HomeMy WebLinkAbout690 Eagle Crest Rd - 210518301004 - IS-1001-90INDIVIDUAL 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. 1001
Please call for final inspection before covering any portion of installed system.
OWNER: Patricia Dorf/Dor Worth Construction PHONE: 926-3907
MAILING ADDRESS: PO Box One Edwards CO 81632
AGENT: owner
PHONE:
SYSTEM LOCATION: Lot 26 Block 6 Lake Creek Meadows
LICENSED INSTALLER: LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 986 SQUARE FEET OF TRENCH BOTTOM, 300 1 f of 10" S132 or 200 If of
infiltrator system (32 Units) per owners request.
SPECIAL REQUIREMENTS:
Place inspection portals at end of each line.
ENVIRONMENTAL HEALTH OFFICER: �'" 7�` < DATE: i
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: (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.
INSTALLED ABSORPTION OR DISPERSAL AREA: S(AMRE FEET. fo S L
INSTALLED SEPTIC TANK: CL S� GALLONS DEGREES FEET —40 i/ 1 -1','-3-
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 OFFICER: `�`
- / DATE:
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT k: CHECK N: CASHIER:
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number:
P . 0. BOX 179
j EAGLE, COLORADO 81631
949-5257 Vail 328-7311 Eagle 927-3823 Basalt
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00
NAME OF OWNER: Po fiti C' /'1 o i
MAILING ADDRESS: &C))( Cfie 3. PHONE: '?2 -7
NAME OF APPLICANT (If different from owner):
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTEM (If applicable):
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: r ATUC101
LICENSED INSTALLER: ( ) YES ( ) NO ,J
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: ( NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address: C � /"&-n 0 6 w �
Parcel Number: Lot Size: Z, 797 19c"12.el
Legal Description: A3OUc--
BUILDING OR SERVICE TYPE (Check applicable category):
Residential - Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residentia - Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS:
WASTE TYPES Check applicable categories
( )
Commercial or Institutional Dwelling
Non -Domestic Wastes - ( )Transient Use
( ) Garbage Disposal ( 'Dishwasher
( vy 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 ( 1r N0
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: (>✓j YES ( ) NO:
WATER CONSERVATION PLAN: ( ) YES ( z-)-NO
NOTE: The Environmental Health Office may reduce the required absorption area upon
approval of an adequate water conservation plan.
SOURCE AND TYPE ATER SUPPLY: ( ) Well ( ) Spring ( ) Creek/Stream
Give,,depth of a 1 w s within 200 feet of system:
If s by u i y wa er, give name of supplier: �/. - 09- -
SIGNATURE: DATE:
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent ground slope Z 3
Depth to Bedrock (Per 8' profile hole) /9 r
Depth to Groundwater table T 8
SOIL PERCOLATION TEST RESULTS: 10 Minutes per inch in Hole #1
cS Minutes per inch in Hole #2
7-,0 Minutes per inch in Hole #3
FINAL DISPOSAL BY:
Absorption renc Bed or Pit
( ) Above Ground Dispersal
( ) Under Ground Dispersal
( ) Other a
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:
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328-7311
Date: August 22, 1990
Dor Worth Construction
P.O. Box One
Edwards,CO 81632
Re: Final of ISDS Permit No. 1001
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,
li��e ��' ez-T-
Roger C. Hosea
Assitant Environmental Health Officer
Community Development
Enclosures: Informational Sheets
Final ISDS Permit
cc: Chrono file
ISDS file#
Building Permit 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
I
I S D S PST #
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER:
LEGAL DESCRIPTION: p° Lg✓lP
MAILING ADDRESS: 0,
TYPE OF DWELLING: NUMBER OF BEDROOMS
TEST HOLES PRE-SOAKED: YES NO
TTME WATER nrpTH TMe1T-TVQ f1T; VAT.T. DnTor Cr1TT nnn%'TT V
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Time to drop last inch 1tg, t� _Z p
PERC RATE: 30 /t'! rzZ - MINIMUM SEPTIC TANK SIZE:
MINIMUMLEACH FIELD SIZE: C26 -rT �
COMMENTS:
aa^^ p
PERC TEST DONE BY:
ronmentai Health Officer
rev. 6/90ks
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
6r/ U& ��r
Nam , kC- Creek. S3
D to Routed D 4 26 llC zP Application No.
Location ,p� �`f/7
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 - AYES 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 -
COMMENTS:
ES NO REVIEWED BY DATE
YES NO
Roads:
Grading:
Drainage:
Recommend Approval:
ENVIRONMENTAL HEALTH: Complies with -
Floodplain Permit Necessary:
REVIEWED BY DATE
YES NO REVIE14ED BY DATE
I.S.D.S. Regs. Compliance:
Recommend Approval:
COMMENTS : ✓//�a'`j f7�//�� IJo✓/�/�iJ y S.Ce
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JOB NAME,
=At
JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
PERMIT # 1001
OWNER: Dor-Worth Construction
LOCATION: Lot 26, Block 6, Lake Creek Meadows
INSTALLER: Paul Long
SIZE OF TANK: 1250 gallons
DWELLING: 4 bedrooms
PERC RATE: 30 MPI
ABSORPTION AREA: 986 sq.ft.
FINALIZED: 8-15-90 BY: Roger Hosea
BUILDING PERMIT # 4419
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
..i ,h O 4 rDER Printed in U.S.A.
