HomeMy WebLinkAbout1630 Spring Creek Rd - 211115200014 (2)INDIVIDUAL 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. 2213-02 BP NO. 14367 OWNER: STEVE KERN PHONE: 970-390-3238 MAILING ADDRESS: 1630 SPRING CREEK RD., GYPSUM, CO 81637 APPLICANT: RIFLE PREMIER HOMES, RICK PHONE: 970-625-0732 SYSTEM LOCATION: 1630 SPRING CREEK RD., GYPSUM, CO TAX PARCEL NO. 2111-152-00-014 LICENSED INSTALLER: AAAA SEPTIC PUMPING & SERVICE, JIM WILSON LICENSE NO.28-02 PHONE: 970-524-9524 DESIGN ENGINEER: PHONE NO. INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: MINIMUM REQUIREMENTS FOR A 1 BEDROOM RESIDENCE 1000 GALLON SEPTIC TANK, 496 SQUARE FEET OF ABSORPTION AREA CREDIT, VIA 16 INFILTRATOR UNITS AS REQUESTED BY INSTALLER. SPECIAL INSTRUCTIONS: INSTALL IN SERIAL DISTRIBUTION IN TRENCHES, WITH A CLEAN -OUT BETWEEN THE TANK AND THE HOUSE AND INSPEC- TION PORTALS IN EACH TRENCH. RAKE ALL TRENCH SURFACES TO PREVENT THE SMEARING OF SOILS AND DO NOT INSTALL IN WET WEATHER. BE SURE TO MAINTAIN ALL APPLICABLE SET BACK REQUIREMENTS. CALL EAGLE COUNTY ENVIRONMENTAL HEALTH FOR FINAL INSPEC- TION PRIOR TO BACK FILLING ANY PART OF THE INSTALLATION, OR WITH ANY QUESTIONS REGARDING THE INSTALLATION. THE BUILD- ING CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED UNTIL THE SEPTIC SYSTEM HAS BEEN INSPECTED AND APPROVED. ENVIRONMENTAL HEALTH APPROVA bri DATE: AUGUST 7, 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: 496 SQUARE FEET (VIA 16 STANDARD INFTT,TRATOR TTNTTS ) INSTALLED CONCRETE SEPTIC TANK: 1000 GALLONS IS LOCATED 105 DEGREES AND 10 FEET 7INCHES FROM THE CLEANOUT ON THE EAST SIDE OF THE HOUSE TO THE LID OF THE FIRST COMPARTMENT OF THE TANi COMMENTS: THE FINAL INSPECTION WAS DONE BY RAYMOND P. MERRY OF EAGLE COUNTY ENVIRONMENTAL HEALTH ON AUGUST 22, 2002. THIS SYSTEM IS LARGE ENOUGH To ACCOMMODATE A ONE BEDROOM RFSIDEN('E ANY ITEM NOT MEETING REQUIREMENTS WILL BE CORRE TED F �1L APPRO L OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED. / ENVIRONMENTAL HEALTH APPROVAL — DATE: SEPTEMBER 4, 2002 r -_ Irecomplete Applications Will NOT Be Accepted (S.t:,; Plan MUST be attached) ISDS Permit # Building Permit # APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P. O. 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: :-telle _ '4/n MAILING ADDRESS: 16.30` Jorl � Md PHONE: APPLICANT/CONTACT PERSON: � �A it � / PHONE: :J / LICENSED SYSTEMS CONTRACTOR: ! Is PHONE: COMPANY/DBA: /I ADDRE�C2d�3 �SJ f ,SGi9� PERMIT APPLICATION IS FOR: (X NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: AO V — %, Legal Description: 5 d� to 1U c1 )d Tax Parcel Number: Physical Address: BUILDING TYPE: (Check a p il/ ble Residential/Single Family Residential/Multi-Family* ( ) Commercial/Industrial* Lot Size: /�T��� _ Y G category) Number of Bedrooms Number of Bedrooms Type *These systems require design by a Registered Professional Engineer IQ 3`-��=���, TYPE OF WATER SUPPLY: (Check Well ( ) Spring Public Name of Sup APPLICANT SIGNATURE: applicable category) ( ) Surface -j-/ ************************************************************************** AMOUNT PAID:�ou RECEIPT #: ���� DATE: I CHECK #: b ),4q CASHIER: ISDS PERMIT # o?a/3-OA PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEATLH -PHSYSICAL ADDRESS: LEGAL DESCRIPTION: MAILING ADDRESS: TYPE OF DWELLING: SE d tle- NUMBER OF BEDROOMS: Q TEST HOLES PRE-SOAKED: YES > NO SOIL TIME WATER DEPTH INCHES OF FALL RATE PROFILE nl 40p r� ai Apr 2 31 1 71 11 as to a ace JL0J�[ �' a 7 ! !a ' L/!