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HomeMy WebLinkAbout19023 Hwy 131 - 168908400005Environmental Health Department P.O. Box 179 500 Broadway Eagle, CO 81631-0179 Phone: (970) 328-8730 Fax: (970) 328-7185 Permit Permit No. OWTS-026541-2023 Permit Type: OWTS Permit Work Classification: New Permit Status: Active Issue Date: 4/26/2023 Expires: 8/21/2023 On-Site Wastewater Treatement System Project Address Parcel Number 19023 HWY 131, BOND AREA,168908400005 Owner Information Address Fleeger Family First, LP Phone: Cell: (214) 878-0333 Email: mattf@gulfcoastwestern.com Inspections: For Inspections Call: (970) 328-8755 Engineer Phone Email KUMAR & ASSOCIATES, Dave Young (970) 945-7988 dyoung@kumarusa.com Contractor License Number Phone Email Spiegel Construction dirthog3@gmail.com(970) 904-0694 Permitted Construction / Details: Install the new system exactly as depicted in the Kumar & Associates design dated April 4th, 2023, stamped and signed on April 5th, 2023 by David A Young. This system is designed to accommodate the maximum daily flows for a seven bedroom residence and a three bedroom guest house. The OWTS consists of two sewer lines, one from the main residence and one from the guest house. A Valley Precast 2,500 gallon, two-compartment septic tank will be used for primary treatment at the main residence and two Valley Precast 1,000 gallon, single compartment septic tanks will be used for primary treatment at the guest house and at the pavilion. A Valley Precast 500 gallon, single compartment septic tank will be used for pressure dosing. A Biotube Pump Vault with an Orenco PF3005 high head pump set to dose 115 gallons per dose will be installed inside the dosing tank. An Orenco V6404 Automatic Distributing Valve will be accessible at the high point of the system. Cleanouts will be located every 100' in the effluent line. The STA consists of 6 trenches of 20 Infiltrator Quick4 Plus Standard chamber for a total of 120. The bottom of the trenches should not be deeper than 2.5 feet. The water line and well should be notated on the record drawing. Install distribution lateral orifice size, orifice shields, spacing, and flushing assemblies should be completed as designed. Do not dig in wet or frozen ground. Contact Eagle County Environmental Health and the design engineer well in advance of requesting inspections prior to backfilling any component of the OWTS. The design engineer is responsible for conducting all inspections necessary to certify the installation and assure the functionality of the system. System certification, along with photos and a record drawing is required to be submitted to and approved by Eagle County Environmental Health prior to the use of the system or occupancy of the dwelling. THIS PERIMT EXPIRES BY TIME LIMITATION AND BECOMES NULL AND VOID IF THE WORK AUTHORIZED BY THE PERMIT IS NOT COMMENCED WITHIN 120 DAYS OF ISSUANCE, OR BEFORE THE EXPIRATION OF AN ASSOCIATED BUILDING PERMIT Issued by: Environmental Health Department, Eagle County, CO Danielle Salinsky Date April 26, 2023 CONDITIONS 1. 2.ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE COUNTY PUBLIC HEALTH AGENCY ON-SITE WASTEWATER TREATMENT SYSTEM REGULATIONS ADOPTED PURSUANT TO AUTHORITY GRANTED IN CR.S. 25-10-101, et seq., AS AMENDED 3.THIS PERMIT IS VALID ONLY FOR PERFORMING WORK ON OWTS ASSOCIATED WITH 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 4.1.6(A)(1) EAGLE COUNTY PUBLIC HEALTH AGENCY ON-SITE WASTEWATER TREATMENT SYSTEM REGULATIONS REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN ON-SITE WASTEWATER TREATMENT SYSTEM TO BE LICENSED Wednesday, April 26, 2023 1 Inspection Result Eagle County, Colorado P.O. Box 179 500 Broadway Eagle, CO Phone: (970) 328-8730 Fax: (970) 328-7185 IVR Phone: 1-866-701-3307 Inspection Number: INSP-523414-2023 Permit Number: OWTS-026541-2023 Inspection Date: 06/29/2023 Inspector: