HomeMy WebLinkAbout84 Spring Pl - 210518201003 - 0847ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT N2 0847 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: David Lokey Telephone: 476-6482 Address: P. 0. Box 520 Vail, Colorado 81658 System Location: 0084 Spring Place, Edwards, CO Licensed Installer: W. Y. Construction License Number: - 009-88-I Conditional installation approval is herebZ grraanted for the following: Minimum requirements: 1 Gallon Septic Tank or Aerated Treatment unit Absorption area of dispersal area computed as follows: Percolation rate: 1 Inch in 10 Minutes Absorption area per bedroom 165 Sq. Ft. Number of Bedrooms 4 X 165 Sq. Ft. minimum requirement per bedroom - equals 660 SQJ Ae-F— Total Sq. Ft. minimum requirementAfeet of trench,. (5o'tTam- Special Requirements:pe;. - 1 , eh fi eq d -59. ��— . , finen -g-� Date: _ 6-15-88 Environmental Health Officer: C CONDITIONS: Sid Fox 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: p ,0�.$FT. INSTALLED SEPTIC TANK: 00GALLONS; _10 DEGREES; B S FEET DESIGN ENGINEER OF SYSTEM: INSTALLER OF SYSTEM: _ U I I I Y )Lk- PHONE: SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR AERATED ACCESS PORTS ABOVE GRADE: PROPER MATERIALS AND ASSEMBLY: COMPLIANCE WITH PERMIT REQUIREMENTS: COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO YES NO — YES /NO VRQ J_ ATrl (Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) r--� DATE (Final Approval)( ENVIRONMENTAL HEALTH OFFICER: DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER: RETAIN WITH RECEIPT RECORDS PERMIT Name of Applicant: David Lokey Name of Owner: David Lokey Amount Paid: $275.00 Receipt Number: 4994 Date: 6-15-88 Cashier: EH Check # 1644 White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY EAGLE, COLORAD01781631 No3212' 949-5257 Vail 328-7311 Eagle 927-3823 Basalt PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00 NAME OF OWNER: David Loke MAILING ADDRESS: P. 0. Box 520 Vail, Colorado 81658 PHONE: 476-6482 NAME OF APPLICANT (If different from owner): ADDRESS: ©aQ L-( S��-«� �L�c 2. PHONE: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: W, C cgs-5M, �Tw,✓ LICENSED INSTALLER: (-\-) YES ( ) NO 00 - 88 - T ADDRESS: 85R0rnae Yiew Cf.. GVD5UM RiC�37 PHONE: 5-7585 PERMIT APPLICATION IS FOR: ( NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: oos,4 s5prim-PUICLEd ardA, Parcel Number: Lot Size: 3.99 ACC Legal Description:- Lot 2 Block 5 Spring Place Lake Creek Meadows BUILDING OR SERVICE TYPE (Check applicable category): Residential - Single Family ( ) Residential - Fourplex ( Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: 3 NUMBER OF BEDROOMS: WA51L lYFU> tunecK applicable categories): ( ) Commercial or Institutional ( ) Dwelling ( ) Non -Domestic Wastes ( ) Transient Use (�) Garbage Disposal (aC) Dishwasher bd Automatic Washer ( ) Spa Tub ( ) Other (Specify): TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: Septic Tank Composting Toilet ( ) Incineration Toilet ( ) Vault Privy ( ) Greywater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Portable 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 WATER CONSERVATION PLAN: ( ) YES O NO NOTE: The Environmental Health Office may reduce the required absorption area upon approval of an adequate water conservation plan. SOURCE AND TYPE OF WATER SUPPLY ( ) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If sup y co nit w ter, give name of supplier: SIGANTURE: DATE: INFORMATION BELOW TO BE FILLED OUT AY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope SOIL PERCOLATION Depth to Bedrock (Per 8' profile hole)_ Depth to Groundwater table _ TEST RESULTS: Minutes per inch in hole #1 Minutes per inch in Hole #2 Minutes per inch in Hole #3 FINAL DISPOSAL BY: Absorption Trench, Bed or Pit { ) Above Ground Dispersal ( ) Under Ground Dispersal ( ) Other AMOUNT PAID: 9 5 ~= RECEIPT NUMB ( ) Evapotranspiration ( ) Sand Filter ( ) Wastewater Pond 4'? DATE: ep -lD - NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. (Environmental Health Dept. - Rev. 4/88) PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125.00 ISDS APPLICATION NO. OWNER: LEGAL DESCRIPTION: L,i_1 2— RURAL ADDRESS: TYPE OF DWELLING: 1X) 1`7. NUMBER OF BEDROOMS: DATE OF PERCOLATION TEST: -TYPE OF SOIL: TEST HOLES PRE-SOAKED: YES NEI PERCOLATION RATE: RECOMMENDED MINIMUM SEPTIC TANK SIZE: a/ RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED 'MI IMUM SQUARE FOOTAGE PR BEDROOM: s S SITE HAS-BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. V�y Z_ Environmental Health Officer Date COMMENTS: Rev. 5/31/84 �:� .,;a moomw 847 Lokey 0084 Spring riace 2105-018-01-003 JOB NO. J�0— JOB LOCATION BILL TO DATE STARTED If - ( X-�--.( —(o llha� 4�13d0'w- v SO — COM ?dCo- 9 3R/ R-( �,63-44 dU,(Uv6�ti fil& I ._I mp r -3�3I - �-7/ v 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 )LEER Printed in U.S.A.