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HomeMy WebLinkAbout1680 Sunset Ln - 239128402002 - 1178-92ISINDIVIDUAL 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. 11 M, Please call for final inspection before covering any portion of installed system. OWNER: Sarah Goddard PHONE: 963-9165 MAILING ADDRESS: 1680 Sunset Lane AGENT: PHONE: SYSTEMLOCATION: 1680 Sunset Lane, Carbondale, CO 81623 LICENSED INSTALLER: StUtsuion Cerba8 LICENSE NO-4 DESIGN ENGINEER OF SYSTEM: 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 477 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 11 infi1trat8r t,pits; ip trenches or 160 ft SR2 in trenches Install inspection portals at end of each trench 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 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: T 7 7 SQUARE FEET. /� INSTALLED SEPTIC TANK: i �v GALLONS DEGREES / FEET orq UL&r? SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS ANDASSEMBLY V YES NO COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: 1/ 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: �(i DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANTIAGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: Incomplete Appiicatlons Will NOT Be Accepted (Site Plan MUST be attached) ISDS Permit ## ` 7� Building Permit APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P. b. BOX 179 EAGLE, CO 81631 �l 328-8755/927-3823 (Basalt) "2 :+::�yC�:��****Nc**yc:k�It�cyc****YcyC**:�***:��k*:evc�cycyc�4c:kicyr:�yc***�*:k:��Cvc:F�cYlyt*vtycYcycyc9c*yeyc:cycyc�k�r�+c PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $.�&p MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" *�***�tYcyc�ycYcycytycyc*yc�cytycYCYcyt�Yryc*yc�:c*Y[hycYCYCYcycyc*:Fyt*�c�cyc;cyc7rycyrycyc*Yc�ryevcycyc��YtycycYcYc�c***ycyc* PROPERTY OWNER: 54 Q VA O�OZ04.,R MAILING ADDRESS: 1 &.60 T �k,-3E PHONE: q6 - 10 APPLICANT/CONTACT PERSON: tgc.L i�r�y PHONE: a(v3-3 Cc%aG AL. r^Vt7—i fi $f��� LICENSED SYSTEMS CONTRACTOR: 4-r T-jAL6 PHONE: q aJ-J]Z3j S*z^M Gex-ba-�.. =nc . COMPANY/DBA: "mot Z ADDRESS: PERMIT APPLICATION IS FOR: (1✓) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Legal Description: S®��P6E�� SV�i�a��-51t�i.3 �oLi�1G 2 Lei" Eae.LE V Tax Parcel Number: �Qi� Lot Size: SACS-- Physical Address: itog® 5uv.3 5� � L Ay J.4E .�SZ Uf la7$� �® 61&23 BUILDING TYPE: (Check applicable category) ( 1 Residential/Single Family Number of Bedrooms ( ) Residential/Multi-Family* Number of Bedrooms ( } Commercial/Industrial* Type TYPE OF WATER SUPPLY: (Check applicable category) ( V) Well ( ) Spring ( ) surface ( ) Public Name of Supplier: *These systems requil de ign by a Registered Professional Engineer SIGNATURE: / Date: 7-'j3 -92 yc rr yc Yc Yc vc yc *p*. Yc Yc :k yc * �c Yc yt �k Yt �k Yc �C Yc Yc yt Y[ Y[ yf Yr Yr �t * * Yc Yc Yc Yc Yc �c �c :k AMOUNT PAID: Oy RE PT DATE: 7 %lv h2 CHECK p'? L CASHIER: TIME LOG: TRAVEL: PERC: FINAL: 1JUJ rCKrll I PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER: LEGAL DESCRIPTION: )Le S,c,nSe�' (U12-1 MAILING ADDRESS: TYPE OF DWELLING: NUMBER OF BEDROOMS TEST HOLES PRE-SOAKED: YES NO TIME wArnvn "T r%Mr 1 2 3 1 -'-- 2 3 iart.11GJ yr 1 2 rHLL 3 RATE SOIL PROF 1 2 p' j a c ., , `( • �5 •5 , a �. , 7 7 a.5 1� 21 wh a,31 L5.�5 1,a l.?5 14 o?.? as3.3 41 25 : Z& .'27 ,� Ilo. c�6 9.5 1 /./a 1.37 ,g 9 �, 7 �, � 7 33 5� 6 , '� 3i '3Z -7' � D )8.aS r /• t �5 . 75 .875 •75 .75 �. 5 .7 .7 3. 9D 9� 5Z) :910 3 -'17 .'52 ,it jr- b /6 19.0 �i (�o.5a -q.s . 75 -75 • 5a • 7� l7 • D &zi75 2. a 6, 7 1.5 /� / � o g , 7 �.� . a� 8 , � 5, Time to drop last inch PERC RATE: LI,S 2 MINIMUM SEPTIC TANK SIZE:_ c MINIMUM LEACH FIELD SIZE: COMMENTS: �`� / I1 d . � �-� i n �.� n A L, . � �-, i . A , i qr A— � • PERC TEST DONE BY: 1-4 - Environmental Heal rev. 6/90ks Officer g00 —y77 z S DATE: - - oQ I -- 9 a--olh Cry J-& D`ac-C 319 9a3-1 �' 1118G0p,0or�aVtn8o 3w�s�- (,ane� JOB NAME J _ JOB NO. I Ill BILL TO DATE STARTED DATE COMPLETED DATE BILLED Q4 JOB COST SUMMARY tI TOTAL SELLING P11�111(11'1�� ®■ TOTAL MATERIAL 01 _ ,Al W2 • Mll =•_ -■ W. I M9111111F • -■ MISC. COSTS •• ' ( NOW TOTAL JOB COST! _■ GROSS PROFIT LESS OVERHEAD COSTS OF _■ JOB FOLDER Product 277 � p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Y Printed in UI IODC�© t ,� 5MAV�) M P 0c) Pi Cie