HomeMy WebLinkAboutColumbus Lode - 219923100003INDIVIDUAL 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. 953,
Please call for final inspection before covering any portion of installed system.
OWNER: Vincent Gal 1 igar PHONE: 790-2911
MAILINGADDRESS: 13479 Virgo Ct., Littleton, CO 80124
AGENT: PHONE:
SYSTEM LOCATION: Columbus Lodge Mining Claim USMS No. 11186, Fulford, CO
LICENSED INSTALLER: owner LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS: 6
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. 1
SPECIAL REQUIREMENTS: Conde tl On: No Surface Discharge
ENVIRONMENTAL HEALTH OFFICER: - DATE:
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUI ENTS 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: (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.
INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET.
INSTALLED ANK: 70'� GALLONS DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: /�
PROPER MATERIALS AND ASSEMBLY + YES NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: X YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED.
COMMENTS:
ENVIRONMENTAL HEALTH OFFICER: " �5 DATE: f
c
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
Four 1nnV vst *'s -ins Y l�er 4ey, ss���, 6lny Ye�U�nC� �Av+ _�0 Q�tfik�lP�
AP? TCA„'^. FOR r•• i/" aL S r..,:\(; D i c,^q %.L T-
E::vIRo,-"IENT AL i:EALTiI OFF ICE - EAGLE Cl`•U'T'
P.O. Colorado
�50 L��?
Eag1a , Colo ra�lo 81631 No
PERMIT APPLICATION FEE: S150.00 328-7317 PFRCOLITIO`d TEST F=_ $1251.:(
NAME OF OI,'\ER: U1�1 � , G6U \ c alc
ADDRESS:
NA.`IE OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (if applicable):
ADDRESS:
Pt.rc ;14' 1<i:�i V:�Jiu: �, "r�;:; INS ILLATION OF SYSTEM:
N+v", 3Ro-��tl
PHO;;E: lu.,k ;
PHONE:
PHO:: E :
Licensed Installer (see attached list): YES- NO
ADDRESS:
- PHONE:
PER`fIT APPLICATION' IS FOR: ( ) New Installation ( ) alteration ( ) Repair
LOCATION OF PROPOSED T7,,1nTVTn7AT CrT-ar., T)TcDn(ZAT cvcTt^.r.
aLreeci Lcural raaress :
Lot Size:
Legal Description:
BUILDI`iG OR SERVICE TYPE (check applicable cate^_orv_):
(K) Residential - Single Family (AAomA- a'�, ai,iti) Residential - Quadplex
( ) Residential - Duplex
( ) Co--::::ercial (state usage)
( ) Residential - Tr_Dlex
NUifBER OF PERSONS: r.\- NL IBER OF BEDROOMS:
WASTE TYPES (check apolicable cate^_ories):
( ) Co«:mercial or Institutional
( ) Dwelling"
( ) Non -Domestic Wastes ( ) Transient Use
( ) Garbage Disposal
( ) Dishwasher
( ) Automatic Washer 1" ( ) Spa Tub
( ) Other
HYPE OF INDIVIDUAL SEI:AGE DISPOSAL SYSTF;•I PROPOSED: (t��l�l � dlspQse� of of 9 w, L,1i� e�otn�
( ) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( ) Greywater (x) Chemical Toilet SedrS
( ) Pit Privy ( ) Aeration Plant ( ) ( Recycling, Potable Use ) Other
( ) Rec,cling, Other Use
WILL EFFLUENT BE DISC:iA_RGED DIRECTL`i INTO T1AT_RS OF THE STATE: YES ( ) NO
IS SYSTc I DESIGNED FOR LESS T'rIAN 2,000 GALLONS PER DAY: YES NO ( )
WASTEi:LATER FLOW REDUCTION PLAN: YES ( ) NO
(I yE;S see atiaC�ied Cc2S etw,zte•, Stow seduction 1ne,thodS)
NOTE: The EnvZ1Lo;Lnej7,tae Heae-tz O".Leemall educe the •`ceotu,`.2d ab.serLptcon a.Yea upon
app,tovae o5 an adeGuat-, 6-(.ct,1 AeduGtCoa pEa;i.
