HomeMy WebLinkAbout86 Red Canyon Creek Rd - 194125302015 - 0919ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631 Telephone: 328-7311 or 949-5257 or 927-3823 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 9 19 Please call for final inspection before covering any portion of installed system. OWNER: IRfoger Vernon PHONE: 569-3440 r MAILING ADDRESS: P. 0. Box 608, Georgetown, CO 80444 AGENT: Self PHONE: 569-3440 SYSTEM LOCATION: 86 Red Canyon Creek Road, Lot 3 Red Canyon Estates Eagle LICENSED INSTALLER: Owner installer LICENSE NO. N/A DESIGN ENGINEER OF SYSTEM* INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: 5 ® GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: ` �� `+vjeA -k-ee�1 0 C� SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Alternating valve to divert flow between two trenches at least 6' apart would be an option but not a requirement Txe- wed /n ces7 'ae k57- loo Ae -E -Ozoax 4' k leA-eL-fire- W - 2fCn nn &XAJ O ENVIRONMENTAL HEALTH OFFICER: - DATE: June 21, 1989 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 Ill, 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: (TO BE COMPLETED BY INSPECTOR): NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE WITH THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS UNTIL THE SYSTEM IS APPROVED' PRIOR TO COVERING ANY PORTION OF THE SYSTEM. p / INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET. / '�7� (/ >, S INSTALLED SEPTIC TANK: • '✓ GALLON_ DEGREES � `'' FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS AND ASSEMBLY L/ YES NO ✓ COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS AD7AR NGE A RE•INSPECTION W EN WORK IS COMPLETED. COMMENTS:` <' 5 c� �// ''� -7,-Z C�00, ENVIRONMENTAL HEALTH OFFICER: DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS APPLICANT/AGENT: Roger Vernon PERMIT OWNER: Roger Vernon wj AMOUNT PAID: $ 275•00 RECEIPT#: 1804 CHECK#: 1529 CASHIER: Jo Brophy �• APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 3305 r ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number: P. 0. BOX 179 EAGLE, COLORADO 81631 949-5257 Vail 328-7311 Eagle 927-3823 Basalt PERMIT' APPLICATION FEE $150.00, PERCOLATION TEST FEE-$125.001 NAME OF OWNER: Rme VP.(`oco p MAILING ADDRESS: ® , Box, 6Q8 6,Q®��►�, 0OA11 PHONE: 56q` 34-40 NAME OF APPLICANT (If different from owner): ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: r 1ero'? LICENSED INSTALLER: ( ) YES NO PHONE: 56''��® ADDRESS: 54me PERMIT APPLICATION IS FOR: C>< NEW INSTALLATION ( ) ALTERATION ( ) REPAIR 10CATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: Parcel Number: Legal Description: Lot Size: BUILDING OR SERVICE TYPE (Check applicable category): Residential - Single Family ( ) Residential - Fourplex ( ) Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: -FWo NUMBER OF BEDROOMS: +hre , WASTE TYPES Check applicable categories : Commercial or Institutional O Dwelling ( ) Non -Domestic Wastes ( ) Transient Use ( Garbage Disposal (X Dishwasher (X) Automatic Washer ( ) Spa Tub ( ) Other (Specify): TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: �G 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 (><f NO IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: (>,-I YES ( ) NO WATER CONSERVATION PLAN: ( ) YES ( 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 (>Q Spring ( ) Creek/Stream Give de f all wells within 200 feet of system: If s plie by cogmu�ity water, give name of supplier: �� A S I GNATURE : �._� %��,®��2�.t/� — DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope Depth to Bedrock (Per 8' profile hole 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 AMOUNT PAID: 0 — RECEIPT NUMBER J&V OCA DATE: NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKEALLREMITTANCE PAYABLE TO: EAGLE'COUNTY=TREASURER"= (Environmental. Health Dept. - Rev. 4/88) t PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125 m PAID ISDS APPLICATION NO. ' 5 OWNER: R"_r V e_tLr)G,7L LEGAL DESCRIPTION: Lot 3.. P—d Co—ru-im EoTcttba, n RURAL ADDRESS: ti Poll oll r(I Ci ( 1rv-, r A 00 K P4 _ TYPE OF DWELLING: NUMBER .L��� 1��1! NUMBER OF BEDROOMS:] DATE OF PERCOLATION TEST: C`� /P �% TYPE OF SOIL: Y- OCAb TEST HOLES PRE-SOAKED: YES NO --k` TIME WATER DEPTH II INCHES OF FALL RATE 1 2­7 3 1 j 2 3 1 1 I 2 3 1 2 3 o,z 2 Z r� c r� PERCOLATION RATE: p RECOMMENDED MINIMUM SEPTIC TANK SIZE: l ! ` �� RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Environmental Health 10tficer Date COMMENTS: ✓' ��"�' q,r,? 0,�p P`� Rev. 5/31/84 7T r a. EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 s (303) 328 7311 Date: June 21, 1989 Roger Vernon P. 0. Box 608 -- Georgetown, Colorado 80444 - --- RE: Issuance of Individual Sewage Disposal System Permit # 919 Enclosed is your ISDS Permit # 919 1'�i1co' t I .e��"/. I'Liz a oste fi: iivs .ate- mu, SPbC,C'iA-�f�0.,1.�'1g!'1,;�0�.��:�� ;0 , a� i stets We can be reached at 32E 11, ext. 530. If you have any questions regarding this permit, please contact the Eagle County Environmental Health Office. Sincerely, //9k A � Eagle County Community Development Environmental Health Office EE:SF/ar xc: File Board of County Commissioners Assessor Clerk and Recorder Sheriff Treasurer P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 479 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE Swer \to= 6-19Name.89 3305 Date Routed p �{ Application No. Lubtion Lit 3, Red Cdny©n E6ta1e5 Please review the attached Individual Sewage Disposal System Permit Application and return it with this completed form the the Environmental Health Office. PLANNING: Complies with - YES NO REVIEWED BY DATE Subdivision Regulations: Zoning Regulations: Recommend Approval: COMMENTS: BUILDING: Complies with - YES NO REVIEWED BY DATE Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: i ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: COMMENTS: YES NO REVIEWED BY DATE vrc nin or11TENJrn ov nn-rr JOB NAME JOB JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED ' 41, / �,,�'t c aY: _. xel vt /' � l / }. � . --. �J•r- /x'.O� �..,/ �jL ;i.,-� i' ,' c" L:� '`-G°r.,-�_ �llt.a�a3 �.: � U G� � �f � z �- _ yr t,� �/ /:� r /,l / yam; ✓ r f..: 0lc Qvlr"tJ� FA GC l/S� G) /% j �L(,�(2/1 SO !'-eG GOI•'r-- /�,UP S(i�' C Ij O 5 i � JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT J✓ 1 LESS OVERHEAD COSTS /o OF SELLING PRICE NET PROFIT JOB FOLDER Product-278 ®p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 I PERMIT 919 OWNER: ROGER & IRENE E. VERNON LOCATION: 86 Red Canyon Creek Road, Lot 3, Red Cyn Estates i nsta."i INSTALLER: OWNER SIZE OF TANK: 1000 gallons DWELLING: 3 Bedrooms PERC RATE: 20 MPI ABSORPTION AREA: 200 ' FINALIZED: 08-29-89 BY: EE PARCEL #: 1941-254-02-011 Printed in U.S.A. ' 'S