HomeMy WebLinkAbout30 Fiddler Creek Rd - 247902200027INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, CO 81631
Telephone: (970) 328-8755
COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 2216-02A BP NO.
OWNER: Sandra L. Nye PHONE: 719-486-2161
MAILING ADDRESS: P. 0. Box 1228 Edwards CO 81632
APPLICANT: Jim Wilson PHONE: 524-9524
SYSTEM LOCATION: 1154 Forest Service Rd.#731 TAX PARCEL NO.
LICENSED INSTALLER: Jim Wilson, AAAA Septic Pumping LICENSE NO. C28-02 PHONE: 524-9524
DESIGN ENGINEER: PHONE NO.
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: MINIMUM REQUIREMENTS FOR A 2 BEDROOM RESIDENCE
1000 GALLON TANK, SQUARE FEET OF ABSORPTION AREA CREDIT, VIA
SPECIAL INSTRUCTIONS: Old fiberglass tank will be pumped then removed. New tank to be installed in same location as original tank A detailed site plan is
required before final will be granted. L. C%Clii (� ,rl l�IrC�r% Z=1
ENVIRONMENTAL HEALTH APPROVAL4 J eLLg., t — o DATE: July 22, 2002
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 WILL RESULT IN 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: SQUARE FEET (VIA )
INSTALLED CONCRETE SEPTIC TANK: 1000 GALLONS IS LOCATED 27070 DEGREES AND 6_ FEET INCHES
FROM THE CORNER OF FNTRV TNTO THE TTnTTCF
COMMENTS: THE FINAL INSPECTION WAS DONE BY RAYMOND P MFRRY nF FAnu F rOIINTy-pNVTRLINMENTAT
HEALTH ON JULY 23, 2002. THIS TANK IS LARGE ENOUGH FOR S RFDRnnmg
ANY ITEM NOT MEETING REQUIREMENTS WILL BE CORRECTED BER IN A� OF'SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS
COMPLETED. /
ENVIRONMENTAL HEALTH APPROVAL "� DATE: JULY 25, 2002
OF
Incomplete Applications Will NOT Be Accepted
(Site Plan MUST be attached)
ISDS Permit # dj q I(, a'
Building Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. 0. BOX 179
EAGLE, CO 81631
Eagle (970) 328-8755, Fax (970) 328-0349, El Jebel (970) 927-3823
****************************************************************************
* FEE SCHEDULE
* APPLICATION FEE $350.00
* THIS FEE INCLUDES THE ISDS PERMIT, SITE EVALUATION (PERCOLATION TEST,
* SOIL PROFILE OBSERVATION) AND FINAL INSPECTION
* ADDITIONAL FEES MAY BE CHARGED IF A REINSPECTION IS NECESSARY, OR A
* PRE -CONSTRUCTION SITE VISIT OR CONSULTATION IS NEEDED
* REINSPECTION FEE $47.00, PRE -CONSTRUCTION SITE VISIT FEE $85.00
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
PROPERTY OWNER: cl i-4 !/�, �
MAILING ADDRESS: '� � I RpZA PHONE: _
APPLICANT/CONTACT PERSON: if`►- V 1L i `Sf?y\ PHONE:
LICENSED SYSTEMS CONTRACTOR: k/ / L11 (Ic) l [SU PHONE:
y
COMPANY/DBA: km& ADDRESS: 2 % �?g
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION ( REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPO/SjAL SYSTEM:`
Legal Description: 0
/
tG ^F%
Tax Parcel Number:
Physical Address: / 1 59 / Clmyrfsj1,Ut�
BUILDING TYPE: (Check applicable category)
Residential/Single Family
Residential/Multi-Family*
( ) Commercial/Industrial*
Lot Size:
7 3
Number
Number
Type _
T--Lr14.
of Bedrooms �?
of Bedrooms
*These systems require design by a Registered Professional Engineer
TYPE OF WATER SUPPLY: (Check applicable category) /Upo ct,
( Well ( ) Spring ( ) Surface
( ) Public Name of pplier:
APPLICANT SIGNATU Date: ;ZOIZ-0
AMOUNT PAID: �5c� �-� RECEIPT #: 01� 3 rq DATE: -7192- 10 z
CHECK #: CASHIER: -—
DEPARTMENT OF
ENVIRONMENTAL HEALTH
(970)328-8755
FAX (970) 328-8788
TDD: (970) 328-8797
TOLL FREE: 800-225-8136
www.eagle-county.com
EAGLE COUNTY, COLORADO
July 25, 2002
Raymond P. Merry, REHS
Director
Sandra Nye
P.O. Box 1228
Edwards, CO 81632
RE: Final of ISDS. Alteration Permit #2216A-02. Property location: 1154 Forest
Service Rd #731, Eagle County, CO.
