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HomeMy WebLinkAbout167 Wapiti Way - 247106302012DEPARTMENT OF: ENVIRONMENTAL HEALTH (970) 328-8755 FAX: (970) 328-8788 TOLL FREE: 800-225-6136 www.eaalecountv.us P.O. Box 179 500 Broadway Eagle, CO 81631 www.eaglecounty.us EAGLE COUNTY PERMIT APPLICATION FOR ONSITE WASTEWATER TREATMENT SYSTEM OWTS PERMIT # BUILDING PERMIT # INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED (SITE PLAN MUST BE INCLUDED) FEESCHEDULE APPLICATION FEE $800.00 MAJOR REPAIR FEE $800.00 MINOR REPAIR F 400.00 This fee includes the OWTS Permit, Site Evaluation (Percolation Test, or Soil Profile Observation) and Final Inspection. Additional fees may be charged if a re -inspection is necessary, or a pre -construction site visit or consultation is needed. The re -inspection fee is $135.00 Make all remittance payable to: Eagle County Treasurer. Property Owner: %�2/M c/ Nl c22r/ c .•! Phone: 970 -'5'- 613 '5'- Mailing Address: 14 7 W.g-V emailf�c��a�l�5 Registered Professional Engineer: 771N! Phone: Applicant or Contact Person: 2e4(t ST�Ier-Ae.i Phone: 970 3792 71 z Licensed Systems Contractor: AS�Lt-�/79d�flt/� . License # Company / DBA: Phone: Ci7a 9& 3 0377 Mailing Address: / O 13a x / O5o G'O4-tz- e16 z 3 email I"f 1 e tl C'ti Cain Permit Application is for: New Installation Alteration `Repair Location of Proposed Onsite Wastewater Treatment System: Legal Description: /& 7 6-),9-P/77 W Tax Parcel Number: 2 4 B 0 V 5 0 oZ O 1 a Lot Size: -2.) Assessor's Link: www.caglecountv.us/i)atie/ Physical Address: Building Type: / Single Family Residential / Multi Family Number of Bedrooms: Number of Bedrooms: Commercial / Industrial* Type of Use: *These systems require design my a Registered Professional Engineer Type of Water Supply: Private Well Spring Surface '� Public If Public Name of Supplier: 2,0w0 1 51-1 w2.tr5 Applicant Signature: f' x�c�ciFxxa�cxca$xx�ycxxx�e;rxhexaeYc�Y�;e$e�>c�:�c�xXc;c>;e�',e>jexac;cac>,cacx3cacac$cxxxx$cxx�e;ehe$e�e�eaeaeae�Yxx�cxaF�cxt�xac�!chex��ac�e;exx Office Use Only Amount Paid: _ Receipt #: _. Check #: n 1 Date: May 3, 2011 Project No. 1814 Brian Morrison 167 Whapiti Way, Ruedi Shores Basalt, Colorado 80465 Septic Tank Installation Observation 167 Whapiti Way Eagle County, Colorado Brian, ALL SERVICE septic, LLC reviewed the septic tank installation observation for the subject property. On April 28th 2011 a 1050-gallon two-compartment poly Infiltrator™septic tank was installed.Risers and appropriate lids were installed. There were inlet and outlet PVC tees in place. The septic tank was generally installed according to specifications.This observation is not a guarantee of workmanship and/or parts and materials.ALL SERVICE septic,LLC should be notified if changes were to tank components. Please call with questions. Sincerely, ALL SERVICE septic, LLC Reviewed By: Timothy R. Petz Richard H. Petz, P.E. 2 copies sent Copy emailed to Eagle Copy emailed to Rick Stevens Copy emailed to Brian Morrison N SEPTIC TANK RECORD RTY `,NE D RAW I N G PROPS 0' 15' 30' Scale. 1" = 30'=0" i DRIVE EXISTING SEPTIC TANK ABANDONED. 1050-GALLON, TWO -COMPARTMENT PLASTIC (INFILTRATOR) SEPTIC TANK INSTALLED. EXISTING DRAIN FIELD 2 -v D DECK 0 0 3-BEDROOM RESIDENCE RUEDI SHORES PROVIDES WATER TO THE RESIDENCE. THERE ARE NO WELLS. P.O. Box 2844 Brian Morrison H11 + Glenwood Springs, Colorado 81602 167 Whapiti Way \ A / S P lI C Phone 970.618.5033 Basalt, Eagle County, Colorado �/ V ER��rE Fax 303.216.2796 I'1 U Project Number: 1814 �t r t�' e { a4/f k .