HomeMy WebLinkAbout559 Lake Creek Rd - 210506405002 - 0971ISINDIVIDUAL 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. 971 Please call for final inspection before covering any portion of installed system. OWNER: Richard Nelson PHONE: 949-5152 MAILING ADDRESS: nrawer 5400 Avon, CO 81620 AGENT: PHONE: SYSTEM LOCATION: 171559 lake Creek Rd., Edwards CO 81632 LICENSED INSTALLER: owner LICENSE NO. DESIGN ENGINEER OF SYSTEM: INSTALLATION ISyREBY GRANTED FOR THE FOLLOWING: GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. f DISPERSAL AREA RE UIREMENTS: s QUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. of 10" S132 SPECIAL REQUIREMENTS: Dosing chamher must he co nstructed to prevent back -drainage of effluent 50' setback from irrigation ditch required. ENVIRONMENTAL HEALTH OFFICER: /rXDATE: 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. INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET. INSTALLED SEPTIC TANK: GALLONS DEGREES FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALSAND ASSEMBLY YES NO COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WH N WORK IS COMPLETED. COMMENTS: f�9 ` —��a2 E f 1 P ` ENVIRONMENTAL HEALTH OFFICER: —2 DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION 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: 33 r� P. 0. BOX 179 ' EAGLE, COLORADO 81631 949-5257 Vail 328-7311 Eagle 927-3823 Basalt PERMIT APPLICATION FEE $150.00 NAME OF OWNER: PERCOLATION TEST FEE $125.00 MAILING ADDRESS: 'OfgjW" ,S_qOy Arow+ fib Zo PHONE.: NAME OF APPLICANT (If different from owner): ADDRESS: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: ©Gv a/C7Z LICENSED INSTALLER: ( ) YES ( NO ADDRESS: PHONE: PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: 6.0K 00312> Parcel Number: arcs Lot Size: 00 acres Legal Description: S � MN �rr�� Sad Diu<s<o BUILDING OR SERVICE TYPE (Check applicable category): Residential - Single Family ( ) Residential - Fourplex (�) Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: NUMBER OF BEDROOMS: WASTE TYPES Check applicable categories): �— Commercial or Institutional ( Dwelling " ( ) Non -Domestic Wastes ( ) Transient Use ( ) Garbage Disposal Dishwasher i Automatic Washer ( ) Spa Tub ( ) Other (Specify): TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: X 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: (>C) 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: (X) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If suppli y nit water, give name of supplier: SIGNATURE: DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope 0719 SOIL PERCOLATION Depth to Bedrock (Per 8' profile hole Depth to Groundwater table TEST RESULTS: L- Minutes per inch in Hole #1 10 Minutes per inch in Hole #2 Minutes p'er inch in Hole 43 FINA DISPOSAL BY: Absorption Trench, Bed or Pit ( ) Above Ground Dispersal ( ) Under Ground Dispersal ( ) Other AMOUNT PAID: 00 RECEIPT NUMBER ( ) Evapotranspiration ( ) Sand Filter ( ) Wastewater Pond .� DATE: NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER". (Environmental Health Dept. - Rev. 4/88) q !^ PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125.00 467 r OWNER: A /C LEGAL DESCRIPTION: V 0/ _ �J S �_ !'LPi1N G,.• Q ISDS APPLICATION NO. 3 -/ 9 `sas> - -,, 4 9 3 RURAL ADDRESS: TYPE OF DWELLING: ' NUMBER OF BEDROOMS: DATE OF PERCOLATION TEST: f TYPE OF SOIL: �'aR TEST HOLES PRE-SOAKED: YES NO TIME WATER DEPTH 1l\ INCHES OF FALL RATE 1 2 3 II 1 2 3 li 1 2 3 1 2 3 13 . C-? r� 1 3 r l , A;L � � _ �� ►� �P .5'ryiPl i0rr/� 3 ` , ® f . 