�4 ii e, 3 tr T ) �g` (� t,h 1 q ff 3 5' -0 `� as 0 y �, �t . y y a, y cep ti '7` S 1 o � 4 J- 7as 1 Io %DY /0 1107, 1 1 TIME TO DROP LAST INCH: L� mdL PERC RATE:. f 0 - ^0 MINIMUM LEACH FIELD SIZE: MINIMUM SEPTIC TANK SIZE: ZL60� S ps-17// �/Y Ism Peamit # (?13- Date T Q^-^� Fina Inap en cammlateneas Form d/ Tank is I. d o l) gal. Tank Material _Tank is located a�€t. and _0-? degrees from 1pss....hc 1�oeos�d Tank is located ft. and degrees f lank set level. Tank lids within 6" of finished grade. size of field YU ft= units /©_ ° lineal ft- Technology SL �aeanout is installed in between tank and house(+ 1/100ft)- here 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 gasket etc. T is -bas two =:compartments with the.;!�;aieg+s�.�:cQ tment closest to the L house. a►eure: distance and relative zmepth of field. 3 ft . tSoia interface raked. Inspection portals at the -end of each trench.. roper distance to setbacks. L- Chambers properly installed as per manufacturer$ specifications. (Chambers latched, end plates properly installed, rocks 'removed from trenches, etc.) 5 -Type of pipe used for building sewer line leach field Other Inspection meet8 Copy form to installer's file if recommendations for improvement Pere suggested. ACTION TAKEN: setbacks Well Potable House Property Lake Dry Tank Drain Water Lines line Stream Gulch Elel d 100 25 20 10 50 25 10 10 50 10 5 10 50 10 * 10 JOB ESE- COU TY-E ff; HEALTH P.O. BOX 179 SHEET NO. EAGLE, CO 81631 CALCUUITED BY__ DATE �1 CHECKED BY DATE ®C� YMIIUU(: 7 21IF 1(JIngR �IICGRJ (Iry'1 �raaaeul U®rtK., wuro., mus. ui./ �. iu wun rnvnc �uu rncc �-m�[rvw. -111. L y. IL.L11u rl-C1111C1- Fluillu QCL1G'� r J ti(U UCJ UUItfs UU1-I I-VG-+..+urtvll rGyC 41s3 /xi /�7 0 TI II - 4 7_7fafaD I.ICM fall. MEZDM TM • COf-1 C rni IFJTV Chll i L-ICGI TN parr: - ? enL by: NITle t-r'erfller- r1Ulfle 5clle3i '.7lu ue-D uula} JU1-I r ue-, vrPit } ayc ter.+ .4w- ��doe 1 C� fry v r I irn MA. Ma mm rr.. l7ncl c -r-a 161TV MR I UC'rl TW I ��p el) fio lea,, h1 �'ela/ PAO= : 7 'YOp `L h C'" Lin iOoeer Or; ve— I U id 8 s She pr$janQ POG I% -I 0 /� Legal Description: I 9'7 6 Tract 85, Township 5 South, Range 85W of the 6th Principal Meridian 1 Physical Address: 1630 Spring Creek Rd, j Gypsum, CO 81 637 OIL Vq-964 is � se ��� /�-- 2213-02 Tax #2111-152-00-014 JOB NAME_ Lot B, Spring Creek, KERN ,/ -2762 1630 Spring Creek Rd., Gypsum JOB NO. - l `t JOB LOCATION BILL TO DATE TART D DATE COMPLETED DATE BILLED A ^ r K _ r/ 0 o Y'-. ' - ^ JOB COST SUMMARY //f Q.)TOTAL SELLING PRICE G ✓ 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 JOB FOLDER Printed In U.S.A. (i) Recycled Content 10% Post-Consurner