�" Owner EAGLE NTY DEPARTMENT OF ENVIRONM AL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 John C. Owen PERMIT N9 434 (this does not constitute • a building or use permit) System Location Lot 22 - Ruedi Shores Subdivision - Filing 2 , Licensed Cep=aeter Owner ��� ,- * Conditional Construction approval is hereby granted for a l000 x Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 20 minutes 600 sq. ft. absorption area per bedroom 300 sq. ft. # of bedrooms 2 May we suggest Date June 3, 1980 X 300 sq. ft. minimum requirement FINAL APPROVAL OF SYSTEM: Inspector gallon z J 1000 gallon septic tank 600 sq. ft. leach field Erik Edeen 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. xx Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. xx roper materials and assembly. Installed: 1,000 gallon tank 840 sq. ft. leach Adequate absorption (or dispersal) area. (12'x70') field xx Adequate compliance with permit requirements. xx Adequate compliance with County and State regulations/requirements. Date September 23, 1980 Inspector Les Douglas, Building Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE * CONDITIONS: 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, 3.2Brequires 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 PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES 32;-7311 949-5257 927-3823 ENVIRONMENTAL HEALTH BOX 850 EAGLE, COLORADO 81631 PERMIT FEE _ $75 PERCOLATION TEST FEE = $50 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NAME OF OWNER: � a b1 � . � ADDRESS: e3Z.Z.9 PHONE: yZ,(-9'43s NAME OF APPLICANT (IF DIFFERENT FROM OWNER): ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: o� a C (O „) ADDRESS: PHONE: PERMIT APPLICATION IS FOR: New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED FACILITY: County F d G�� Lot Size r, Q City or Town, if within City or Town Limits r LEGAL DESCRIPTION: QLQ )G Loa- z z 2IZZ-4ji ' � Okc s STREET (RURAL) ADDRESS: IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? Yes ( ) No BUILDING OR SERVICE TYPE: (Check applicable category) ( ✓� Residential - Single-family dwelling ( ) Residential - Triplex ( ) Residential - Duplex ( ) Residential - Quadplex ( ) Commercial - State usage # Persons "Z # Bedrooms WASTE TYPES: (Check all applicable) ( ) Commercial or Institutional ("'j Dwelling ('') Garbage Grinder ( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher ( ) Other Automatic Masher SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( ) Creek or Stream Give depth of all wells within 200 feet of the system: If supplied by community water, give name of supplier: 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 NjILL EFFLUENT DL U1Jl^.HtiRlatD DIRECTLY INTO 1�IHICRJ l)f IIIC SIAIV: ) Yes (� iYU Signature Date //- INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER ' �77 GROUND CONDITIONS: Percent Ground Slope: r) 9 1980 Depth to Bedrock (per 8' Profile Hole): Depth to Groundwater Table: ­j SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole No. '-,A-,;AEN AL HEALTH Minutes per inch in Hole No. 2 Plinutes per inch in Hole No. 3 FINAL DISPOSAL BY: ( Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Above Ground Dispersal ( ) Sand Filter ( ) Underground Dispersal ( ) 'Wastewater Pond ( ) Othielr_• REPAIR PERMIT APPLICATION FOR INDIVIDUAL SE14AGE DISPOSAL SYSTEMS 5' 