Salinsky, Danielle Permit Type: OWTS Permit Inspection Type: OWTS Final Inspection Work Classification: NewOwner:Fleeger Family First, LP Job Address:19023 HWY 131 IVR Pin Number:198588 BOND AREA, CO Project:<NONE> Parcel Number:168908400005 Contractor:Phone: (970) 904-0694 / Cell: Spiegel Construction Inspection Status: Approved Inspection Notes Inspector Comments Added Item: Septic Tank NOTE: The guest house and pavilion have not been constructed yet and this is being finalized as is. A Valley Precast 2,500 gallon, two-compartment septic tank was installed for primary treatment at the main residence and two Valley Precast 1,000 gallon, single compartment septic tanks were installed for primary treatment at the guest house and at the pavilion. A Valley Precast 500 gallon, single compartment septic tank was installed for pressure dosing. A Biotube Pump Vault with an Orenco PF3005 high head pump set to dose 115 gallons per dose was installed inside the dosing tank. Added Item: Record Drawing Received 10/17/2023 from K&A. Added Item: Record Photos Received 10/17/2023 from K&A. Added Item: Site and Soil Received 4/18/2023 from K&A. Added Item: Final Certification Letter Received 10/17/2023 from K&A. Added Item: General Plan Received 4/18/2023 from K&A. Added Item: Soil Treatment Area (STA) Wednesday, October 18, 2023 For more information visit: http://www.eaglecounty.us Page 1 of 2 NOTE: The guest house and pavilion have not been constructed yet and this is being finalized as is. Inspected 6/29/2023 - The ADV was not at the high point of the system. This was to be adjusted. Inspection ports were not located at one end of the trenches. An Orenco V6404 Automatic Distributing Valve will be accessible at the high point of the system. Cleanouts will be located every 100' in the effluent line. The STA consists of 6 trenches of 20 Infiltrator Quick4 Plus Standard chamber for a total of 120. Added Item: Identification of Systems Contractor Spiegel Construction was the licensed installer. Wednesday, October 18, 2023 For more information visit: http://www.eaglecounty.us Page 2 of 2 5020 County Road 154 Glenwood Springs, CO 81601 phone: (970) 945-7988 fax: (970) 945-8454 email: kaglenwood@kumarusa.com www.kumarusa.com Office Locations: Denver (HQ), Parker, Colorado Springs, Fort Collins, Glenwood Springs, and Summit County, Colorado October 16, 2023 Matt Fleeger 6640 Spring Valley Road Dallas, Texas 75254 mattf@gulfcoastwestern.com Project No. 22-7-270.02 Permit No. OWTS-026541-2023 Subject: Partial Certification of Onsite Wastewater Treatment System, Remodel of Main Residence, Fleeger Ranch, 19023 Highway 131, Eagle County, Colorado Dear Matt: A representative of Kumar & Associates observed the installation of the Onsite Wastewater Treatment System (OWTS) for the residence at the subject site as required by the Eagle County Environmental Health Department. Our observations and recommendations are presented in this report. The services are supplemental to Kumar & Associates agreement for professional services to you dated April 1, 2022. We previously designed the OWTS for the residence and other facilities as submitted in our report dated April 4, 2023, Project No. 22-7-270.02. The system was designed for seven bedroom in the residence and three bedrooms in the guest house. The system was installed by Spiegel Construction. We performed our as-built evaluations on June 29 and August 22, 2023. The OWTS components observed included: sewer lines, cleanouts, septic tanks, effluent line, pump, control panel, automatic distributing valve (ADV) and soil treatment area (STA) and the locations of these components. The installation and locations of the system components were verified as shown on Figure 1. Pictures of the OWTS components made during the site visits are included with this report. The locations of the components were provided by Beck Building. At