SOURCE AND TYPE OF WATER SUPPLY: ( ) hell �2C
( ) Spr;ng (�') Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier:
C S I GNTATURE: DATE:
44
- - - - - - - - - - - - - - - - - - - - - - - - - - - - --_ L411� - - -
INFORMATION BELOW TO BE FILLED OUT BY FNVI1RON!1EPJ`TAL HEALTH OFFICER:
GROUND CONDITIONS: Penceist Gnoujid S.Zope
Depth .to Bedtoeh (pen 8' PtoStiee Hole)
Depth to Gnound:cate.t Tab.ee
SOIL PERCOLATION TEST RESULTS:. { intLtcs pe.-c .6Lch in Nose * I
jtti.nu,tcs pert inch .to Ho.ee #2
i'LZILLLIL'LS pe't iil&L iu Hop-e #✓
FINAL DISPOSAL By: -
( ) Abso.,Lpt,ZoA Taench, Bed o.t Pit
( ) Above Gncu;zd D.i.,spexsae
( ) Unde,-Lg•`tottuzd Dispe,'tsae
( ) O.the t
( ) Evapo.t%ans pia ti.on
( ) Sa;zd F.i FItct
( ) Was.t ccca.tc-'c Pond
Amo=t Paid: / 4- Recci,ot Ncnnbc.'c �j %"�'J DcLt2:
----------------------��1ia---------------------
NOTE: Site Plan must be attached to•application.
(Env. Health Department - Rev. 4-07-83)
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
Vincent R. Galligar,
13479 Virgo Ct.
Littleton, Co. 80124
Re: Columbus Lodge
Dear Mr. Gal 1 i gar : --
This letter is in response to your, application for a permit
to install an individual sewage disposal system. Please
submit the manufacturers specifications and installation
instructions to complete your, application.
The 150.00 application is the standard application fee and no
refund will be forth coming.
If you have any questions concerning this matter, please give
me a call.
Sincerely,
Sid Fox
Environmental Health
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
gle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631
DM ITC CnDD4
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
'-ems �, (",
9/31f* Ck Name
DA4 Ro to LA
Application No.
Lo tion �,�M
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:
rnMMFNTS
BUILDING: Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies wi`th4 -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
ENVIRONMENTAL HEALTH: Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
COMMENTS:
117
Z 3
YES NO REVIEWED BY DATE
r
YES NO REVIEWED BY DATF
REVIEWED BY
DATE
' ..
MANUAL
M � Y
."s + -
4 � '
-
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== a ( 1 1_ r
7Nmm 111ITR!JAI -0
Your Pak-A-Potti IV is a portable, two -tank design. The fresh water
assembly includes a fresh water storage tank, flush bellows, cover
with self-locking lid latch, seat, water fill cap and tissue dispenser.
The lower section consists of a waste holding tank, self -storing,
swivel pour -out spout, deodorant storage pocket, air vent for smooth
emptying and holding tank cap. The waste holding tank is detached,
for easy carrying to a permanent toilet facility, by releasing locking
lever. Pak-A-Pottig Holding Tank Deodorant is placed in the waste
holding tank to help reduce odors.
DANGER � POISON
Pak-A-PottiG Holding Tank Deodorant may be harmful or fatal if
swallowed. Causes severe burns. Strong sensitizer. Contains
methyl alcohol and formaldehyde. Cannot be made nonpoi-
sonous. Avoid contact with skin, eyes, and mucous mem-
branes. Avoid prolonged or repeated breathing of vapor. Pro-
longed or repeated contact may cause allergic irritation.
FIRST AID: In case of contact, flush with water for 15 minutes.
