HomeMy WebLinkAbout192S Little Dipper - 194135202027INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631
Telephone: 328.7311 or 949-5257 or 927-3823 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1036.
Please call for final inspection before covering any portion of installed system.
OWNER: Bruce Carey PHONE: 303-328-7353
MAILING ADDRESS: P.O. BOX 1947, Eagle, CO 81631
AGENT: PHONE:
SYSTEM LOCATION: 0192 Little Dipper Road Bellyache Ridge (Lot 48S. Filing 2)
LICENSED INSTALLER: .T.A. Rnskins LICENSE NO. 14-91
DESIGN ENGINEER OFSYSTEM-
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 675 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Maintain 101 from property line, do not install in fill materials
137.5 lineal ft. (22 units) infiltrator, inspectionportalsat end of each line.
ENVIRONMENTAL HEALTH OFFICER: /\ DATE: `f^ 57
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQU/R S OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM
REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED /N 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 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. SECTION /1/, 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: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE WITH THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS UNTIL THE SYSTEM IS APPROVED
PRIOR TO COVERING ANY PORTION OF THE SYSTEM. p 17 Y _`
/ J L � >T2uC/O/
INSTALLED ABSORPTION ORDISPERSAL
'�E.RRSAL AREA: B14 .86REFEET. �H'I /LYY2J�J�
INSTALLED S EPTICTANK: JAB' L GALLONS ._L� DEGREES IS FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALS ANDASSEMBLY 4-0— YES NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED.
COMMENTS: �J
ENVIRONMENTAL HEALTH OFFICER: �.DATE: /
ENVIRONMENTAL HEALTH OFFICER: / DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
AMOUNT PAID: RECEIPT N: CHECK
ISDS Permit # Q
Building Permit # 4�
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8730/927-3823(Basalt)
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00
PROPERTY OWNER: g
p-ct C e;-
0 A, G(
MAILING ADDRESS:
ecX 16i�7
4�0`
PHONE:3:zs -�73,3
APPLICANT/CONTACT
PERSON:
6a/c6C
PHONE:
LICENSED SYSTEMS CONTRACTOR: J-, A S ksfz/ / to's _
` ADDRESS: �Z)X 13 24, (f fn/,A PHONE: �12Z 'L3°7A�a®
PERMIT APPLICATION IS FOR: ( NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: 10T— =FX' S Z Z
Parcel Number: 11:F4L- 3S�-CD _ oa7 Lot size:°_,G}Cp_e�
Physical Address: Cis �) t, iTLc DiPr^r_-7'- P_/p ,
BUILDINGPE: - (Check
Residential /
Residential /
( ) Commercial /
HOT TUB
WATER CONSERVATION PLAN:
TYPE OF WATER SUPPLY:
Give depth of all
applicable category)
Single Family Number of Bedrooms
Multi -Family* Number of Bedrooms
Industrial* Type
Yes ( ). No )
Yes ( ) No ( )
well( ) Spring ( ) Surface ( )
Public b4 Name of Supplier: J^jCtcY/ieH �
wells within 200 feet of system:
*These systems require design by a Registered Professional Engineer
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
SIGNATURE
*********
* *** *************
AMOUNT PAID: �%S 00 RECEIPT# DATE:-�-�
CHECK # / CASHIER:
TIME LOG
Travel Pert Final
li
I
Application jp 3
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER: '5 ✓(/GQ ca ll4e
LEGAL DESCRIPTION:
MAILING ADDRESS: •130x 1q,1-7 ru,5;-�
TYPE OF DWELLING: NUMBER OF BEDROOMS 3
TEST HOLES PRE-SOAKED: YES NO_
TIME WATER DEPTH INCHES OF FALL
RATE SOTT. PROFTTA
1
2
3
1
2
3
1
2
3
1
2
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Time to drop last inch 7-o,2,
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PERC RATE: Z3 MINIMUM SEPTIC TANK SIZE: (ODy
MINIMUM LEACH FIELD SIZE: �7S +• t=Y 125a ''SyK/!Pd
COMMENTS: Mq,h �411', lO / Ae,°,4 Pr
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PERC TEST DONE BY:
rev. 6/90ks
eU DATE:
al Health officer
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