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 l4ealth 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 PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS: OWNER OF SYSTEM: ADDRESS: APPLICANT: ADDRESS: _ DATE: DEPARTMENT OF ENVIRONMENTAL HEALTH (970) 328-8755 FAX: (970) 328-8788 TOLL FREE: 800-225-6136 www.eaglecounty.us P.O. Box 179 500 Broadway Eagle, CO 81631 www.eaglecounty.us OWTS PERMIT # S =-1 I - % ocZO BUILDING PERMIT # INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED (SITE PLAN MUST BE INCLUDED) FEESCREDULE APPLICATION FEE $800.00 MAJOR REPAIR FEE $800.00 MINOR REPAIR F 400.00 This fee includes the OWTS Permit, Site Evaluation (Percolation Test, or Soil Profile Observation) and Final Inspection. Additional fees may be charged if a re -inspection is necessary, or a pre -construction site visit or consultation is needed. The re -inspection fee is $135.00 Make all remittance payable to: Eagle County Treasurer. Property Owner: %�Ief Xf Phone: 970 -9?Vy--5-6 3 Mailing Address: 7 email Registered Professional Engineer: 77r4-1 Phone: 4,70 td /,:r3 :!z4 33 Applicant or Contact Person: 2t44(t S7Z)1e-1-VJ Phone: 97a 3792 7S" ,_�' Licensed Systems Contractor: License # __ 37Z —1 Company / DBA: Phone: q:70 9&,3 ©3'77 Mailing Address: Fo 13 a x / V t o G'p14-Ee-- 0/6, 23 email I"f i'e v en r p.up&o Pcttii,cOvl,r�, e�y� Permit Application is for: New Installation Alteration 'Repair Location of Proposed Onsite Wastewater Treatment System: Legal Description: /& 7 77 W ' Tax Parcel Number: �2 q B0 l _5 0 a o r a Lot Size: Assessor's Link: www.eaglecountv.usipatie/ Physical Address: Building Type: GJ %177 G,f / Single Family Residential / Multi Family Number of Bedrooms: Number of Bedrooms: Commercial / Industrial* Type of Use: *These systems require design my a Registered Professional Engineer Type of Water Supply: Private Well Spring Surface "� Public If Public Name of Supplier: 12_b-w4 t 51-1 ot2em Applicant Signature:��'(/JE--®_. Office Use Only Amount Paid: _/ Receipt #: Check #: b 1 Date: 1 O 41 I 0 PERCOLATION TEST FEE: $50 OWNER: �76 -S D APPLICATION NO. �7 LEGAL DESCRIPTION:�� RURAL; ADDRESS: TYPE OF DWELLING: # OF BEDROOMS: DATE OF TEST: 57' TYPE OF SOIL: TEST HOLES PRESOAKED: YES NO TIME WATER DEPTH INCHES OF FALL RATE 1 2 3 1 2 3 1 2 3 1 2 3 �2zz 3s d sh i PERCOLATION RATE: Z ® TANK SIZE: 1,—cd SQUARE FOOTAGE PER BEDROOM: LEACH FIELD SIZE: Site has been reviewed and tested for percolation rate. We recommend: APPROVAL !/ DISAPPROVAL DATE: to � 1 � EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICER 0434 Lt 22, Ruedi Shores Sub, JOB NAME Flg 2 OWEN D'rc+ol �7d'79 _nG2 _n7 _n� 7 JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED 5 r JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL BOR PERMIT #434 NCE TAX OWNER: John C. Owen STS LOCATION: Lot 22 - Ruedi Shores Subdivision - Filing #2 INSTALLER: Hyrup Construction DWELLING: Residential - 2 bedrooms x 300 sq.ft. SIZE OF TANK: 1,000 gallons TAL JOB COST PERC RATE: one inch/20 minutes (600 sq.ft.) GROSS PROFIT 840 sq.ft. leach field (12' x 70') SS OVERHEAD COSTS. Y. OF SELLING PRICE Finalized: 9-23-80 By: Les Douglas NET PROFIT JOB FOLDER Product 278 I�a NEW ENGLjANP BU: Printed in U.SA- &A-�' W - IfIz -413' Datep R 0 V E D Peirmit # ...................................... Insp. ...................................... -------- ---- -- -- ----- ----------------- --- 6GIE--Co-U-N-Ty,-- COLORADO mi Lo _w :t 1\3 —A � 0 tx PC