the time of our site visits, the guest house and the pavilion had not yet been constructed or connected to the OWTS. We should be contacted for a full certification of the system when the construction has been completed. On August 22, 2023, after power had been supplied to the pump, a pump performance test was performed with adequate pump pressure observed. It is our opinion that the OWTS was installed in general conformance with the above referenced design. The observations and recommendations presented above are based on our site observations and our experience in the area. We make no warranty either express or implied. Alterations to the system or improper backfill and site grading could affect the operation and effectiveness of the OWTS. Kumar & Associates OWTS PHOTOGRAPH LOG REMODEL OF RESIDENCE 19023 HIGHWAY 131 EAGLE COUNTY, COLORADO Project No. 22-7-270.02 Photograph 1: Sewer line exiting residence and going to septic tank. Photograph 2: Valley Precast 2,500 gallon, 2-chamber septic tank for main residence. OWTS PHOTOGRAPH LOG REMODEL OF RESIDENCE 19023 HIGHWAY 131 EAGLE COUNTY, COLORADO Project No. 22-7-270.02 Photograph 3: Valley Precast 1,000 gallon, 2-chamber septic tank for proposed guest house. Photograph 4: Schedule 40 effluent pipe under proposed driveway. 1.5” Schedule 40 effluent transport line to soil treatment area (STA). OWTS PHOTOGRAPH LOG REMODEL OF RESIDENCE 19023 HIGHWAY 131 EAGLE COUNTY, COLORADO Project No. 22-7-270.02 Photograph 5: Valley Precast 1,000 gallon, 2 chamber septic tank for pavilion. Photograph 6: Valley Precast 500 gallon, 1-chamber septic tank with pump in foreground. OWTS PHOTOGRAPH LOG REMODEL OF RESIDENCE 19023 HIGHWAY 131 EAGLE COUNTY, COLORADO Project No. 22-7-270.02 Photograph 7: Orenco PF3005 pump in dosing tank. Photograph 8: Orenco V6606 Automatic Distributing Valve (ADV). OWTS PHOTOGRAPH LOG REMODEL OF RESIDENCE 19023 HIGHWAY 131 EAGLE COUNTY, COLORADO Project No. 22-7-270.02 Photograph 9: Soil Treatment Area (STA) with observation ports and flushing assemblies. Photograph 10: Control panel. EAGLE �JNTY DEPARTMENT OF ENVIRONM—)TAL HEALTH Box JJX 6th & Broadway IT MUST BE POSTED AT SITE Eagle, Colorado 81631 CALL FOR FINAL INSPECTION (328-7311 or 949-5257or949-56° PERMIT a 4�® (this does not constitute • a building or use permit) �- Owner Archie F. Strauss / Marjorie Elliott &J�� System Location 18.5 mi north on Hwy 131 between Bond & McCoy Licensed % ����/%y Owner is responsible for installation of system by * Conditional Construction approval is hereby granted for a 1,000 gallon XX Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 10 minutes 600 sq. ft. total absorption area absorption area per bedroom 300 9 of bedrooms 2 x 300 sq. ft. minimum requirement May we suggest 600 sq.ft. leachfield and 1,000 gallon septic tank Date 30 December 1980 Inspector Erik W. Edeen FINAL APPROVAL OF SYSTEM: No system,shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved prior to,covering any part. t� Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. Proper materials and assembly. Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date 4-15-81 Inspector /s/ Sidney N. Fox RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE I NDITIONS: 1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973 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 structures not approved by the building and Zoning office 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, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material variation from the terms or specifications con- tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or h-*.h EAGLE COUNTY ENVIRONMENTAL HEALTH ROUTE FORM NAME )ATE REFERRED-7; �� / �c�� APPLICATION CIO. LOCATIONIs u ?lease review the attached application and return it and this completed form -o the Environmental Health Office. MA -MN-- Complies with: Yes N Subdivision Regulationsil Zoing Regulations r G G_ ,5,7 Recommend Approval .omments: 311ILDING Set Backs _ Site As - Other Recommend Approval ;omments : . ?N,TNEER- (not always necessary) Roads Grading Drainage i Recommend Approval 'omments: Reviewed By a aawvl,nt-LVLV 1Uo1 FEE: $SO APPLICATION NO. OTkTZN ER : �E RU RAI; ADDRESS: TYPE OF DWELLING: OF BEDROOMS: DATE OF TEST: TYPE. OF SOIL: cSxGc�pC✓G y TEST HOLES PRESOAKED: YES NO TIME WATER DEPTH INCHES.OF FALL 1 2 3 I 2 .. 