For eyes get prompt medical attention. If swallowed give 1 or 2
glasses of water and induce vomiting. Milk or egg white in water
may be given. Call physician or Poison Control Center prompt-
Iy.Read caution on back label carefully. Children and handi-
capped should be instructed for proper usage. Keep out of
reach of children.
Do not add Pak-A-Potti Holding Tank Deodorants directly into
toilet bowl while holding tank valve is closed. Pressure due to heat
and altitude change can build up in the waste holding tank causing
bowl contents to splash upward upon opening the holding tank
valve. Before each use, open and shut the holding tank valve with
seat cover closed to vent the waste holding tank.
€tctswatinn anc
1. Preparing the waste holding tank for use:
Turn the Pak-A-Potti IV onto its front edge, with the locking lever and
water fill cap facing upward. Slide locking lever all the way to the left
— unlocked position. Separate the units by pivoting them away from
each other and lifting the water tank from the guide sockets at the
front edge of the waste holding tank.
Pull valve handle out. Add Pak-A-Potti Deodorant to waste holding
tank through valve opening. Push valve handle in and reassemble
unit.
The waste holding tank incorporates a preformed storage pocket
for an 8 oz. bottle of Pak-A-Potti Holding Tank Deodorant.
LIQUID
GRANULAR
HOLDING TANK CAPACITY (GALLONS) HOLDING TANK CAPACITY (GALLONS)
2. Filling the fresh water and %.aste holding t,Mk:
Position the fresh water tank assenbly -)n the floor with water fill cap
facing upward. Remove cap and fill tank with fresh water, 2.4 gal-
lons. Replace and tighten cap securely. DO NOT ADD PAK-A-
POTTI HOLDING TANK DEODORANT OR ANY OTHER HOLDING
TANK DEODORANT TO THE FRESH WATER TANK ASSEMBLY.
"OVER
HOLDING —
TANK
VALVE
/ � 384•�8
3. Attaching the freshwater and waste holding tanks:
Place both units on their front edges, facing each other; with the
water fill cap and waste holding tank cap facing upward. Align units
by inserting tabs under front edge of f resh water tank into sockets on
the front edge e` waste holding tank. Pivot the back ends of the two
sections towaras each other until they are firmly seated, then slide
the locking lever all the way to locked position. Place Pak-A-Potti IV in
its normal upright position. Depress flushing bellows while opening
holding tank valve to mix chemical deodorant with a small amount of
water to cover tank bottom. Then close valve.
The holding tank valve is opened by pulling straight out on the
valve handle located on front side of waste holding tank, and closed
by pushing the valve handle all the way in.
4. Flushing the toilet bowl:
Before each use, open and close the holding tank vaive :Kith the seat
cover closed. This will vent any pressure that may have built up as a
result of heat or altitude, and will prevent the bowl contents• from
splashing upward during flushing operation. Add a sheet of tissue on
the holding tank valve blade or add water to the bowl prior to us
After using, flush by sequentially opening the holding tank :ah
and depressing the fleshing bellows. This dual action results in the
best avaable bowl rinse and efficient use of water.
5. Emptying the waste holuing tank:
Pak-A-Potti IV should be emptied whenever the contents of the
waste holding tank approach the two indicator level tabs as seer
through the waste valve opening. DO NOT ALLOW THE TANK TO
BECOME OVERFILLED.
Before emptying the waste holding tank, make certain that the
holding tank valve handle is all the way in, then uncouple the units as
described under Item #1: Carry the waste holding tank to any
permanent toilet facility. Shake waste holding tank to break up
solids. Rotate the pour -out spout to desired position and remove
cap. Depress air relief valve with thumb while emptying. Rinse with
fresh water, replace spout cap, rotate pour -out spout to store posi-
tion. Add Pak-A-Potti Holding Tank Deodorant a.:, specified and lock
the two modules back together.
