HomeMy WebLinkAbout407 Meadow Rd - 210507401020 - 0812ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT Np 0812 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: Irene B. Westbye Telephone: 476 2952 Address: P.O. Box 3213 Vail, CO 81658 System Location: 0407 Meadow Road Edwards Licensed Installer: 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: i Inch in I9 Minutes Absorption area per bedroom 200 Sq. Ft. Number of Bedrooms_ X —9 00 Sq. Ft. minimum requirement per bedroom - equals 400 Total Sq. Ft. minimum requirement Special Requirements: Date: 9-25-87 Environmental Health Officer: Era.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 andcause 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: 1 ZC�SQ. FT( . INSTALLED SEPTIC TANK: l GALLONS; f (,C DEGREES;-FEET`''0�;'� 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 G /NO COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO COMMENTS: - L' > �� 1 1, l-) (Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) DATE (Final Approval) r� ENVIRONMENTAL HEALTH OFFICER: DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER: RETAIN WITH RECEIPT RECORDS PERMIT Name of Applicant:-- TrPnP R_ WeGth37e Name of Owner: AmountiVaid: $275.00 Receipt Number.-3925 Date:9-2',-37 Cashier: Earlene Check 112601 White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner A DT Tl.AT" FOR •r�•�'�.. .�L ';C.'�:�k,?�IC7'�C:\L S— �7 rL••.l T... ENVIRON ?E::TAL iic—ALTii OFF TCE - EAGLE P.O. L"O:•: S30 ram- Eagle, Colorado 81631 No PER:•?IT APPLICATI TON FEE: 8150.00 328-7311 PFRCOL:ITI0N TFS T F--: �50.00 NA.`IE OF OI.'\ER: RC,Ntc T3 wi~S"t t3yt=, ADDRESS: fox 3at3 , 0ff L„ .e-Z 8 (,(Q $ PEiO::E�t�-�o2lti> 4•7r.-29Sa.. NA11E OF APPLICANT (if different from owner) : ADDRESS: DESICN .E::GINEER OF SYSTEM (if applicable) : ADDRESS: Pix:.+v 1`1 L�L..)i V�YJ 11J i.L 4.i a! IL SIALT % ION Or SYSTE'H: PHONE: PHONE: Licensed Installer (see attached list): YES- NO ADDRESS: • P HO:: E PER`1IT APPLICATION IS FOR: (✓) New Installation ( ) alteration ( ) Repair LOCATION OF PROPOSED INDIVIDUAL SET.'AGE DISPOSAL SYSTL^_-1: Street/Rural Address: 04c)7 Men -P%nnw Fkep�D.p at>tU RnS Lot Size: 44.1 Jo q Acp Legal Description: 6,p t g t,.ocK, %A a L hKg QP-MEr, (Y\a"ows BUILDI`iG OR SERVICE TYPE (check aoolicabia cate^_orv): ( ✓ Resiaential - Single Family ( ) Residential - ( ) Residential - Duplex ( ) Co.•-::::ercia(state l (staate usage) usage) ( ) Residential - Tr_olex NUMBER OF PERSONS: % NrYBER OF BEDROMS : WASTE TYPES (check applicable cate^_ories): ( ) Co=ercial or Institutional ( ) Dwelling ( ) Non -Domestic Wastes ( ) Transient Use ( ✓) Garbage Disposal (p-) Dishwasher ( ✓) Automatic Washer ( ) Spa Tub ( ) Other -TYPE OF P7DIVIDUAI. SEI•:AGE DISPOSAL SYS i r�-I PROPOSED: (�) 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 