HomeMy WebLinkAbout1929 Copper Spur - 168904100001INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N2 0 7 8 8
P.O. Box 850 - 550 Broadway
Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927-3823
YELLOW COPY OF PERMIT MUST PLEASE CALL FOR FINAL INSPECTION BEFORE
BE POSTED AT INSTALLATION SITE COVERING ANY PORTION OF INSTALLED SYSTEM
Owner: Michael & Jo Etta Ledgerwood
Address: P. 0. Box 1002, Craig, CO 81625
System Location: 1929 Copper Spur Road - Bond
Telephone: 824 -67 08
Licensed Installer: Jim Matlock 653-4478 License Number:
Conditional installation approval is hereby granted for the following:
Minimum requirements: 1000 Gallon Septic Tank or Aerated Treatment unit
Absorption area of dispersal area computed as follows:
Percolation rate: Inch in Minutes
Absorption area per bedroom Sq. Ft.
Number of Bedrooms 2 X Sq. Ft. minimum requirement per bedroom -
equals Total Sq. Ft. minimum requirement
Special Requirements: 60 feet of 3 foot wide trench
Date
-I
CONDITIONS:
vironmental Health Officer:
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, 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 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 system is approved prior to covering any portion of the system.
INSTALLED ABSORPTION OR DISPERSAL AREA: / SQ. FT. ;
INSTALLED SEPTIC TANK: I GALLONS; DEGREES; FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: i - / r PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE: YES NO
PROPER MATERIALS AND ASSEMBLY: YES ' NO
COMPLIANCE WITH PERMIT REQUIREMENTS: YES NO
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO
COMMENTS:
(Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when
work is completed.)
DATE (Final Approval) 'ENVIRONMENTAL HEALTH OFFICER: -
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS
Name of Applicant: Michael Ledgerwood Name of Owner: Same
Amount Paid: 2 00. 00 Receipt Number: 3018 Date: 4-16-87 Cashier:
Check #550
PERMIT
E. Huenink
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPLT_CATTO': FOR T'�"T77" AL DLSPOSAL S':S PET !T
PER.`fIT APPLIC:.TION FEE:
NA.`1E OF OI.TNER:
ADDRESS:
Etti'IRONMENTAL Eir—ALTH OFFICE - EAGLE COU', _'.
P.O. Box 350
Eagle, Colorado 81631
8150.00 328-7311 PF.RCOL-MON
V�- t-� "72Xa�
NA.`fE OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTE.`t (if applicable):
ADDRESS:
Ph004 i,LI' i -i1' lib L" 1 �;': INS ILLATION OF SYSTEM:
Licensed Installer (see attached list):
PHO`iE:
V t
Z FEE: S50.00
n- PHO;E:
YES Nff - T/M /41Tc0tie-
ADDRESS: PHONE: �S� _ �/�l7c9
PER`fIT APPLICATION IS FOR: (� New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL S b4AGE ISPOSAL SYSTEM:
Street/Rural Address: �yyzx r
Lot Size:
Legal Description:
BUILDING OR SERVICE TYPE (check applicable cateaorv):
() Residential - Single Family
( ) Residential - Dualex
( ) Residential - Tr_plex
NUMBER OF PERSONS: 15
WASTE TYPES (check applicable cate?ories):
( ) Cor-mercial or Institutional
( ) Non -Domestic Wastes
( ) Garbage Disposal
( ) Automatic Washer
( ) Other
TYPE OF INDIVIDUAL =.,AGE DISPOSAL SYSTF-M PRn?nSFn•
( ) Residential Quadplex
( ) Co—n -ercial (state usage)
NUMBER OF BEDROOMS:
( ) Dwelling
( ) Transient Use
( ) Dishwasher
( ) Spa Tub
('�() Septic Tank ( ) Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( ) Greywater ( ) Chemical Toilet
( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use
( ) Other ( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (�C)
IS SYSTE_`I DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES O NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO OO
(I 6 Yes, see attached tiaS tE'wa.te,t 5.2ciu ,'LeduCti c n methods)
NOTE: The Env.cto;v-nenta.Z Heae-t'L 03'6.teeAL matt ,teduce the ,teou'i'ted ab.Satption atea upon
apptovae o5 an adequate was exat2t 6&tv lLeductton p'Zai.
SOURCE AND TYPE OF T.TATER SUPPLY: ( ) k'ell (�) Spring
( ) Creek/Stream
Give depth of all wells within 200 feet of system: /i0 ��-
If supplied b y community c�ter, give name of s�plier:
SIGNATURE: - - Z,� - - -.� � - - r 7
� - - - - DATE: - l _ - - -
INFORMATION LOW TO BE PILLED OUT BY ENVYRON"fENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent Gaou►zd Slope
r Depth .to Bedtoeh (pvL &' Ptco'Zee Hote) 7 E
Depth .to GtouncLeate,t Tab.2e -2 ey '
SOIL PERCOLATION TEST RESULTS:. M.c;Lutes pelt .C'n6i in Hoi-e n1
hl,i.nuta pets inch .to HoZe # 2
IMLi-PLU tC S peAL iACIL -t 0 HOZe # j
FINAL DISPOSAL BY:
( ) Ablso.tpti.oii Tneach, Bed o,t Pit ( ) Evapot,tansPiAati.on
( ) Above Gncund DZ5peA5aE ( ) Sand F.iZtct
( ) U;tdvLjctound Dtispensae ( ) 1Va5.twcatet Pond
( ) O.th t
Amuu;Lt Paid: ad Receipt Numbe.t �501
- - - - - - - - - - - - - - - - - chv # _ ,50 - - - - - - - - - - - - - - - - - - -
NOTE: Site Plan must be attached to'application.
(Env. Health Department - Rev. 4-07-83)
COLORADO DEPARTMENT OF HEALTH
ACCOMMODATIONS INSPECTION REPORT
Name Co. Acct. No. Category No.
Location { r a-, - =:4 ,2„� ,' Zip
Owner Address Zip
Operator Address Zip
Units Capacity Dale Female Juv.
Water, Source -Type Sewage, Type -Method Food Food Source
Swimming Pool
An inspection of the above noted facility on this date reveals the violations and deficiencies
listed below which you are hereby ordered to correct:
e I 'L"e�" Y 611t
/,
DatV
CPS:57
(5-75-10)
Received By
Inspected By -'-
Score
COLORADO DEPARTMENT OF HEALTH
r ACCOMMODATIONS INSPECTION REPORT
Name '"/ ` Co. l/<- ��' _ Acct. No. Category No.
Location Zip
Owner _=- , ,_ , �, GIB Address Zip
Operator Address Zip
Units Capacity_ Dale Female - Juv.
Water, Source -Type t Sewage, Type -Method 1 /� Food Source
Swimming Pool
An inspection of the above noted facility on this date reveals the violations and deficiencies
listed below which you are hereby ordered to correct:
t "/ r
`7 CG
r L�
Date Receiv
CPS:57 (5-75-10)
M
Inspected By
Score
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
Name _
'- '2
Date Routed
ocation
6If5 q
App 11 cati on- No
Please review the attached Individual Se..iage Disposal System Permit Application and return
it with this completed form to the Environmental Health Office.
PLANNING: Complies with -
Subdivision Regulations:
Zoning Regulations:
Recommend Approval:
COMh',ENTS :
.. YFS ..ran-oGVTr,Jcl' QV
- --
UMIC
f
BUILDIidG: Complies with - YES j NO j REVI -1ED BY DATE
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
YES NO REVIE;-IED BY DATE
EN'/IRO?1PiEiJTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Reco,�.mend Approval:
YES
NO
REVIEWED BY
DATE
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