6. Refilling Paper Tissue Dispenser:
After separating the fresh water tank and waste holding tank, place
fresh water tank on front edge while steadying tank with one hand,
rotate tissue dispenser past its detent position and unthread from the
(4) track pins. Replacement is accomplished by reversing above
steps.
Spread tissue dispenser ends apart to remove empty tissue tube.
Install new roll by spreading ends. Over -spreading will result in
damage to the tissue dispenser.
7. For winter operation:
To`prevent possible damage in sub -freezing temperatures, add toilet
anti -freeze to trash water storage tank. Add 4 oz. of Liquid Pak-A-
Potti ! folding Tank Deodorant or 2 oz. of Granular Pak-A-Potti
Holding Tank Deodorant to the waste holding tank. Depress and
refill flushing bellows to prevent freeze damage.
8. Cleaning and Maintenance:
Use a mild dishwashing detergent to clean plastic seat, tanks and
WATER FILL COVEF.
NG
WS
WASTE FRESH
HOLDING WATER
TANK TANK
rnp ASSY.
CARRY DEODORANT I�
HANDLE STORAGE
/
WASTETANK
HOLDING
ASSY. TISSUE
DISPENSER
bowl. The seat and cover snap off for added convenience. DO NOT
USE SCOURING POWDERS, ACIDS OR CONCENTRATED
r` EANSERS, WHICH CAN DAMAGE PLASTIC PARTS AND RUB -
ER SEALS.
Lubricate the valve blade and shaft occasionally with alight film of
sii1cene spray. This will prevent sticking after extended :.;orage.
9. Storage:
Empty fresh water holding.tank completely. Pour 1 oz. of deodorant
_,into waste holding tank and mix with one gallon of cold water. Shak?
,tack. Pour out and rinse tank with co/dwater. Do notuse hot water to
c,ean tanks. With both tanks empty, place into storage.
Pak-A-PUttO Holding Tank
Deodorant
Controls odor in waste holding
tank. Fresh pleasant odor. Com-
patible with all sanitation sys-
tems. Biodegradable. Septic
tank safe. Child resistant cap.
Model No. 6 73541 Box of six 8
fI. oz. bottles.
Model No. 6 73544 32 fl. oz.
1-quart bottle.
%_8
v - -
Key
No.
Part
No.
Description
1
15757A
Cover Assembly
2
1326"10
Seat
3
12901
Cap. Water Fill
4
15746A
Water Tank Assy.
(Intl. #7)
5
15205W
Cap, Waste Holding Tank
6
15752A
Waste Holding Tank Assy.
(Intl. #8)
7
12667
Flushin, Bellows
8
13119
Carry Handle
9
13105
Tissue Dispenser
10
15204W
Spout
11
15180
0 Ring
12
14609
Owner's Manual (Not Shown)
Specifications
CAPACITY: Waste Holding Tank-
4.5 gallons
Water Holding Tank-
2.4 gallons
MATERIAL: Polypropylene and ABS
SIZE: 17-1/4" D (438mm)
15-1/8" W (384mm)
13-7/8" H (352mm)
NOTES:
Portable toilets are legally acceptable in most states* for use in
vessels not having permanently installed toilets.
*U.S. Coast Guard regulations allow such use. However, some
states and province of Ontario do not permit portable toilets.
Check local and state marine laws before purchasing.
:k-A-Potti) Holding Tank
reodorant
Specially designed for portable
toilets. Packaged in new,conve-
nient 16 oz. plastic "bottle.
Biodegradable. Fresh pleasing
odor. Goes ':o work instantl_-1,,
Helps keep ,ioldir3 tank clean.
Model No. 6 73547
16 oz. bottle.
Pak-A-PottP Toilet Tissue
Snowy -white, specially formu-
lated water-soluble toilet tissue.
Flushes easily from bowl ... dis-
integrates rapidly in waste hold-
ing tank. Helps prevent messy
clogs. Recommended for all
portable and fixed sanitation sys-
tems.
Model No. 6 73537
Package of four rolls.