DIRECTL`i INTO ?'ATERS OF THE STATE: YES ( ) No X ) IS SYSTEM DESIGNED FOR LESS 79AN 2,000 GALLONS PER DAY: YES NO ( ) WASTEi•'ATER FLOW REDUCTION PLAN: YES ( ) NO (I S yes , see attached was L e-,=Let Stew .tedU.0 Lien me;dLods) `\ NOTE: The Ei2VZt0{une{LUC' HeQe-vi Uj3CCC" mall ieducei'Le `C2GLLC`Cd ab.sei(J(C;2 a, -Lea upon app-tavae Ua an Qd2GUCL�C Ltias L C l'C�t e 5(L'(V i2d(�CtCO;L SOURCE AND TYPE OF IJATER SUPPLY: ( ) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If supplied by community water, give name of supplier: oppeg- g'Prc.L.E, uer�,.,p_y ��SCrt GNATURE " R �' Q-a.JL S I : , a DATE: . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INPORt{ATION BELOW TO BE PILLED OUT BY ENVIRONU'VJFTAL HEALTH OFFICER: ✓ q�,� - - - - - - - - 044 GROUND CONDITIONS: Pencent G.tound Slope c� C `R , ��S4�4w, r Depth to Bedtoeh (pet 8' P-toStiee Hole) > �� Depth .to Gttoujzdxa.te,t Tabte SOIL PERCOLATION TESI RESULTS:. % M.c{Lu,t'cs Pe'L-ciLC{L in Hoxe TI / © h(inti tes pen. inCh .to Hot e # 2 / 47 1•i.6LU1Lt s pe'% i'Ec'L ,t o Hoze 43 FINAL DISPOSAL BY: (5�) Abso.-LptLoil Thench, Bed o.t P,ct ( ) Evapa.t=tspjAati.ai2 Above Gacund D.i,s pe na.e ( ) Sand FiUct $D ( ) Un&tg.tound Dispe-tsae ( ) Was.tcxa,te.t Pond ( ) Othe t Amount Pa, d: �t? �G %J� Recci,pt NLu;{bct �9a� DILL, : e� - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - NOTE: Site Plan must be attached to•application. (Env. Health Department - Rev. 4-07-33) PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE:a50.00 ISDS APPLICATION NO.&%Z OWNER: LEGAL DESCRIPTION: e�U f l .RURAL ADDRESS: -�ne27 /__� Pa C6, TYPE OF DWELLING 5'�� �u'"''�� NUMBER OF BEDROOMS: DATE OF PERCOLATION TEST: —7 TYPE OF SOIL: 6�It�21SU, TEST HOLES PRE-SOAKED: YES NO�� TIME 1!i 07 2_2 WATER DEPTH 3 II INCHES I 1 OF FALL 2 3 1 RATE 2 ! ;<s � ;i 0 l� z PERCOLATION RATE: RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: (% SITE HAS BEEN REVIE!-JED AND TESTED FOR PERCOLATION RATE. 6 <5z Z,t_t�,e, age-�� Environmental Health Officer COMMENTS: Rev. 5/31/84 _ y---- 9-/7 Date 31Va AS G31113 UA3d OtJ S3A fi A9 G3i';3Iit3d ON S3A 31VO AS G3li3IA3d I ON I S3A �6 Z 31ti0 : Leno.Addy puaw.;.,00ad :aoUeLLdwoO •s5ad 'S-0'S-I :fiaessaoaNl gLwJad ULeLdpOOL3 y4 Lr•l sa L { du:o0 Hi]V-3H TJil:31-:I:O'd l AN3 r S1NNNOO :Lenoaddy puawwooad :a5eULeao :6ULpeag :speod y;LM saLLdwoo :a33NI5I43 = S1N3I;Pd0� :Lenoaddy puawwooad :panssl gIw.aad 5ULpLLng :a03 paLLddy ;Lwaad 5ULPLpq - y4L14 saLLdwoo :OtdI nIla 9 . �..0lj :Nenoaddy puawwooad :suoLgeLn5ad 6uLUOZ :suoL4eLn5ad UOLsLnLpgnS A8 GZfl3IJ13Zt. ... 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JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED M'pA0O-,Hv� Co �nf-q,lr I� 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 JOB FOLDER Printed in U.S.A. Sie A <r4 !0-1-b7 i