HomeMy WebLinkAboutBlk 2, Lot 3,4 - 219724307003INDIVIDUAL 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. 1 O 46- Please call for final inspection before covering any portion of installed system. OWNER: John Lutke PHONE: 616-895-4493 MAILING ADDRESS: 8365 -Warner, West Olive MI 49460 AGENT: PHONE: SYSTEM LOCATION: Lots 3 & 4 Fulford, Block 2 LICENSED INSTALLER: LICENSE NO. DESIGN ENGINEER OF SYSTEM• INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Vault privy required due to lot size need licensed installer. 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 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 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: ISDS Permit # V Building Permit # APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY P.O. BOX 179 EAGLE, CO 81631 3��730/927-3823(Basalt) PERMIT APPLICATION FEE V $150.0 PERCOLATION TEST FEE $125.00 �r�r,fr�r��c�r��r�rsr�r�r�t�rsr�r�t��vrit�rrr�rsr�r�r�r�r�r�c�r�r�r�r�r�r�r�c�r��r�r�r PROPERTY OWNER: MAILING ADDRESS APPLICANT/CONTA LICENSED SYSTEMS CONTRACTOR: ADDRESS: PHONE: PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIV L SEWAGE �j SPOSAL SYSTEM* Legal Description: ,b��C���G�-Qj Parcel Number: Lot size: Physical Address: BUILDING TYPE: - - (Check applicable category) ( Residential / Single Family Number of Bedrooms ( ) Residential ./ Multi -Family* Number of Bedrooms ( ) Commercial / Industrial* Type HOT TUB Yes ( ). No WATER CONSERVATION PLAN: Yes ( ) No ( ) TYPE OF WATER SUPPLY: Well( •Spring ( ) surface ) Public Name of Supplier: Give depth of all wells within OO feet of system: *These systems require design by a Registered Professional Engineer NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION MAKE ALL REMITTANCE PAYABLE TO: "EP,6GLE COUNTY TREASURER" r SIGNATI7RE : DATE AMOUNT PAID: 1,� RECEIPT# DATE: CHECK # CASHIER: TIME LOG Travel Perc Final - COMMUNITY DEVELOPMENT DEPARTMENT (303) 328.8730 EAGLE COUNTY, COLORADO May 3, 1991 John Lutke 8365 Warner West Olive, MI 49460 725 CHAMBERS AVE. P.O. BOX 179 EAGLE, COLORADO 81631 FAX (303) 328.7207 RE: Issuance of Individual Sewage Disposal System Permit No. 1046 Enclosed is your ISDS Permit No. 1046. The enclosed copy of the permit must be posted at the installation site. You must call our office for final inspection before covering any portion of the installed system; the deadline for final inspections is December 1. If you have any questions, please feel free to contact us at the following numbers for your calling area: Basalt/El Jebel 927-3823 ext. 730; Eagle Valley 328-8730. Sincerely, Roger Hosea Asst. Environmental Health Officer community Development cc: ISDS file. encl. RH/alm DESIGN STANDARDS VAULTS A vault shall have a minimum 1,000 gallon effective capacity and may be permitted under limited use occupancy for water carriage sewage systems on property which cannot accommodate a sewage treatment system. A signal device shall be installed to indicate when pumping is necessary. Vaults shall meet the .same installation and construction standards as apply to septic tanks except that no effluent outlet shall be provided. VAULT PRIVY A vault privy shall be built to include: 1) Fly -tight construction; 2) A superstructure affording complete privacy; 3) An earth mound around the top of the vault and below floor level which slopes downward away from the superstructure base; 4) A floor and riser of concrete or other impervious material; and 5) Seats and covers of easily cleanable, impervious material, hinged, self -closing and fly -proof. All venting shall be fly -proofed with No. 16 or tighter mesh screening. Effective capacity of the vault shall be no less than 400 gallons. Q. Cr (D ►-b < (D D W Ul W ►'• c+ (D c+ •y ;3 c+ p t:r )-i UQ P- c+ O Ul :3 In vQ 90 C (D o�z a YO �r C+ N•rx(D o• •• a .. mb o� °� `K° a. K C+ O K 0 c O a K 0"4 O Z' 0 N (D C O K (C O n R t+ • O (D (D c+ G sv c+ pi O O t� e= N, O r ►;, < (D J K (D N- Y O QC (D C )l ;z O tv K' G O (D Y YK n O Ul c+ cr,C) 0 O O N -d HOC Ill Ul 0 (D (D (D a r• O O \ sv K p O•GO (D C = Y (D CD C+ (D tD fD CJ �-h Ul O.. K ►�- r� O t a, O ►�•YO K ct• N K n N- Y -Ar sv C 1-3 O S�. G Y• U, c+ (D c+ (D (D It (D W P �i N 0 G Y• (D Y• Y- CJ ."S. r+ F+, N (D O P C+ '*J N G O �5 G -0 Ott p .. O• OlO (D O O G c+ 0 $ (CD Y• rf• 91 (D (D 4. O i Q. (D C c+ O tD (D '. O cG+ 0 0 O U; G .0 G O (D r+ c+ Y• O G u 1046-91 TxPrcl#2197-243-07-003 JOB NAME _ Lots 3 & 4, Block 2, Fulford John Lutke JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED '�s3� JOB COST SUMMARY lam' Ire v l �` fir , `y� r^ e�U o'✓ c� fAL SELLING PRICE AATERIAL _ LABOR _ (� Q9- SURANCE ALES TAX a� 1C. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT JOB FOLDER Product 278 ®O NEW ENGLAND BUSINESS SERVICE, INC.. GROTON, MAC Printed in U.S.A.