HomeMy WebLinkAbout52 Grand Traverse Cordillera - 000000000000 - 0809IS Temp PermitINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT N2 0809 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: Kengi lgfon T.and TmTPRf Tn,-nt PArf nPrR Telephone: 926-1500 Address: P.O. Box 988 Edwards, CO 81628 System Location: 51 Grand Traverse Licensed Installer: Chadwick Construction Box 67 Minturn License Number: Conditional installation approval is hereby granted for the following: Minimum requirements: Gallon Septic Tank or Aerated Treatment unit Absorption area of dispersal area computed as follows: Percolation rater Inch in Minutes Absorption area per bedroom Sq. Ft. Number of Bedrooms X Sq. Ft. minimum requirement per bedroom - equals Total Sq. Ft. minimum requirement Special Requirements: _�>>%t({� �� Ca-► /L �7 {�C� C Liza L 4 Date: 9/22/87 Environmental Health Officer: Fr;k Fdeen (� 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: 'Z�, —GALLONS;. J00DEGREES; DESIGN ENGINEER OF SYSTEM: INSTALLER OF SYSTEM: SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR AERATED ACCESS PORTS ABOVE GRADE: PROPER MATERIALS AND ASSEMBLY: COMPLIANCE WITH PERMIT REQUIREMENTS: 1006309 FEET YES NO YES NO YES NO COMPLIANCE WITH COUNTY / STATE REGULATION 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 (Final Approval���� ENVIRONMENTAL HEALTH OFFICER:. DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER: RETAIN WITH RECEIPT RECORDS PERMIT Name of Applicant: Kensington Land Investment Name of Owner Same Amount Paid: $150.00 Receipt Number: 3924 Date: 9 / 2 2 / 8 7 Cashier: E. Huenick Check ll 0025 White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner APor T_CAT'^, FOR - ^*' T AL Sr'.:\(; DTc .c:�L ,C- Fr. ."f l ENV1R0;'`1ENT.\L HEALTH OFF TC7 - EAGLE CC1I :;T:. P.O. Sox 350 / Eagle, Colorado 51631 \ PERMTT APPLICATTON FEE: S150.00 328-7311 PF.nCOL:\TION TEST F=' $125.00 NAME OF OWNER: i�.o.�S..�n.� � -, � ��,, s �_ � L 10_ ...L __ ADDRESS: /`:-C1�)C �c�(L� LDS C'O PHO::E: e NAME OF APPLICANT (if different From owner) : ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (if applicable) ADDRESS: PHONE: INSIALL:ATION OF SYSTEM: ` Licensed Installer (see attached list): YES_ NO ADDRESS: ,G.'d. X L °° �S PHONE: PERMIT APPLICATION IS FOR: ></ New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED I%DIVIDUAL SE?•?AGE DISPOSAL SYSTE-4: Street/Rural Address: Lot Size: O C c Y Legal Description: e, f-/�.ems BUILDING OR SERVICE TYPE (check aoolicabla cate^-ory): ( ) Residential - Sir gle Family ( ) Residential - Duplex ( ) Residential - Tr_plex NUMBER OF PERSONS: -� WASTE TYPES (check apolicable cate^ories): ( ) Cor-nercial or Institutional ( ) Non -Domestic Wastes ( ) Garbage Disposal ( ) Automatic Washer ( ) Other ( ) Residential Quad:)lex () Co•--::ercial (statue usage) ../ NUMBER OF BEDR00_•IS : ( ) Dwelling ( ) Transient Use ( ) Dish.,asher ( ) Spa Tub -TYPE OF I^TDIVIDUAL SE? -.AGE DISPOSAL SYS=1 PROPOSED: ( ) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet Vault Privy ( ) Greywater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use (} Other/d,,oU 7czri /G/a�j �,/ ( ) Recycling, Other Use WILL EFFLUENT BE DISCiARGED DIRECTLY INTO ?.AT='RS OF THE STATE: YES ( ) NO (x) IS SYSTc I DESIGNED FOR LESS —MAN 2,000 GALLONS PER DAY: YES ("-I' NO ( ) WASTE?dATER FLOW REDUCTION PLAN: YES ( ) NO ( ) (I S Yes, see attached ttias.i etCate-t S.ecco .%edu�ctzcn me,t,'tcds ) NOTE: The EnvZ'Lo;unemtae Hea%t;t O'a.ice-t matt educe the •teouited ab.so,,Lp.tion a,tea upon app,tovae oS an adeGuat., teas -i zx tit 3&cv .Leduc,tCon pZ an. SOURCE AND TYPE OF WATER SUPPLY: ( Well ( ) Spring ( ) Creel/Stream Give depth of all wells within 200 feet of system: If supplied by communeater, give name of supplier: LI/j SIGNATURE: / G yDATE: • - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INFORMATION BELOW TO BE FILLED OUT BY ENVIRON.'IENTAL HEALTH OFFICER: GROUND CONDITIONS: Pencent G,tou;td S-2ope r Depth to Bedtoch. (pen 8' P,to'Zee Hote) Depth .to Gnoun&a tet Tab.ee SOIL PERCOLATION TEST RESULTS: ►tut(Is pet .(_ncj1 cn Ho�_e n1 Af i.nu,tes pelt .inch to Hoee #2 rMK;zu,tes pe't i,tck to Hoze #3 FINAL DISPOSAL BY: ( ) Abs o.tptco;l Tne;tc-L, Bed o t PZt ( ) Evapo.ttans pZkation ( ) Above Gncund DZspe•7.sa,2 ( ) Sa;zd Fi-Etet ( ) Undetg.tound Dispetsae ( ) Wastcicatzt Pond A11o=t Paid: /5© mb Recc�;,t Ncunbe.t 1V Data: �Qi-� o oa5- NOTE: Site Plan must be attached to'application. (Env. Health Department - Rev. 4-07-33) L5uj L00L 1 thing 1 Cordillera 51 Grand Traverse JOB NAME JOB NO. JOB LOCATION _ BILL TO DATE STARTED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL PERMIT # 809 OWNER: KENSINGTON LAND INVESTMEMP PARTNERS LOCATION: 52 GRAND TRAVERSE -CORDILLERA INSTALLER: CHADWICK CONSTRUCTION SIZE OF TANK: HOLDING TANK DWELLING: TEMPORARY CONTT. TRAILER PERC RATE: N/A ABSORPTION AREA: N/A FINALIZED: 9-25-87 BY: ERIK EDEEN TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT :)LVGR Printed in U.S.A.