16 �� I / �, rr + r oa ,r y 100.01 PERCOLATION RATE: RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: 5-:20S -, rdt 64 ;s i rrs RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:��� SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. COMM eX Rev. 5/31/84 MEMORANDUM DATE: May 15, 1990 TO: ISDS file #971 FROM: R.P. Merry3A'c RE: Sizing and permitting of septic on 0559 Lake Creek Rd. Richard Nelson (Chupa) originally received ISDS permit #938 issued on 8/29/89. This permit was issued assuming an engineered system requirement due to the original location of the septic system. The applicant called on 5/7/90 requesting a change in the system as he decided to move the location of his absorption field to a plateau at a higher elevation. He requested a percolation test be performed on the property to determine appropriate sizing of the system. The application indicated 2 bedrooms and the system was sized accordingly. On 5/15/90 Sam Yantzer of Nelson-Zeeb Construction called and indicated they wished to size the system larger as the applicant had future plans of adding an additional dwelling. He stated that the applicant wished to add a 3 bedroom unit to the system. Therefore, a modificaiton was made to permit #971 indicating a size able to accomodate 5 bedrooms total. A 1500 gallon tank and 440' of 10" SB2 piping. Permit # 938 was voided. EAGLE COUNTY BUILDING DIVISION P. O. Box 179 Phone: 328-7311 INSPECTION REQUEST S S !7� I BUILDING PERMIT NO. DATE: JOB TME^�i4 �l NAME: c GC r C! . RIECEIVED: �( ' PM' CALLER: (S 9io Cl7 OTHER: LOCATION: j� 1 C., /�iti(� ❑ PARTIAL Ready for Inspection: ❑ MONDAY ❑ TUESDAY ❑ WEDNESDAY ❑ THURSDAY AP--F'RIDAY ❑ AM C ,PM COMMENTS: ��✓l.l, Gip �,��a/ (L, ' APPROVED DISAPPROVED F-1 REINSPECT ❑ Upon the Following Corrections: DATE: TIME: O �l INDIVIDUAL 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. Please call for final inspection before covering any portion of installed system. OWNER: Richard A. Nelson PHONE: 949-5152 MAILING ADDRESS: Drawer 5400, Avon, CO 81620 AGENT: PHONE: SYSTEM LOCATION: 0559 Lake Creek Rd., Edwards, CO 81632 RMN Ranch Subdivision LICENSED INSTALLER: Owner LICENSE NO. DESIGN ENGINEER OF SYSTEM: INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: GALLON SEPTIC TANK OR GALLON AERAZFET ATM T NIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED SQUARTREN B OM. SPECIAL REQUIREMENTS: G ENVIRONMENTAL HEALTH OFFICER: DATE: - 6e-_Z __6 1 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. INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET. INSTALLED SEPTIC TANK: GALLONS DEGREES FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS ANDASSEMBLY YES NO COMPLIANCE WITH COUNTY/STATE 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 OFFICER: DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: 5tNl tY.xerox ieiecop.ar 'lulu ; n-ie-tly $;lU NelsonlZeeb Const, COUNTY MANAGER # 2 r WRJ-s.RGY. 76 COLORADO DIVISION OF WAFER RESOURCES r 818 Centannisll Bldg.,1313 Sherman St., Denver, Colorado SO= JUL 17 r ',PERMIT F R Application must �+ APPLICAttON O M � be complete whereIRECENED. (X ) A PERMIT TO USE GROUND ` applicable. Type or print In BLACK ( JUN 2 9 isOR: ( ) A PERMIT TO CONSTRUCT A ) A PERMIT TO INSTALL A PU MN � - W.Y I N K- No overstrikes ar wares unless x�' ( ) REPLACEMENT FOR NO. i 0011 P.M initialed. (IIm. ( ) OTHER WATER COURT CASE NO. ,017 CKQUE 60. Q, ng NAME Richard A. Nelson STREET P.D. Box 355 CITY Edwards - Colorado 11632 (Stem) (Zio) TELEPHONE NO. (303) 949-5152 County Eagl e '- SE X of the 5E b, Section 5 Twp. 5 , Ping. 82 JL' .Alu P.M. (N.9) (!.W) (3) WATER USEAN12.WELL DATA \. Proposed maximum pumping rate (gpm) 15 `k Average annual amount of ground water to be appropriated (acre -feat):_ 1 Number of acres to be irrigated: U Proposed total depth (feet). 