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HomeMy WebLinkAbout1015 W Squaw Creek Rd - 210710100051INDIVIDUAL 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. 1788-98 BP NO. 12077
OWNER: MATTHEW DONOVAN PHONE: 970-845-9484, 476-3511
MAILING ADDRESS: P.O. BOX 1532 EDWARDS CO 81632
APPLICANT: SAME PHONE:
SYSTEM LOCATION: 1015 WEST SQUAW CREEK RD., EDWARDS, CO TAX PARCEL NO. 2107-101-00-051
LICENSED INSTALLER: EDWARDS EXCAVATING, DON JOHNSON LICENSE NO. 35-98 PHONE: 970-926-3395
DESIGN ENGINEER: PHONE NO.
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK 1125 SQUARE FEET OF ABSORPTION AREA VIA 37 INFILTRATOR UNITS AS REQUESTED BY OWNER.
SPECIAL REQUIREMENTS: INSTALL IN SERIAL DISTRIBUTION IN TRENCHES WITH A CLEAN OUT BETWEEN THE TANK AND THE HOUSE,
INSPECTION PORTS IN EACH TRENCH. RAKE TRENCH SURFACES TO PREVENT SMEARING OF SOILS. FENCE OFF LEACH FIELD TO PRE-
VENT ANIMALS FROM GRAZING IN THE AREA. DO NOT ALLOW VEHICULAR TRAFFIC OVER SEPTIC SYSTEM. CALL EAGLE COUNTY EN-
VIRONMENTAL HEALTH FOR FINAL INSPECTION PRIOR TO BACK FILLING ANY PART OF THE INSTALLATION. OR WITH ANY QUESTIONS
REGARDING INSTALLATION. BUILDING CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT SEPTIC SYSTEM APPROVAL.
ENVIRONMENTAL HEALTH APPROVAL: DATE: JULY 2. 1998
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 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: 1147 SQUAREFEET(VIA 37 TNFTT,TRATOR TTNTTS )
INSTALLED CONCRETE. TANK: 12 5O GALLONS IS LOCATED 14 c;_ DEGREES AND 1 V 1 U!$T FROM CLEANOUT
COMMENTS:
ANY ITEM NOT MEETING REQUIREMENTS WILL BE CORRECTED BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN
WORK IS COMPLETED. [/
ENVIRONMENTAL HEALTH APPROVAL J1T DATE: SEPTEMBER 24, 1998
.(Site Plan MUST be attached)
ISDS Permit # /
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. O. BOX 179
EAGLE, CO 81631
328-8755/927-3823 (El Jebel)
**************************************************************************
* PERMIT APPLICATION.FEE $150.00 PERCOLATION TEST FEE $200.00
*. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
**************************************************************************
PROPERTY OWNER:
MAILING ADDRESS:
APPLICANT/CONTACT PERSON: Sort
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PHONE: 1
MAILING ADDRESS:13
_
LICENSED ISDS CONTRACTOR:
cD04 ao/
PHONE: 77O
Ift-
COMPANY/DBA: alert-ds I�K c" %hc
ADDRESS:
***************************************************************************
PERMIT APPLICATION IS FOR:
New Installation (
) Alteration
( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Building Permit #
(if known)
Legal Description: Subdivision: �� &td( %4AcA Filing: _Block: Lot No.
Tax Parcel Number: Q Z-1 �- Q- (� Lot Size:
Street Address:
ME
***************************************************************************
BUILDING TYPE: (Check applicable category)
( Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
Number
Number
Type _
of Bedrooms
of Bedrooms
TYPE OF ATER SUPPLY: (Check applicable category)
Well ( ) Spring ( ) Surface
( ) Public Name of Supplier:
*These systems requ' e design by a Registered Professional Engineer
SIGNATURE: Date:
i
TO BE COMPLETED BY THE COUNTY
AMOUNT PAID: RECEIPT # : _ DATE:
CHECK CASHIER: '
ISDS PERMIT # l ���'. T
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEATLH .
OWNER:_
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11 Iul J)m oya-m
PHSYSICAL ADDRESS:
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LEGAL DESCRIPTION:
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MAILING ADDRESS:
o- &v
C—dw a'r Ws
TYPE OF DWELLING:
6-s5
NUMBER OF BEDROOMS:
TEST HOLES P
TW
`���n . R DEPTH
YES/ NO
INCHES OF FALL
SOIL
RATE PROFILE
n'
150
13
-3`%
1�
55-
'
lay
15'
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21
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3' Y
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33
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91
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6 6�
10
TIME TO DROP LAST INCH: S " 8 PERC RATE: & ro`
MINIMUM LEACH FIELD SIZE: MINIMUM SEPTIC TANK SIZE: C S—d
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COMMENTS: r�Vl CL ,,4j IYU el Fi el ct PL6
sas
ENVIRONMENTAL HEALTH SPECIALIST DATE hod x ,U g L
A0,4
21
ISDS Permit #1'7W'- 7e
Date�-&
ISDS Final Inspection
Completeness ,/Form
✓ Tank is f a gal. Tank Material yzA(10 i
V/ Tank is located I % �i0 ft. and l y V' degrees from (� ✓mod✓
(permanent landmark)
Tank is located ft. and degrees from
(permanent landmark)
Tank set level. ✓ Tank lids within 8" of finished grade. 3 ✓I5-p--✓5
✓ Size of field /11/ ft2 _ units lineal ft.
Technology trlA S
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 tape, rubber gas` k�t� etc.
Tank has two compartments with the larger compartment closest to the
house.
_ Z Measure distance and relative direction to field. 191;L"
y Depth of field 3 ft.
✓ Soil interface raked.
✓ Inspection portals at the end of each trench.
Proper distance to setbacks.
V_ Chambers properly installed as per manufacturers specifications.
(Chambers latched, end plates properly installed, rocks removed from
trenches, etc.)
Type of pipe used for building sewer line Sit 3✓ leach field 5PDe
Other
Inspection meets requirements.
Copy form to installer's file if recommendations for improvement were
suggested.
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
Tank 50 10 5 10 50 10 * 10
CALCULATED BY DATE
CHECKED BY DATE
0!4, •::::r?-'NEML' FZs!•500•tiS
1788-98 Tax# 2107-101-00-051
' Parcel L, Ole Ranch, DONOVAN
JOB NAME 1015 west Squaw Creek Rd. JOB NO.
Edwards, CO
,140'InR I nr-Armm
BILL TO
DATE STARTED'
k
DATE COMPLETED
DATE BILLED
;�
fig.. -
JOB COST SUMMARY
q /
1 (
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
l/
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 277
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JOB FOLDER
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