HomeMy WebLinkAbout4270 Hwy 6 - 211304401001INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N? 0872
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: Sammy D. Satterwhite Jane Massey
Telephone:_ 1-800-777-7288
Address: P. 0. Box 480 Gypsum, Colorado 81637-
System Location: Hi
Licensed Installer: S-a�-Owner 3Z37License Number: - NSA
Conditional installation approval is hereby granted for the following:
Minimum requirements: 750 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 Sq. Ft.
Number of Bedrooms 1 X Sq. Ft. minimum requirement per bedroom -
equals Total Sq. Ft. minimum requirement
Special Requirements: Mai ntai n at least 10 foot setback from the property line and at least
100 feet from any well. f6O ITIUQAI ee4 0 -�) � � S�
Date: 9-14-88 Environmental Health Officer: _S Sid Fox
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 portign of the system.
INSTALLED ABSORPTION OR DISPERSAL AREA:1426SQ. FT� V ,
INSTALLED SEPTIC TANK: � GALLONS; � DEGREES; _ FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: `~ y 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
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO
COMMENTS:
(Any item checked NO requires coiENMENTAL
before final approval of system is made. Arrange re -inspection when
work is completed.) // _,,,_ r
DATE (Final Approva[)� HEALTH OFFICER:
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: Sammy_ D. Satterwhite Name of Owner: Same
Amount Paid: _$275. 00 Receipt Number: 346 Date:-8-29-88 Cashier: J Brophy
Check # 26900
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY No.
P. 0. BOX 179
EAGLE, COLORADO 81631
949-5257 Vail 328-7311 Eagle 927-3823 Basalt
PERMIT APPLICATION FEE S150.00 I PERCOLATION TEST FEE $125.00
NAME OF OWNER:
MAILING ADDRESS: Zt 2
A-t-�—�v�l J z 7 - -7-1 7- 728 ' ne
Ma55e�
ZS_ 6 h 7gorPHONE: ZIV- 6 3 - /72s
NAME OF APPLICANT (If different from owner):
ADDRESS: F O. BOx, LJ80 C V DSU M . Co (91(037
DESIGN ENGINEER OF SYSTEM (If applicable):
PHONE:
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: �-n•` �-� %�`a/f7
LICENSED INSTALLER: ( ) YES ( C4_
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: (`✓) NEW INSTALLATION
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address: Cif 6
Parcel Number: 21132-60—may L76t Si
Legal Description:
ALTERATION ( ) REPAIR
ze:
BUILDING 0 SERVICE TYPE (Check applicable category):
Residential- Single Family ( ) Residential Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential- Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS: J
WASTE TYPES Check applicable categories):
Commercial or. Institutional ( Dwelling
( ) Non -Domestic Wastes ( ) Transient Use
( ) Garbage Disposal ( ) Dishwasher
( ) Automatic Washer ( ) Spa Tub
( ) Other (Specify):
TYPE OF Ioi VIDUAL 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 UKIM
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: ( YES ( O
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: (V_YES ( ) d0
WATER CONSERVATION PLAN: ( ) YES ( NO
NOTE: The Environmental Health Office may reduce the required absorption area upon
approval of an adequate water�onservation plan.
SOURCE AND TYPE OF WATER SUPPLY: ( d) Well ( ) Spring ( ) Creek/Stream D
Give depth of all wells within 200 feet of system: , Cu&L
If su pl ed by �,omgiaiity water, give name of supplier:
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent ground slopey f-,I
Depth to Bedrock (Per 8' profile hole).`-Z
Depth to Groundwater table
SOIL PERCOLATION 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 ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( ) Under Ground Dispersal ( ) Wastewater Pond
( ) Other 0�4_ L4 Q 0/
AMOUNT PAID: .00 RECEIPT NUMBER �jL7 � � DATE:
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
(Environmental Health Dept. - Rev. 4/88)
1
PERCOLATI(O`l TEST
ENVIRONMENTAL HEALTH CEPARTMENT
Eagle Count/
FEE: $125.00 ISDS APPLICATION ;0..�a
OWNER:
LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING: r
��^ NUh16ER OF BEDRCuP•1S:
DATE OF PERCOLATION TEST: TYPE OF SOIL:
TEST HOLES PRE-SOAKED: YES NO y % �Qr���v,•
J
1
3.oy
TIF'E
I 2
q
,_05
�5
II
3 �I
1 g. � I
1
s'�
as
WATER DEPTH
2
/s `
II
1 3 n
I";C*;-,'ES OF FALL RAT
1 1 1112 1 3 it 1
7��I
li
If
II �
II
I I I
62 I ►� �
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I I II
I it {
I II I I
II i I
I
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PERCOLATION RATE: 11_*;s-T t���1e� )' Jar- 0 - ailcre
/0 , 0,0
RECOMMENDED MINIMUM SEPTIC TANK SIZE: �.S_O ��►�c�
RECOjMMENDED MINIMUM LEACH FIELD SIZE:
RECOiMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
SITE HAS BEEN REVIEl•!ED AND TESTED FOR PERCOLATION RATE.
nvironmental Health Officer Date
COMMENTS: FliVTrAe6" . __ �
-------------
Rev. 5/31/84
JOB NAME C M I��%� � JOB NO.�
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
PERMIT # 872
OWNER: Sammy D. Satterwhite
LOCATION: Highway 6 West of Gypsum, Dotsero
Satterwhite Log Homes
INSTALLER: Ron ASt
SIZE OF TANK: 1000 Gallons
DWELLING: 1 Bedroom residence
PERC RATE: 10 MPI
ABSORPTION AREA: 160' of 10" SB 2
FINALIZED: 11-25-88 BY: Erik Edeen
PARCEL #�
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
pail tc�i�1 olo�S OO' ����� Printecl in U.S.A.
-k , g I 13 0 q-�f o 1
