HomeMy WebLinkAboutBlk 21, Lot 3,4,5,6 - 219723401011INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631
Telephone: 328-8755
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1305
Please call for final inspection before covering any portion of installed system.
OWNER:Roger Yost PHONE: 328-1046
MAILINGADDRESS: P.O. BOX 734 city: Eagle state: CO ZIP: 81631
APPLICANT: same PHONE:
SYSTEM LOCATION: Lots 3 , 4 , 5 , 6, Block 21, Fulford TAX PARCEL NUMBER: 2197-234-01-011
LICENSED INSTALLER: N/A LICENSE NO:
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
750 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED N/A SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Install a 750 gallon septic tank/holding tank. Prior to backfilling fill tan
with water to prevent collapse. Maintain compartment lids within 8" of finished grade
.17
ENVIRONMENTAL HEALTH APPROVAL: DATE: J
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. 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. CHAPTER IV, SECTION 4.03.29 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM TO BE LICENSED.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMPLIANCE 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: N/A SQUARE FEET.
INSTALLED SEPTIC TANK: 1000 GALLON 45 DEGREES 14 FEETFROM NE Corner of north side of house
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY X YES NO
COMPLIANCE WITH COUNTY / STATE REQUIREMENTS: X YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED.
COMMENTS:
n
ENVIRONMENTAL HEALTH APPROVAL •I � DATE:
ENVIRONMENTAL HEALTH APPRO L: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT # CHECK A
ISDS Permit #
Building Permit # 6878
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8755/927-3823(Basalt)
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.0
PROPERTY OWNER:
MAILING ADDRESS:— P--D K 7? 4 SCE -"o B1C-�iPHONE • I®4�p
APPLICANT/CONTACT PERSON: V-DsE�R_ yOS^j' PHONE • 32..P.—104-(o
LICENSED SYSTEMS CONTRACTOR:
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: 'C>< NEW INSTALLATION ( ) ALTERATION ( ) REPAI
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: Lo ES 3 4 5
Parcel Number: i 1
Lot size: lB(°y X Epp
Physical Address: Utjr_Liowk_)
BUILDING TYPE: (Check applicable category)
Residential / Single Family Number of Bedrooms
( ) Residential / Multi -Family* Number of Bedrooms
( ) Commercial / Industrial* Type
TYPE OF WATER SUPPLY: Well( ) Spring ( ) Surface ( .)
Public ()4 Name of Supplier: ruLFol? o
*These systems require design by a Registered Professional Engineer �A�c�
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY. TREASURER"
SIGNATURE:
************
M1
DATE:
AMOUNT PAID:_ I�� RECEIPT# DATE: �;� �
CHECK # L CASHIER•
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328.8730
EAGLE COUNTY, COLORADO
May 1 2 . 1995
Roger Yost
P.O. Box 734
Eagle, Co 81631
725 CHAMBERS AVE.
P.O. BOX 179
EAGLE, COLORADO 81631
FAX (303) 328.7207
RE: Final of ISDS Permit No. 1305-95 Parcel #2197-234-01-011.
Property located at: Lots 3,4,5,6; Block 21, Fulford.
Dear Mr. Yost,
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. This permit does not indicate
compliance with any other Eagle County requirements. Also
enclosed is a brochure regarding the care of your septic system.
Be aware that later changes to your building may require
appropriate alterations of your septic system.
If you have any questions regarding this,permit, please contact
the Eagle County Environmental Health Division at 328-8755.
Sincerely,
Jeff Fedrizzi
Environmental Health Specialist
ENCL: Information Brochure
Final ISDS Permit
enclosures
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328.8730
DATE:
TO:
FROM:
EAGLE COUNTY, COLORADO
May 12, 1995
Roger Yost
Environmental Health Division
725 CHAMBERS AVE.
P.O. BOX 179
EAGLE. COLORADO 81631
FAX (303) 328.7207
RE: Issuance of Individual Sewage Disposal System
Permit No. 1305-95, Tax Parcel #2197-234-01-011
Property Location: Lots 3,4,5,6; Block 21,
Fulford.
Enclosed is your ISDS Permit No. 1305 is valid for 120 days. The
enclosed copy of the permit must be posted at the installation
site. Any changes in plans or specifications invalidates the
permit unless otherwise approved. Please call our office well in
advance for the final inspection.
Systems designed by a Registered Professional Engineer must be
certified by the Engineer indicating that the system was
installed as specified. Eagle County does not perform final
inspections on engineer designed systems.
Permit specifications are minimum requirements only, and should
be brought to the property owner's attention.
This permit does not indicate conformance with other Eagle County
requirements.
If you have any questions, please feel free to contact the
Environmental Health Division at 328-8755.
cc: files
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13.05-95 YOST
Lots 3,4,5,E Block 21
Fulford 2197-234-01-011
JOB NO.
BILL. TO
DATE. STARTED DATE COMPLETED DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
'TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 �® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 Printed in U.S.A.
J.OS FOLDER