QWNER'S MANUAL
.:the Model Number of your Portable Toilet v ill be found on the instruction label
located on the underside of the toilet cover. Always mention the Model Number when
requesting service or repair parts for your Sears Portable Toilet.
All parts listed herein may be ordered from any Sears, Roebuck and Co. retail or
catalog store.
WHEN ORDERING PARTS, ALWAYS GIVE THE FOLLOWING
INFORMATION AS SHOWN IN THIS PART LIST.
1. PART NUMBER 3. MODEL NUMBER, 259.73634
2. PART DESCRIPTION 4. NAME OF ITEM, "PAK-A-POTTI `0 IV"
If the parts you need are not stocked locally, your order will be electronically transmit-
ted to a Sears Repair Parts Distribution Center for expedited handling.
Warranty service is available by returning the Pak-A-Potti to the nearest Sears Service
Center.
Sea) t Roebuck and Co., SP^rs Tower BSC 41-3, Chicago, IL 60684 P74609
Rev. A 2-87
ar. -Fo-x
=�, U \V%)VAtzi ai Anm
= a le (;DUt�y) C i3lo,
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ILA �;�I��� , A� iv,&s�, �S a1s
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RECEIVED
EAGLE COUNTY
COMMUNITY Y DEVELOPMENT
JOB NAME
953 Glligar
Mining
Columbus Lodge
JOB NO. J
C
I r1Q 1 Af'�ATIAAI
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
,-
C}
PO , ,
PERMIT NO. 953
OWNER: VINCENT GALLIGAR
INSTALLER: OWNER
SIZE OF TANK: Pak-a-Potti
4.5 gallons
Finalized: 11-01-89 BY:
parcel # : 2199-231-00-003
RPM, RS L JOB COST
. !OSS PROFIT
OVERHEAD COSTS
F SELLING PRICE
NET PROFIT
A
FOR`: /
FROM r
DATE
P.M.
OF
TIME
f.(1
<�
❑ URGENT
PHONE
AREA CODE NUMBER EXT.
ELEPHONED
ElCAME TO SEE YOU ElRETURNEDYOURCALL
ESSAGE: 11MILEASE
CALL ❑ WANTS TO SEE YOU
❑ WILL CALL AGAIN
1
—
4. SI JED
Printed 14 P.S.A.
Cor. 3
r\
Cor. 4
0
�Fo,
tp
�90
O, O
O �G
I O,,
�G
0
sue.
s
2 STORY FRAME
C11 DWELLING
i � 9
a `
�O
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10! WIDE DIRT ROAD
I (APPROXIMATE LOCATION)
L:
SITE
Col
EAGL
LAN
UMBUS LODE
COUNTY, COLORADO
SUR YOR'S CERTIFICATE
I, Stephen R. Wuj k, a Registered Professional Land
Surveyor licensed in the State of Colorado do hereby
certify that this map is a true and accurate represen-
tation of a surve7 made under my supervision during
June 1988. `
Date Step en R. Wuje P.L.S. 5 9_
11'
100 200 300
SCALE-- I" = 100'
G� \ ;or.
2 11:
NOTES:
1) Date of survey: June 1988
2) • Indicates original wooden post
boundary monument and bearing trees found
in place. Replaced posts with rebar and
aluminum cap monuments, L.S: 20695.
3) O : Indicates bearing trees found to
obliterated original corner: Set rebar and
aluminum cap reference monument, L.S. 20695,
N. 64. 53' 13" E. 7.70' from Corner No. 4.
b �y it a ice: v�J ED �: 'termer . +!
Johnson, Kunkel & Associates, Inc.
LAND SURVEYING • CIVIL ENGINEERING -'MAPPING
3-,--At-
P.O. Box 409 . 113 East 4th Street
-
Eagle, Colorado 81631 • Phone: (303) 328.6368
Prepared for: Bob G a I I i g a r
DRN. B. H.
DES.
CHK.
REV.