Dear Ms. Nye:
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 (970) 328-8755.
Sincerely,
I
Janet Kohl
Eagle County Environmental Health Department
ENCL: Informational Brochure
Final ISDS Permit
cc: files
OLD COURTHOUSE BUILDING, 551 Broadway, P.O. Box 179, Eagle, Colorado 81631-0179
DATE: July 22, 2002
TO: AAAA Septic Pumping
FROM: Environmental Health Division
RE: Issuance of Individual Sewage Disposal System Alteration Permit #2216A-02.
Property Location: 1154 Forest Service Rd. #731, Eagle County, CO., Nye
residence.
Enclosed is your ISDS Alteration Permit #2216A-02. It 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. If you have not been contracted to install
this system please contact Eagle County Environmental Health.
Also enclosed is the ISDS Final Inspection Completeness Form. The items on this form need
to be completed before you call for your final inspection. Also, please note any special
conditions which may have been placed on the permit. Do not back fill any part of the
installation until it has been inspected. If all items are not completed, a reinspection fee of
$47.00 must be paid before a reinspection is made.
Please call our office well in advance to allow for scheduling of final inspection. Your building
permit TCO will not be issued until final approval has been given for the ISDS Permit.
Permit specifications are minimum requirements only, and should be brought to the property
owner's attention.
This permit does not indicate conformance with other Eagle County requirements.
If you have any questions, please feel free to contact the Environmental Health Division at 328-
8755.
cc: files
Enclosures: ISDS Permit # 2207-02; ISDS Final Inspection Completeness Form
Hope Lode t �: =��. roofed area
MS 18531 Utility Building i ISM. rT"
5:60 Acres
6
Apparent Access Easement ---� o
dirt roadway Q
well
/
se
/ deck
49 4' _
�/
[� . CIO house N' t
deck t t
' 1
1 t
❑
/ phone
i pedestal w
• o W
t
300.18'
I
�gall
�
8r
° Found W 1/4 Corner Section 2 Everfing Star
M8 5950
MS 7(
Found"Con
for Corner N
Q9
w
rA
0
It
MS 2443
(natpatmted)
I ; J�, I
Hope Lode
mom
ms 18531
ION
5.60 Ams
V
a.
Umk
ON
CA
C)
'g, houn
`�
�✓ ( z s
4
41
. I ' deck
Vi
_j
MS 16234
MS 16234
MS 7015
ISDS Permit # �v Date�a-
ISnS Final IngRect on
Cg=leteness Form
✓ Tank is MOO gal. Tank Material
_IZank is located ��ft. and oj70 degrees from Gayer o
(pstiswe l.oas�c) //
Tank is located ft. and degrees from
j
Tank set level. ✓ Tank lids within S" of finished grade. 3 r-Jss.-s m,. f
car
Size of field fts units lineal ft.
Technology W-SW e--�
/Vb Cleanout is installed in between tank and house(+ 1/100ft).
y There is a "T" that goes down 14 inches in the inlet and
outlet of the tank.
✓Inlet. and outlet is sealed with tar•-.tapei rubber gasket etc.
-'Fisk Yeas t*o=c►partments with the la gar-..,cQpartmeat closest to the ...;,,
house. /
_ msa$ure, distance and relative Sze
Dopth of field. - ft.
Soul interface raked. 11-..4.1W
IVO_ Inspection portals at the.end of each trench._
roper distance to setbacks.
Chambers properly installed as per manufacturer$ specifications.
(Chambers latched, end plates properly installed, rocks 'removed from
trenches, etc.) Type of pipe used for building sewer line.= • leach field
her -
Inspection meats reduirements.
Copy form to installer's file if recommendations for improvement were
stiggested.