3. 1 2. 3. PERCOLATION RATE: j�'� /'7 /� TANK SIZE: 0 SQUARE FOOTAGE PER BEDR0O 4: LEACH FIELD SIZE �O Sitehas been reviewed and tested `or ercolation rate. We recommend APPROVAL DIS APPROVAL DATE: c5 d 60 EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICER RATE Surveyable Description of STRAUSS PARCEL A parcel of land in the County of Eagle, State of Colorado, located in Tracts 44, 45 ' and 4,8of Sections, 5, 6, 7, 8 and 9; Township 2 South, Range 83 West of the Sixth Principal Meridian according to the Independent Resurvey of said Township and Range as approved by the U.S. Surveyor General in Denver,Colorado,,on April 30, 191.8; said parcel being south'and'west of the Iacovetto Parcel and Colorado State Highway,131 and north and east of the Colorado'River in Tracts ,44 and in'the westerly portion of Tract 45 along a line, between corner No. 4, of Tract 45 and Corner No. 6 of Tract 39. Said parcel contains approximately 48 acres ,moreior;less. Subject, however, to easements and rights -of -way; for roads, highways, railroads, ditches and public utilities of record or as same exist. -tion CONSTRUCTION PERMIT APPLICATION 1 of'3 Jurisdiction of EAGLE COUNTY USE THIS FORM WHEN APPLYING FOR ANY OR ALL OF THE FOLLOWING PERMITS: CIRCLE THOSE THAT APPLY— [ A ] Bering [ B ] Plumbing [ C ] Electrical [ D ] Mechanical [ E ] Road Cut/Right of Way F ] ridividual Sewage Disposal System [ G ] Grading [ H ] Sign Applicant to complete numbered spaces only. JOB ADDRESS y, / LEGAL 1 DESCR.� LOT NO. BLK TRACT ( EE ATTACHED SHEET) 2 OWNER G' MAIL ADDRESS ZIP PHONE ,-"e l�//OW 0Q#+T-R Q4;OR MAILADDRESS %/PHONE `LICENSE NO. 4 ARCHITECT OR DESIGNER MAILADDRESS AONE LICENSE NO. 5 ENGINEER MAIL ADDRESS PHONE LICENSE NO. 6 LENDER MAI L ADDRESS - BRANCH 7 USE OF BUILDING %J t �(/ „/ C' ` No. of Dwelling Units 8 Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOV ❑ REMOVE 9 Describe work: 10 Change of use from Change of use to 11 Valuation of work: $ 14 Total floor area of structure: 12 Acreage or sq. footage of lot: 15 Height of structure above finish grade: 13 Sq. footage of lot coverage: 16 Special conditions and Additional Information: SITE PLAN MUST BE INCLUDED WITH THIS APPLICATION: exceptions are listed in Eagle County Building Resolution. For site plan preparation instructions refer to Eagle County publication "Graphic & Submittal Requirements for Site Plans". 17 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED SIGNA REOF NTRACTOR OR AUT ORI ED AGENT DATE HEREIN. OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE p �j PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. IGNATUR OF OWNER (IF O ER BUILDER) DATE APPLICATION ACCEPTED V V PLANS CHECKED BY APPROVED FOR ISSUANCE BY White Copy —INSPECTOR Blue Copy —APPLICANT Green Copy —ENVIRONMENTAL HEALTH ;1 OWNER of EAGLE COUNTY APPLICATION FOR PERAlffin WORK IN COUNTY RIGHT OF WAY 1. Work is for: (circle those that apply) WATER, SEWER, GAS, ELECTRIC, TELEPHONE, TV CABLE, DRIVEWAY ACCESS, OTHER 2. Show roads with names, buildings, and location of cut or driveway (with dash lines) on 8%"x11" sheet. NOTE: Constructing plans and specifications prepared by a professional Engineer registered in the State of Colorado may be required by the County Engineer. Road Cut Dimensions: 3. WI DTH LENGTH DEPTH 4. Square feet of pavement to be repaved 5. Lineal feet of pavement to be saw cut 6. DATE START DATE COMPLETE 7. Is all material, labor, and equipment available to complete work? 8. Supplemental sheets have been completed and are attached hereto and made a part of this application. 