SHEET OF
DATE I JULY
1988
REV.
Jog NO. JK/ 88l115
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631
Telephone: 328-8755
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1 5 1 4
Please call for final inspection before covering any portion of installed system.
OWNER: Brad Jennings PHONE: _( (970) 945-9802
MAILINGADDRESS: 2509 Blake Ave. OIry:Glenwood Sprgs State: CO Zip: 81601
APPLICANT: Brad Jennings PHONE: satBe
SYSTEMLOCATION: Columbus Lode Npw York mt-- TAX PARCEL NUMBER: 2199-231-0O-003
LICENSED INSTALLER: Wa1t2T`s CnmlanV/ Ed WAlters LICENSE NO: 5-95
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
A' i �
1000 GALLON SEPTIC TANK * N q60 Jar' va4 i S y-tn, +^^it,i+ -
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: AS per owners` reouest, holding tank installed now, absorption field may be
installed at a future date -441.al ��,,�>���� % �► ,Pc'�/r�t,'f r �, , f�-�,� ti
ENVIRONMENTAL HEALTH APPROVAL: DATE: AUGUST 21, 1995
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE OUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS, ADOPTED PURSUANT
TO AUTHORITY GRANTED IN 25- 10- 104. 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. CHAPTER IV, SECTION 4.03.29 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM TO BE LICENSED.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
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: N/A SQUARE FEET.
INSTALLED SEPTIC TANK: 1000 GALLON 15 ') DEGREES 16 FEET FROM house
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY YES _ NO
COMPLIANCE WITH COUNTY/STATE REQUIREMENTS: X YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED.
COMMENTS: Pictures of out -house structure received 12/14/95 Separate permit will be required
for the absorption field in the future. Q
ENVIRONMENTAL HEALTH APPROVAL: DATE: � '' 4 `'S—
ENVIRONMENTAL HEALTH APPROVAL: U DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT # _ _ __ CHECK #
(Site Plan MUST be attached)
ISDS Permit # 1
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. O. BOX 179
EAGLE, CO 81631
328-8755/927-3823 (El Jebel)
**************************************************************************
* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
*
*
* MAKE ALL.REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
PROPERTY OWNER: P/}(� �CAIN! GS PHONE: $OZ
MAILING ADDRESS: TSa9 !TL-4eF' %/G _ Gi�i �. now- �.� r� .� .
APPLICANT/CONTACT PERSON: SAA PHONE: (qan 5'l�
MAILING ADDRESS:
LICENSED ISDS CONTRAFTOR: _ PHONE: -oZ 5
COMPANY/DBA: U !12 4 ADDRESS: ate
PERMIT APPLICATION IS FOR: New Installation ( } Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Building Permit #
(if known)
Legal Description: Subdivision: 1v1.4— Filing:_Block: Lot No.
Tax Parcel Number: 9 - Z - Q Q - Q 3 Lott Size: /D Ac-
Street Address: GdLJl�lt3c>S o t7� -- Sc_¢) �4� JG—CZ�j j(cs 1�zsu
5vR1�E`� t nsco
BUILDING TYPE: (Check applicable category)
(t.-r Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
Number
Number
Type _
of Bedrooms %
of Bedrooms
TYPE OF WATER SUPPLY: (Check applicable category), 4 M!61/ -
( ) Well (t ' Spring ( ) Surface S
,409
( ) Public Name of Supplier: GJEL,L P,9/-4 r 0. 1h
*These systems
SIGNATURE:
**********************
design by a
********
1476%' d!166 %
Registered Professional Engineer
Date: 8
*****************************************
TO BE COMPLETE BY THE COUNTY
AMOUNT PAID: RECEIPT #: DATE:
CHECK #: _T CASHIER: _6'�
EAGLE COUNTY, COLORADO
Date: August 21, 1995
TO: Walter's Company
FROM: Environmental Health Division
RE: Issuance of Individual Sewage Disposal System
Permit No. 1514-95 Tax Parcel #2199-231-00-003
Property Location: Columbus Lode, New York
Mountain.