ACTION TAKEN:
setbacks
Well 'Potable House Property Lake Dry Tank Drain
Water Lines line Stream Gulch
Field 100 25 20 10 50 25 10 10
Zan& 50 10 5 10 50 10 * 10
PHOOUCI2041(Singh Sheeisl Zd54Padded ®®hK. Grdm. Mass. 0191. To Ordn PHONE TOU/.EE 1-BOD-225-6300
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
PLEASE CALL FOR FINAL ► P. 0. Box 850 - 550 Broadway
INSPECTION BEFORE COVERPNG Eagle, Colorado 81631
ANY PORTION OF INSTALLED SYSTEM
328-7311 or 949-5257 or 927-3823 PERMIT NO. N° 57 1
PERMIT MUST BE POSTED
AT INSTALLATION SITE
OWNER: Ken Bouldin ADDRESS: 2307 Hickory Crest, Memphis, TN 38119
SYSTEM LOCATION: U.S. Forest Service Road 731 Tennessee Pass
LICENSED INSTALLER: Jack Berga LICENSE NUMBER:
**CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following:
MINIMUM REQUIREMENTS: j�p gallon septic tank or aerated treatment unit.
Absorption area or dispersal area computed as follows:
PERCOLATION RATE: T inch in 'j minutes.
Absorption Area per Bedrooms sq. ft.
No. of Bedrooms x sq. ft. minimum requirement per bedroom
total sq. ft. minimum requirement.
**COND
SPECIAL REQUIREMENTS: E'Slc, V\ 0-A<, 5Y7l ��Srx�h7`tmr,
1. All installation must comply with all requirements of the 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 building and zoning 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: No system shall be deemed to be in compliance with the Eagle
County Individual Sewage Disposal System Regulations until the installed system is
approved prior to covering any part. r
Installed Absorption or Dispersal Area: 4re &n sq. ft.
Installed Septic Tank: gallons.S�
Design Engineer of System:
Installer of System:
Septic tank cleanout to within 12" of final grade or
aerated'access ports above grade? Yes _� No _
Proper materials and assembly? Yes V No
Phone:
Compliance with permit requirements? Yes_ No
Compliance with County/State regulations requirements? Yes No
COMMENTS:
(Any item checked "No" requires correction before final approval of system is made.
Arrange a re-. spection when work is completed.
DATE: INSPECTOR:
Pc4L--.A
RE -INSPECT ON ATE: INSPECTOR.
RETAIN WITH RECEIPT RECORDS p RMIT/NO. N! 57 !
CHARGES Jack VaBouldin
Name of Applicant:
Percolation Test = $50.00
Name of Owner: Ken Bouldin
Permit Fee (includes final inspection) = Amount Paid: $200.00
ALL CHECKS OR MONEY ORDERS ARE TO BE Receipt Number: 5376
MADE PAYABLE TO: EAGLE COUNTY Cashier: Lorraine Funke
White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner
E.,,,,
BOx °90
E;',GLE, COL`-D-11CO 10,1C.31
PER`'IT 1 EE _ $ i 50
FE=CCL:;TI� TEST FEE
F
APPLICATIO11 FOR iNDI':IDUAL SE'::P.GE DISP9S,11 SYSTE'•' PEF:'!IT
NAME *OF 01•PNER: _ 00 L1 L1)14
ADDRI-:SS: 2-302 AiCkj)Q2 ' ( eE i Miki 'I-at4. .31e PHO"IE : t Vl - 75+76/8 -
NAME OF APPLICANT (IF DIFFERENT FROM 01-111ER):
ADDRESS: :P.o, gog 19.54. LEA6illLt._E 0, 80401 PHONE: r40Nd::_1
DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): NSA
ADDRESS: PHONE:
-PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: _�� 3tEJ?1�A
ADDRESS: �Po� 6oj= 0S4 , LEAb (LL_;_= ; Coto • 60.4 &1 PHONE: N6 =
P,-RMIT APPLICATI011 IS FOR: "Iew Installation - ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County g�C<-_ ._E Lot Size Sao 17 AC
City or Town, if within City or To,. -in Limits
LEGAL DESCRIPTION: ►�iR'� � n„31 R+>✓Y¢ 5cc-: L- I1104 5cc:, -3 i- 195i 80 VA
STREET (RURAL) ADDRESS: 73J h'"'yi✓A1l� .E. �
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? O Yes ( ) No
BUILDING OR SERVICE TYPE: (Check applicable category)
Residential - Single-family dwelling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex 5
( } Commercial - State usage
# Persons.- Bedrooms a
WASTE TYPES: (Check all applicable)
( ) Commercial or Institutional (:) Dwelling ( ) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher
( ) Other ( ) Automatic flasher
SOURCE AND TYPE OF 14ATER SUPPLY: (K) Well ( } Spring ( ) Creek or Stre ' P`
Give depth of all wells within 200 feet of the system: j - too =
If supplied.,by community water, give name of supplier:
-TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
O Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
:._ T .. , _
'hull, h r'r Vv I i %{,ir. jjLi„J iUiiCL i T,-_./tI iii_, iw tc'tv,t' VJ
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use
( ) Greyviater ( ) Other
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO 1•1ATERS OF THE STATE?