9. Special conditions: 10. 1 certify that I have read all requirements of the RESOLUTION and will abide by the same, and that all utilities have been notified as required. (date) (applicant's signature) APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT I. utSIGIv UNJUINEEK OF SYSTEM (if applicable): ADDRESS: / PHONE: 2. PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: A_&—ej Ti' tea- Tl� �`��� ADDRESS: �,'� ���ff h PHONE: 4e, 6 — 6—Y at` 3. BUILDING OR SERVICE TYPE: (Check applicable category) �;oK Residential — Single-family dwelling ( ) Residential — Triplex ( ) Residential — Duplex ( ) Residential — Quadplex ( 1 Commercial — State usage I'm # Persons WASTE TYPES: (Check all applicable): ( ) Commercial or Institutional ( ) Non -domestic wastes ( ) Other Dwelling ( ) Transient Use # Bedrooms) ('>< Garbage Grinder T>4 Dishwasher ( ) Automatic Washer 5. SOURCE AND TYPE OF WATER SUPPLY: ( ) Well J54 Spring ( ) Creek or Stream Give depth of al I wells within 200 feet of the system: If supplied by community water, give name of supplier: 6. TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( Septic Tank ( ) Aeration Plant ( ) Chemical Toilet ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, Potable Use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greywater ( ) Other 7. 1 hereby certify that I have read and examined this application and know the same to be true and correct. SIGNATURE DATE White Copy —INSPECTOR Bklf CoDv—APPLI CANT r.aa c v—FNI\/IRl1nIMFnrn 91� N"- .3 of 3 CONSTRUCTION PERMIT FEES S e BUILDING Permit Fee Plan Check Fee Building Total Fee ELECTRICAL Permit Fee Additional Charges Electrical Total Fee SEWAGE DISPOSAL SYSTEM Permit Fee Percolation Test System Total Fee ROAD CUT/RIGHT OF WAY Permit Fee Additional Charges Roadcut Total Fee PLUMBING MECHANICAL Fuel: Oil ❑ Nat. Gas ❑ LPG ❑ PERMIT FEES Type of Equipment No. Fee Air Cond. Units - H.P. Ea. Refrigeration Units - H.P. Ea. Boilers - H.P. Ea. Gas Fired A.C. Units- Tonnage Ea. Forced Air Systems - B.T.U. M. Ea. Gravity Systems- B.T.U. M. Ea. Floor Furnaces - B.T.U. M Wall Heaters- B.T.U. M Unit Heaters- B.T.U. M Evaporative Coolers Clothes Dryers Ventilation Fan Range Hood Air Handling Unit— C.F.M. Incinerator PERMIT PERMIT FEES Type of Fixture or Item No. Fee WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER LAUNDRY TRAY CLOTHES WASHER WATER HEATER URINAL DRINKING FOUNTAIN FLOOR - SINK OR DRAIN SLOP SINK GAS SYSTEMS- NO. OUTLETS WATER PIPING & TREATING EQUIP. WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM TOTAL FEE.$ SEWER �— - PERMIT $ TOTAL FEE $ DATE: / O FEE TOTAL: DATE: REC'D. BUI LDI NG DEPT. /17 DATE: ZaCK ,19 REC'D. ENVIRONMENTAL HEALTH DEPT., DATE: REC'D. ENGINEERING DEPT. White Copy —INSPECTOR Blue Copy —APPLICANT Green Copy —ENVIRONMENTAL HEALTH Canary Copy —ASSESSOR Pink CODv—ENGINEERING GnldPnrnrl rnnv—EXTRA U46U 1t3.0 mlles N on Hwy 1:31, Between Bond & McCoy�� JOB NAME en Bone Coy JOB NO. Parcel # JOB LOCATION _. BILL TO DATE STARTED DATE COMPLETED DATE BILLED 'p 00 0 i 11ni j JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL - _ -- -- - -- -- -- ftic�ec� PERMIT #480 Ifi��- OWNER: LOCATION: 18.5 miles north on Hwy. 131 (between Bond & McCoy) N1 Hk 66 2�- ay 13 -1s A'1ifxo"c.