HomeMy WebLinkAboutAurora Claim Patent 15750 - 22012330001211
ISDS Permit #
Building Permit #
ON FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
VIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8730/927-3823(Basalt)
FEE $150.00 PERCOLATION TEST FEE $125.00
PROPERTY OWNER:
MAILING ADDRESS: 999 N. Lake Shore Dr., Chicago,°IL PHONE: (312) 787-5024
_
APPLICANT/CO60611 _
NTACT PERSON: Tim. Rosen - _;ONE: (303) 949-7771
LICENSED SYSTEMS CONTRACTOR: Vail Valley Plumbing & Heating, Inc y(p
ADDRESS: p,0, Box 2048 Avon CO 81620 PHONE: (303) 949-7771
********xx*x*1*
PERMIT APPLICATION IS FOR: (X) NEW INSTALLATION { ) ALTERATION { ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: Aurora Claim; Patent #15750
Parcel Number: Lot size:
Physical Address:(Upper Turquoise Lake)
BUILDING TYPE: - •- (Check applicable category) Primitive Cabin
( ) Residential / Single Family Number of Bedrooms
( ) Residential / Multi -Family* Number of Bedrooms
( ) Commercial / Industrial*
HOT TUB Type
WATER CONSERVATION PLAN: Yes ( )• No X
TYPE OF WATER SUPPLY. noneYes ( ) No (X)_ _
_ Well
--. ( .} -spring-( ) Surface ( .)
Public ( ) Name of Supplier: n/a
Give depth of all wells within 200 feet of system: n a
*These systems require design by a Registered Professional Engineer
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
s
SIGNATURE: V_ fL�
AMOUNT• PAID:RECEIPT#
CHECK #�-�,�_
TIME LOG
Travel Perc Final
I
DATE: 10/4/91
DATE:
CASHIER: ��
1113
3
l�
VN
J
M
41
