid: Recce lot NLunbe•t
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTE: Site Plan must be attached to -application.
(Env. Health Department - Rev. 4-07-33)
EAGLE COUNTY ENVIRONENENTAL HEALTH OFFICE
Name)
Date Routed
Location
V/ /
App i I cati on -ldo
Please revie,;i the attached Individual Sewage Disposal System Permit Application and return
it with this completed form to the Environmental Health Office.
PLANNING: Complies with -
Subdivision Regulations:
Zoning Regulations:
Recommend Approval:
COINXI,ENTS :
BUILDING: Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
YES ran
.
.✓L0000-
IM
6, � �,?
:
YES I NO
REVIE!-IED BY
DATE
YES ! NO I REVIE!VIED BY
DATE
EN11IRO'1i`4E'1TAL HEALTH:
Complies with -
Floodplain Permit Necessary:
YES
NO
REVIE!JED BY
DATE
I.S.D.S. Regs. Compliance:
Recce ,mend Approval:
!`n- 4-4rrirr -
G
_
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO.
OWNER: (j—ems/yam SCL �y I
LEGAL DESCRIPTION:
G
RURAL. ADDRESS:
TYPE OF DWELLING:��--� �_ NUMBER OF BEDROOMS:
DATE OF PERCOLATION TEST: �p �D ` �f % TYPE OF SOIL: Lev __ 7
TEST HOLES PRE-SOAKED: YES
NO _<
TIME
WATER DEPTH
II INCHES OF FALL
RATE
1
2
3
1
2
3
1
2
3
1
2
.
i
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE:
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: Z-/"el-) r°�2
SITE HAS BEEN REVIEIHED AND TESTED FOR PERCOLATION RATE.lire
Environmental Health Officer
COMMENTS:
Rev. 5/31/84
Date
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George Scheaffer
JOB NAME Lot 2 Block 4 Lake Creek
5ca�n�� Iv ties av Joe fro,
JOB LOCATION
BILL TO
DATE STARTED DATE COMPLETED
all
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DATE BILLED r, -
4til
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TOT
PERMIT #787
OWNER: GEORGE SHAEFFER
LOCATION: LOT 2 BLOCK 4
LAKE CREEK MEADOWS
INSTALLER:
SIZE OF TANK: 1250 GALLONS
DWELLING: RES, SINGLE FAM, PERC RATE: 5 INCHES IN 8 MINUTBSDROOM
ABSORPTION AREA: 140 SQ. FT.
FINALIZED 9-18-87
BY: ERIK EDEEN
JOB FOLUtH K00um zro r_n��QD —._._ _ J V = r V"L jL-_ .
