HomeMy WebLinkAbout143 Lariat Loop - 210505402002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631 Telephone:328.7311 or949-5257 or 927.3823 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1030 Please call for final inspection before covering any portion of installed system. (303) OWNER: Sohn and Kelly Lannan PHONE: 926-2152 MAILING ADDRESS: P.O. BOX 668, Edwards, CO 81632 AGENT: PHONE: SYSTEM LOCATION: 0143 Lariat Loop, S-40 Subdivision (Lot R-9) LICENSED INSTALLER: LICENSE NO. DESIGN ENGINEER OFSYSTEM' INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: 1 - 250 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED 1,138 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 380 Lineal Feet Of 10" SB2 or 231.25 Lineal Ft. (37 Units) of infiltrator. Place inspection portals at end of each line. ENVIRONMENTAL HEALTH OFFICER: DATE: 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 SEA VIOLATION OF A REQUIREMENT OF THE PERMIT AND CAUSE FOR BOTH LEGAL ACTION AND REVOCATION OF THE PERMIT. 3. SECTION /A 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 INSPECTORk 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: �xY l t//'j��l l2 SQUARE F(E^ET'J. 38a` 0iS&a. INSTALLED SEPTIC TANK: � GALLONgF Q DE S _S� FEET �� SEPTIC TANK CLEANOUT TO WITHIN B" OF FINAL GRADE, OR: PROPER MATERIALS AND ASSEMBLY —X YES NO COMPLIANCEWITH 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 OWNER: AMOUNT PAID: RECEIPT C CHECK M: CASHIER: 26,4 e4- 4g04 0 Permit # )D�,� APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 7-IT ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY P.O. BOX 179 EAGLE, CO 81631 328-8730/927-3823(Basalt) PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00 NAME OF OWNER: c/(tfn/ R 441V/J47V '4Avo /-ZG �' � L. /it/A� MAILING ADDRESS: 96- &k &&e �G✓��S a PHONE: '�Z- ZiSZ NAME OF APPLICANT (If different from owner): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: /J �l�/�%n%�DiII pozC� _ ADDRESS: PHONE: PERMIT APPLICATION IS FOR: ) NEW INSTALLATION ( ) ALTERATION ( ) R LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: L07 S- D SUBOidiSlai:f O/i/3 Gu Parcel Number:a�(�S -pa-pp Lot size: Legal Description: BUILDING OR SERVICE TYPE: (Check applicable category) ('?C) Residential. / Single Family - - ( ) Residential / Multi -Family ( ) Commercial / Indust ial NUMBER OF PERSONS: ` �% NUMBER OF BEDROOMS:_ SPA TUB Yes ( ) No ( ) WATER CONSERVATION PLAN: Yes ( ) No ( ) SOURCE Aft TYPE OF WATER SUPPLY: Well( ) Spring (.) Creek/Stream ( ) Give depth of all wells within 200 feet of system: If supplied by community water, give name of supplier: /E / SIGNATURE: �`t \�C�r� DATE: :r:r:r�x*vxww,r,F*�*��� �xw**� war,rrr*�yrre*rryryr�w:r*rrr�v�witrer*x�rrxw'�rx9rrr���� �:ex:�r��rx* 2CD AMOUNT PAID: G�7 �� RECEIPT# J/✓ T,✓ DATE: a - CHECK # Q K'j%D -CASHIER: TIME LOG Travel Perc Final e© 60 NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" Application # & 3<�, I PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER: J 674k, d- LEGAL DESCRIPTI6N: S- 1-1a, MAILING ADDRESS: TYPE OF DWELLING: S NUMBER OF BEDROOMS ,r*rr�t�,r�x,��rrr,r�x:r,rrr r�:rrrrr**x,r,rrr,rrrrrx*�r�r,r,r,r ��r TEST HOLES PRE-SOAKED: YES NO TIME WATFR nrpTN TTiei nV FDTT DTTC cnTT nnnz TTL 1 2 3 1 2 3 1 2 3 1 1 2 0' ;15 '16 'l7 Si 9 la 1 ��•I 01 : LZ � i I O %y %y �— Za 20 2 �s :� :z7 9i 9 /z . 10 i %y �j yy zo zo I'fa 3' 3 o 3" . j7- H 1Vz_ y 3/y 10 %Z %l �y Viz/ 2- w Z� 4 , <Y '36 j7 y%z lD l03/y / y �y — 2 Z6 61 `30 ; ( ;5 Z I.0 l d %� it %H % /t� I/y 2-0 zd Cl 8 zo Za 00 of P (° 10;/� Time to drop last inch 1{d 36 3� ,�T PERC RATE: 140 MINIMUM SEPTIC TANK SIZE: /2 S&I MINIMUM LEACH FIELD SIZE: j/38Z yr COMMENTS: 3f{O /l 7Qa� of 10 r, 5/�y 01z Z �- -� PER/JC� TEST �D/ONE BY: �i, 402*CG_ DATE: Envdronmegtal Health Officer rev. 6/90ks liar Lor on�wix4 a LI.t/.fN , Fi O D r C— O co 0 W x O A r O D m m 0 0 3 r r m r m 0 I V L. cu Z O O O N 0 m 0 6 m s 9 F D -I m r r N .� o 0 D -I m 0 v m Q O 3 -o r q m v m m o Z umi oN mm Q D r cN� on fA can � ccn -y1 X C Z m O -I r al(n OAnna..v r D m ID- 0 r" r- r �— O n 0 o m;u zrm D ou �N mu) N -o M o L W n N Z � N N 3 D A D D i z Z D rn .a` w w0 r r '�O o w F- rt n F'• H II rrt Ind n t-' 0 o Fl o 'd N v O U] In 4-- O O In c G O C N • I O O N