Signature
( ) Yes (X ) No
INFORMATION BELO!-/ TO BE FILLED OUT BY Ei1VIRniIIIE1ITAL HEALTH OFFICER
GROUND CO1DI T IONS: Percent ground Slope:
Depth to Bedrock (per 8' Profile Hole):
Date d' t- •Y' g-r `.
Depth to (iroun-:.•iater Table:
SOIL PERCOLATION TEST RESULTS: Z v Pinutes per inch in Hole Plo. 1
�Sr Minutes per inch in Hole No. 2
2� 11i nutes per i nch in Hole ;lo . 3
FI'IP%L DISPCS''•.L BY: (><T___A,bsorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( ) Un�erground Dispersal ( ) 1.4aste:•iater Pond
( ) Ot�•er
G
'
^ '
PERCOLATION TEST FEE: $50
956
~ ^^^^"^^, "'', n
OWNER: Ken 8noldio
LEGAL DESCRIPTION: USMS #18531 - NE-4; Sec 2 & NW-14; Sec 3; T8S; R80W (Tennessee Pass
RURAL ADDRESS:
U.S. Forest Service'Road-
TYPE OF DWELLING:
^
# OF BEDROOMS:
DATE OF PERCOLATION TEST: TYPE OF SOIL:
TEST HOLES PRESOAKED? Y83 , N� »" '
WATER DEPTH
INCHES OF FALL
PERCOLATI0N RATE:
PA EL —
RECOMMENDED MINIMUM SEPTIC TANK SIZE: /1000
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM- �
3it2 has been reviewed and tested or perc t
n al He
Date Enviro me t- _=Vn I
COMMENTS:
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
?---x> L4-. C�
Name
Date Routed � �Q\,\Aes%e
CyVeb �v'�:C�+e — e 1.%A�plication No.
Location
Please review the attached Individual Sewage Disposal System Permit Application and return
it with this completed form to the Environmental Health Office.
PLANNING: Complies with - . YES ' NO ' REVIEWED BY.. DATE
Subdivision Regulations:
Zoning'Regulations:
Recommend Approval:
COMMENTS:
BUILDING: Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
YES
NO
REVIEWED BY
DATE.
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
YES
NO
''REVIEWED BY
DATE
COMMENTS:
l v i -t dY 40-A ; c e
ENVIRONMENTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
YES
NO
REVIEWED BY
DATE
X
�
COMMENTS: `
1SI)S 22:16-02A Tax # not available
JOB NAMR 1154 Forest -Service Rd. #731 NYE /
Tennessee Pass Eagle County a�-1
5q
/ sj_ 51 )
JOl3i Na .
^0 1
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
�An
/V
0 q /0
�yj-CL
AL'z &--,,7 d7' --40 _--
0
elm to
JOB COST SUMMARY
TOTAL SELLING PRICE
✓� , / �'
Q 2 c —i
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
UAL I &j Q, Q f 10 n
SALES TAX
_..._ . _.
/
�L j 64- l
LO
�//
4-a J
MISC. COSTS
41�c
TOTAL JOB COST
V.
D i
I oam
S o I e t'U I u- Ea d- 3 fa fss e ASS
GROSS PROFIT
/
ok-�/ (^
d
v
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET .PROFIT
JOB FOLDER Prodwt.278 ®® NEW ENGLAND BUSINESS SERVICE, INC., GROTO MA 01471 JOB
FOLDER
PERMIT # 571
OWNER: Ken Bouldin
LOCATION: U.S. Forest Service Road
731 Tennessee Pass
INSTALLER: Jack Berga
SIZE OF TANK: 1,000 gallons
DWELLING: Residential - 2 bedrooms x 250 sg.ft.
PERC RATE: one inch/18 minutes
Design calls for two 80' absorbtion trenches
3' x 3' x 80' (6" gravel base)
Fianlized: 8-3-82 By: Richard Pylman
Printed in U.S.A.
Z'
�? a