Enclosed is your ISDS Permit No. 1514-95.It is valid for 120
days. The enclosed copy of the permit must be posted at the
installation site. Any changes in plans or specifications
invalidates the permit unless otherwise approved. Please call our
office well in -advance for the final inspection.
Permit specifications are minimum requirements only, and should
be brought to the property owner's attention.
This permit does not indicate conformance with other Eagle County
requirements.
If you have any questions, please feel free to contact the
Environmental Health Division at 328-8755.
cc: files
Community Development Department
(970) 328-8730
Fax: (970) 328-7185
TDD: j970) 328-8797
EAGLE COUNTY, COLORADO
December 22, 1995
Brad Jennings
2509 Blake Ave.
Glenwood Springs, CO 81601
Eagle County Building-
P.O. Box 179
500 [Broadway
Eagle, Colorado 8 163 1 -O 179
RE: Final of ISDS Permit No. 1514-95 Parcel #2199-231-00-003.
Property location: Columbus Lode, New York Mt.
Dear Mr. Jennings, ,
This letter is to inform you that the above referenced ISDS
Permit has been inspected and finalized. Enclosed is a copy to
retain for your records. This permit does not indicate
compliance with any other Eagle County requirements. Also
enclosed is a brochure regarding the care of your septic system.
Be aware that later changes to your building may require
appropriate alterations of your septic system.
If you have any questions regarding this permit, please contact
the Eagle County Environmental Health Division at 328-8755.
Sincerely,
F
Janet Kohl
Environmental Health Department
Eagle County Community Development
ENCL: Information Brochure
Final ISDS Permit
cc: files
12/14/95
Eagle County Building I
Community Development Dept.
Box 179
Eagle, CO. 81631-0179
Attn: Janet
This letter is in regards to ISDS Permit #151495 for a vault and outhouse on
the Columbus Lode mining claim located in Eagle County.As you can see
from the enclosed picture we did build the outhouse structure this fall,
unfortunately this is the only picture that I have of it. If you would like to do a
site visit or have me take some pictures next summer please let me know.
Summer didn't happen until the third week in July this year,
let's hope it will be earlier in 1996. Let me know if you have any questions.
Sincerely,
Brad Jennings
2509 Blake Ave.
Glenwood Springs, Co 81601
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ISDS Final Inspection�k ��
Completeness Form
I
Tank is gal. Tank Material
�. D
Tank is located �_ft. and 15 degrees fromt�t&--)
(permanent landmark)
Tank is located ft. and degrees from
f(permanent landmark)
Tank set level. NL- Tank lids within 8" of finished .grade.
3 rl Size of field ft2
Technology
units. lineal ft.
Cleanout is installed in between tank and house(+ 1/l0oft).
N There is a "T".that goes down 14 inches in the inlet and
outlet of the tank.
Inlet and outlet is sealed with tar tape, rubber gasket
etc.
Tank has two compartments with the larger compartment
closest to the house.
Measure distance and relative direction to field.
Depth of field f t .
1 A Soil interface raked.
i Inspection portals at the end of each trench.
Proper distance to setbacks.
Other
Inspection meets recuirements.
Copy form to installer's file if recommendations for
improvement were suggested.
ACTION TAKEN:
Se0--2tA9, (-r awt ( 1 CW
Setbacks
Well Potable House Property Lake Dry Tank Drain
Water Lines line Stream Gulch
Field
100
25
20
10
50
25
10
10
Tank
50
10
5
10
50
10
*
10
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JOB NAME 1514-95 Tax Parcel# 2199-231-00-003
Columbus Lode JENNINGS
JOB NO.
BILL TO
DATE. STARTED
DATE COMPLETED
DATE BILLED
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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
JOB FOLDER Product 278 ®® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471
JO.IB. FOLDER
Printed in U.S.A.
1514 - 45-
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