100 Aquifer ground water is to be obtained from: BOULDERS AND GRAVEL Owner's wal I designation QRQWNNQ WATER TO IF USED FOR: `t X) HOUSEHOLD USE ONLY DOMESTIC (1) ( ) LIVESTOCK (2) ( ) COMMERCIAL (4) ) OTHER (9) no irrigation (0) ( } INDUSTRIAL (5) ( ) IRRIGATION (6) ( } MUNICIPAL (8) DETAIL THE USE ON BACK IN (111 Name GOLDEN EAGLE DRILLING Street 675 TEN MILE DRIVE City— FRISCO Cotatate) z 1p Telephone No. 668-3564 Lic. No. 1095 FOR OFFICE USE ONLY: MUNOT jf)((jIT 1 ITHIS COLUMN 17 -i 11��1rr172 Receipt -No. - / This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of the permit does not assure the applicant Sug vk: a that no injury' will occur to another vested water A ub right or preclude another owner, of a vested water ty" . a civil court action. 09 OF USE AND LEGAL !._153491. ISSUANCE OF CBS 39-92-W2(3 �)�II)- A RESYDRNTIAL S T8 r TATZ IONNOFTHE SW �BAND gBR1, ALL W OFLN WARLY DESCRIBED ON 1 0 INNAARY WuSEHOLD FAMILY DWELLING AND i' S NONCOMMERCIAL 'ROUND WATER 8 OTHER PUF?0 ESL NOT W92 RETURN FLOW FROM THE USR of THIS WELL BE THRU AN INDIVIDUAL WASTE WATER DISPOSAL WATETEM OF THE DTSZSSTHE RR IS O �AME STREAM SYSTEM IN WHICH THE WELL IS LOCATED. COS APPLICATION APPROVE PERMIT NUmsgn DATE ISSUED JUL 31 IND EXPI RATI O DATE JUL 311991 . A-44J464-o 1. BY TAT �tiv i� wpv �,erox 1 e i ecopier ruEu n— i ty—C;l y � 1 � iv8 I SOii/Lei:l) CiDi1SL, -� �(5) THE LOCATION OF' THE PROPOSED WELL and the area on w ich the water will be used ;must be indicated on the diagram below, Use the CENTER SECTION'(i section, 640 acres) for the wail location. + — --� - - -{- _ + -4- — 4- — -+ — -j- -- -- - I it t MILE, 5380 FEET NORT34 SICTION LINE I +Nar4TH+ _ i 4— —� +- 4-3 4- — + - � 1 - I I 1 ~W f"pry 4. V,7 Luec — } — 7 -�` + I I i — The seale'of the diagram Is 2 inches - f mile Each small souare represents 40 acres. • . WATER EQUIVALENTS TABLE 1Rounded Figural An acre-foot covers 1 acre of land 1 foot deep t cubic foot per second (cfs).. , , 449 gallons par minute (ppml A family of 5 will rmu)ra approximately 1 rife -foot of Wolff per year. 1 acts -foot ... 43.560 cubic feet ... 325,900 gallons. 1.0W opm humped continuously for one dey produces 4.42 acre-feet. WUN I Y MANAUtK i; M � (6) THE WELL MM BE 66ATIib BELO by distances from seotion lines. ~ I,�. 5Q ft; tom SOUTH sec. line . • • tit or south) • son ft• f rn sec. line (east at wait) LOT_BLOCK _ FILING ` SUBDIVISION ' RMN SUBDIVISION (7) TB,ACT ON WH CH WELL WILL BE LOCATE D Owner: Richard A. Nelson No. of acres-- 24.58 . Will this be the only well on this tract? YES (8) PROPOSED CASING PROGRAM Plain Casing 7 in. from 0 ft, to 30 ft. 5ln. from 30 ft. to 100 ft, Perforated casing ,.,,._..,.e..In. from—ft. to ft. In. from —ft. to R. (9) FOR REPLACEMENT WELLSgivedistance and direction from old well and plans for plugging It; (10) LAND ON WHICH GROUND AAIIR WILL BE USED: Owners): RICHARD A. Nr SON No, of acres: 24.58 Legal description: PARCEL B - RMN RANCH ' 01) Dl+TA1Ll=D DESCRIPTIOi'd of the use of ground water: Household use and domestic wells must indicate type of disposal system to be used. HOUSEHOLD ONLY SEPTIC LEACH SYSTEM (12) OTHER WATER RIGHTS used on this iantl, including wells. Give Registration and Water Court Case Numbers. Type or right Used for (purposel Description of land on which used (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS T 7P-IME -PEST OF HIS KNOWLEDGE. SiONATURE OF APPLICANVS) Use additional shoots of paper if more space is required. JOB NA' 971 Richard Nelson 0559 Lake Creek Road ci Kk- artLK- )?og a-f-,- s 4013 ma JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED ,>A a ct X4 J U 6 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 JOB FOLDER printed in U.S.A. FA- s L" \ \ _ 29 - \ \ \ \ \ \ \ \ \ y \ \ CENTER LINE OF DITCH \ \ \ - -- - - - - - - - `'`----'- �'4 EDGE OF LAKE E E K SITE PLAN RECEIVED AUG 14 1999 EAGLE COUNTY COMMUNITY DEVELOPMENT • z Z UJI 0 z z c� LW Date June 1, 1989 Revisions 3=1