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HomeMy WebLinkAbout475 Sierra Vista - 239127302014 - 0969ISINDIVIDUAL 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. 969 Please call for final inspection before covering anV Dortion of installed system. OWNER: John Powers PHONE: 963-1817 MAILING ADDRESS: 1 3114 Hwy 82 Carbondale, CO 81623 AGENT: PHONE: SYSTEM LOCATION: Prise and Sierra Vista, Lot 10 Blk B Aspen Mesa Estates LICENSED INSTALLER: Pro Construction P.O. Box 264 Glennwood Spgs 81602 LICENSE NO. DESIGN ENGINEER OF SYSTEM: INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: iROGALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED 1065f t SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Keep trenches as shallow as possible (6" minimum cover over pipe) Trench lengths must not exceed..... 00' per trench. Provide inspection portal at end ENVIRONMENTAL HEALTH OFFICER: /� < �> DATE: CONDITIONS: 1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OFT 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 111, 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: (r0 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. / 06 S O 3�©� INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET. o /1 Ba n OSeC J✓a cv/l.e INSTALLED SEPTIC TANK: Q GALLONS 4S DE REE FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS AND ASSEMBLY _ YES NO COMPLIANCE WITH COUNTYISTATE REGULATION REQUIREMENTS: 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 OFFICE DATE: 16 x/ ENVIRONMENTAL HEALTH OFFICER: DATE: (RE-INSPECTIO IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 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 TESL` FEE $125.00 NAME OF OWNER: A/P/1/110) �rR�a-� MAILING ADDRESS: J3/ly l vX, K „(?J 4P03 PHONE: %- 3---Z4Z7 NA14E OF APPLICANT (If different from owner): i�C% 0, ADDRESS: 6W '2(v &`Zc /woo,i (OW, g/'6o 2 DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: V,--7aw LICENSED INSTALLER: ( ) YES (X) NO ADDRESS: Ali ly /Q;/ 6,9 /� _6O,/ !` PHONE: PERMIT APPLICATION IS FOR: (><.� NEW INSTALLATION ( ) ALTERATION LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Nnysicat Haaress: Parcel Number: Legal Description: Z ize: ( ) REPAIR L BUILDING OR SERVICE TYPE (Check applicable category): (X) Residential - Single Family ( ) Residential - Fourplex Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: A,-11� NUMBER OF BEDROOMS: y WASTE TYPES Check applicable categories): Commercial or Institutional (X) Dwelling ( ) Non -Domestic Wastes ( ) Transient Use (� Garbage Disposal ( Dishwasher 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 ( ) 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, all wells within 200 feet of system: If suppl�I,Ueyco y water, give name of supplier: /�90 1-' /'7f [-523SIGNATURE:,L! �1'�-'�'� DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope Depth to Bedrock (Per 8' profile hole)k Depth to Groundwater table ' SOIL PERCOLATION TEST RESULTS: 7 %, Minutes per inch in Hole #1 3, Minutes per inch in Hole #2 a Minutes per inch in Hole #3 FINAL DISPOSAL BY: Abs r tion Trees Bed or Pit ( ) bove Groun ispersal ( ) Under Ground Dispersal ( ) Other AMOUNT PAID: RECEIPT NUMBER ( ) Evapotranspiration ( ) Sand Filter ( ) Wastewater Pond NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER". (Environmental Health Dept. - Rev. 4/88) DATE: 5- rncurco. COMMUNITY DEVELOPMENT DEPARTMENT (303) 329 8-730 EAGLE COUNTY, COLORADO October 4, 1990 Dear Applicant: 725 CHAMBERS AVE. P.O. BOX 179 EAGLE, COLORADO 8 16 31 FAX (303) 32S 7207 Please be advised that this office will not be conducting percolation tests between November 15, 1990 and March 15,. 1991. Additionally, all final inspections on installed systems must be completed prior to December 1. If you have any questions, please call me at 328-8730 or 927-3823 ext. 730 in the Easalt/r..1 Tohal area sincerely, Roger Hosea Asst. Environmental RH/alm Health Officer COMMUNITY DEVELOPMENT DEPARTMENT (303) 328-8730 EAGLE COUNTY, COLORADO Date: November 9, 1990 John Powers 13114 Hwy 82 Carbondale, CO 81623 Re: Final of ISDS Permit No. 969 72; CHAMBER~ AVE. P.O. BOX 179 EAGLE. COLORADO 81 F3 1 FAX (303) 328-7207 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. Also enclosed are informational sheets regarding the care of your septic system. If you have any questions regarding this permit, please contact the Eagle County Environmental Health Officer, P.O. Box 179, Eagle, Colorado 81631. We can also be reached depending on your calling area at the following numbers: Vail/Avon 949-5257; Basalt/El Jebel 927-3823; Eagle Area 328-8730. Sincerely, Roger C. Hosea Assitant Environmental Health Officer Community Development - Enclosures: Informational Sheets Final ISDS Permit cc: Chrono file ISDS file# Building Permit file# ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICEme '1 ,S Date Routed i .� Appl is tion No. cation 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 - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: 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' S YES NO REVIEWED BY DATE YES NO REVIEWED BY DATE YFS ND RFVTF14Fn RY NATF M��"Mvm f \. �.. .. -_. _._._ .__. 2. �___.__ n-.,._ .: _ _.__ .. ___ _..__.. __ __ ... _. _. _ _ _ __ .__ _. ', t �. y � __ _ _ ... 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' � r _; _ _._. __._. ___. �_._. � ,. ..__ _. .... a � ^ PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $I25,00 I3D3 APPLICATION NO. 2-3 RURAL ADDRESS: TYPE OF DWELLING: ~~4 NUMBER OF BEDROOMS: ° ~ ' .//4y DATE OF PERCOLATION TEST: SOIL: � TEST HOLES PRE-SOAKED: YES NO TIME T WATER DEPTH INCHES OF FALL RATE 51 1,2 113 ec ` � ���p�' � � ' ~' ~ ��' PERCOLATION RATE: /�Jyj I RF F 969 Powers Lot to BIOCK B = Aspen Mesa Paseo & Sierra JOB NAME vista JOB NO. %1 JOB LOCATION BILL TO DATE STARTED I DATE PERMIT # 969 OWNER: John Powers LOCATION: Paseo and Sierra Vista, Lot 10 Blk B Aspen Mesa Est. INSTALLER: Pro Construction, P.O. Box 264 Glennwood Springs SIZE OF TANK: 1250 gal. DWELLING: 4 bedrooms PERC RATE: 35 mpi ABSORTION: 1065 ft trench bottom FINALIZED: PARCEL.# BP# 4455 OLDER DATE BILLED 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 Printed ir; U.S.A.