� INSTALLER: Jim Matlock SIZE OF TANK: 1,000 gallons DWELLING: Residential - 2 bedrooms x 300 sq.ft. PERC RATE: one inch/10 minutes (600 sq.ft.) Finalized: 4-15-81 By: Sid Fox T �. TOTAL .LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS %OF SELLING PRICE NET PROFIT JOB FOLDER Product 27S Q, , () p o • Printed in U•S,A. EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED INSPECTION BEFORE COVERING Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTION OF INSTALLED SYSTEM 328-7311 or 949-5257 or 927-3823 PERMIT NO. N o 52 3 OWNER: Marjorie Riiimkk Elliott ADDRESS: Box 75, Bond, Co 80423 SYSTEM LOCATION: 19023 Highway 131, Wolcott, co LICENSED INSTALLER: owner -installation LICENSE NUMBER: **CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following: MINIMUM REQUIREMENTS: 750 gallon septic tank or aerated treatment unit. Absorption area or dispersal area computed as follows: PERCOLATION RATE: 1 inch in 20 minutes. Absorption Area per Bedroom 280 sq. ft. No. of Bedrooms 2 x 280 sq. ft. minimum requirement per bedroom 800 total sq. ft. minimum requirement. SPECIAL REQUIREMENTS: DATE: July 8, 1981 **CONDITIONS: INSPECTOR: Erik W. Edeen 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. ,z.(j / #tVivs 01"PvC Installed Absorption or Dispersal Area: sq. ft. Installed Septic Tank: gallons. D Design Engineer of System: Installer of System: , r Phone: Septic tank cleanout to within 12" of final rade or �/� �jc�(j r=&4U6,, aerated access ports above grade? Yes No Proper materials and assembly? Yes No ✓ L Compliance with permit requirements? Yes No �01 l aU/ Compliance with County/State regulations requirements? Yes No CAnT'TtMi checked "No`� requires forrecti on before fi nal- appbval of -system is made. Arrange a re -inspection wherb work is completed.) DATE: 19 INSPECTOR: RE-INSPECTIO ATE: INSPECTOR: RETAIN WITH RECEIPT RECORDS PERMIT NO. N'0_ 523 CHARGES Name of Applicant: Marjor;a Percolation Test = $50.00 Name of Owner: Marjorie Elliott Permit Fee (includes final inspection) _ $75.00 Amount Paid: $1 2 5.00 ALL CHECKS OR MONEY ORDERS ARE TO BE Receipt Number: # 609 6 MADE PAYABLE TO: EAGLE COUNTY Cashier: Jo Ann Deigh.an White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner rLtW)L KLIORN IH13-NURTION WITH YOUR SII`t NLAN AND FEES 328-7311 949-5257 927-3823 ENVIRONMENTAL HEALTH BOX 850 EAGLE, COLORADO 81631 PERMIT FEE _ $75 PERCOLATION TEST FEE = $50 APPLICATION FOR INDIVTD!!AL SEWAGE DISPOSAL SYSTEM PERMIT NAME OF OWNER: ADDRESS: NAME OF APPLICANT (IF.DIFFERENT PIM OWNER): ADDRESS: ��-- PHONE: �92Z,��j l/ PHONE: DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): _ NA ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: ADDRESS: PHONE: PERMIT APPLICATION IS FOR: O0 New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED FACILITY: County Lot Size City or Town, if within City or Town Limit &W LEGAL DESCRIPTION: %9A x STREET (RURAL) ADDRESS: IS SYSTEM DESIGNED FOR LESS THAN 2,09O/ALLONS PER DAY? (Ve)` Yes ( ) No BUILDING OR SERVICE TYPE: (Check applicable category) (�) Residential - Single-family dwelling ( ) Residential - Triplex ( ) Residential - Duplex ( ) Residential - Quadplex ( ) Commercial - State usage # Persons # Bedrooms ,2 WASTE TYPES: (Check all applicable) ( ) Commercial or Institutional (X ) Dwelling ( ) Garbage Grinder ( ) Non -domestic wastes ( ) Transien"L Use ( ) Dishwasher ( ) Other (X Automatic Washer SOURCE AND TYPE OF WATER SUPPLY: ()r,) Well ( ) Spring ( ) Creek or Stream Give depth of all wells within 200 feet of the system: /Y If supplied by community water, give name of supplier: rr TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (7<) Septic Tank ( ) Aeration Plant ( ) Chemical Toilet ( ) Vault Privy ( ) Composting Toilet ( ) Recycling, Potable'Use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greylvrater ( ) Other WILL EFFLUENT BE DISCHARGED DIRECTLY INTO 14ATERS OF THE STATE? ( ) Yes (X) No Signature 'Date ? INFORMATION BEL 44 TO BE FILLED OUT BY AIR01MENTAL HEALTH rFI*CER GROUND CONDITIONS: Percent Ground Slope: 30170 C,r'-.C4-?02 Depth to Bedrock (per 8' Profile Hole): g 4. Depth to Groundwater Table:—�w 9' SOIL PERCOLATION TEST RESULTS: h�I Minutes per inch in Hole No. 1 Z c� Minutes per inch in Hole No. 2 Z0 Minutes per inch in Hole No. 3 FINAL DISPOSAL BY: () Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Above Ground Dispersal ( ) Sand Filter ( Underground Dispersal ( ) 'Wastewater Pond ( Other d ; lui (! ssufi !2S4% _ ti�•s ent _dA. i w4/_ /na '040— L ,•, 0 )ATE REFERRED ,, //�� ROUTE FORM — (V\ P, ly (ZI rs-�k NAME (qUZ APPLICATION "NO. ?. LO'CATION 'lease review the attached application and return it and this completed form -o the Environmental Health Office. '?wANNINCz; Complies with: Yes t`T Reviewed By Subdivision Regulationsl ZoXReg ulations s Recommend Approval .omments: 3UILDING Set Backs -� Site Other Recommend Approval :o=, .ents : . ?W ,TN ER (not always necessary) Roads Grading Drainage j Recommend Approval ;ornments : r FEE: $SO APPLICATION INO. 0 7 Z OWNER: LEGAL DESCRIPTION: RURAL, ADDRESS: / 9D 2 3 )`UL� AS/ , TYPE OF MvrELLING: # OF BEDROOMS. DATE OF TEST: �Q,(� ', /qS TYPE OF SOIL: gAute TEST HOLES PRESOAKED: YES ✓ NO , TUIE Wa�2 7� WATER DEPTH INCHES OF FALL RATE 1 2 3 ! 1 2 3 1 2 3 1 2 '° '3 / f. 6 aG`z 3311 35„ - 0 : 5° 34 3s1Z 12 / rz fZ,00 a /'o t2 d -3Z 4� 36 Ica PERCOLATION P-ATE: zo 04 Ps Tc'041, SIZE. %� O kh ,;-r4, SQUARE FOOTAGE PER BEDROOL1: 'LEACH FIELD SIZE: ©c� 41 fM o � S.i.ta has been reviewed and tested Cor percolation race. - •'e recommend: APPROVAL DISAPPROVAL DATE: EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICER REPAIR PERMIT APPLICATION / o� FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS A permit -fee of $75.. shall be charged for alteration, enlargement, or any repair involving alteration of an existing sewage disposal system. This fee is authorized by Eagle County Individual Sewage Disposal System Regulations adopted and effective March 27, 1980. For minor repairs of less than $100 for maintenance of the individual sewage disposal system, no fee shall be required. A percolation test fee of $50 shall be charged for all new leach fields on repair permits. Percolation testing may be waived at the -discretion of the Environmental Health Officer on certain repair cases where prompt action must be taken to prevent a ,teal th hazard. IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW SYSTEM SHALL BE INSTALLED, COMPLYING WITH ALL CURRENT REGULATIONS. IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE APPLICABLE. DESCRIPTION OF PROBLEM;MALFUNCTION: TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: DATE PRESENT SYSTEM WAS INSTALLED PER11IT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT 14AS ISSUED BY THIS DEPARTMENT: SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS: o 100 0 jt_;bl­d� (' 40 OWNER OF SYSTEM: ADDRESS: APPLICANT: ADDRESS: DATE: 0523 Q19023 Hwy 1311 Bond PKE NAME - JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED I -) - }- 8 JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL ®,� J�LI}Y C %� ((�1��;Y To E�L`-Pao-�c -1 \ PERMIT #523 k� r71C1 T)�le-�t F( 'Z-va. '--gc6cC I} 5r OWNER: LOCATION: C)19023 Highway 131 - Bond, .CO INSTALLER: Owner SIZE OF TANK: 750 gallons DWELLING: Residential - 2 bedrooms x 280 sq.ft. PERC RATE: one inch/20 minutes (800 sq.ft.) �l ! w-oc cs Finalized: 7-1n-81 R"• Grit Cr^-- TOTAL LABOR INSURANCE SALES TAX Misc. COSTS TOTAL JOB COST - GROSS PROFIT LESS OVERHEAD COSTS OF SELLINGPRICE NET PROFIT �Sn d o- 7n;7L-e— �fG Printed in U.S.A. L,) P . kf, 7�v,)K� Eagle County OWTS Systems Cleaners Reporting Form IL NOTE: Required to be submitted to Environmental Wealth within 10 days of cleaning an OWTS s sy tem EAGLE COUNTY Systems Cleaner Company �� L `J2C, License Number Email Addres $ �� Phone Service Technician y Phone 1 Address of Service Tax Parcel # Person Requesting ServicePhone 52�2 - (- l —070q Property OwnergtLh to-"1A\4L)Phone '?R5 ` 71— Septic System Permit Number Tank Size 2��� Date of serviceJ&61 Tank Material Co,tr Sewage Disposal Site General Condition and Functionality of the v//e tv Site sketch showing location of the septic tank access lids measured from at least 2 fixed points (Photos Encouraged Signed r _ Date