HomeMy WebLinkAbout14243 Hwy 6 - 21102100007INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631
Telephone:328-8755
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALL4 TION SITE.
Please call for final inspection before covering any portion of installed system.
OWNER: Michael Hof
MAILING ADDRESS: P.O. BO
APPLICANT: Richard Gil
SYSTEM LOCATION: B' agll
LICENSED INSTALLER: Spieg
DESIGN ENGINEER OF SYSTEM: _
INSTALLATION HEREBY GRANTED FC
1000 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEE!
SPECIAL REQUIREMENTS: Inst
Install inspecti
Call for final i
ENVIRONMENTAL HEALTH APPROVA
CONDITIONS:
1. ALL INSTALLATION!
TO AUTHORITY GR,
9. THIS PERMIT IS VAI
TO OR USE WITH A
REQUIREMENT OF
a CHAPTER IV, SECT
FINAL APPROVAL OF SYSTEM: (TC
NO SYSTEM SHALL BE DEEMED TO
PRIOR TO COVERING ANY FORM
INSTALLED ABSORPTION OR DISPER
INSTALLED SEPTIC TANK: 100 Q
SEPTIC TANK ACCESS TO WITHIN S"
PROPER MATERIAL AN
COMPLIANCE WITH CC
\ " ITEM CHECKED NO RI
PERCOLATION TEST FEE
RETAIN WITH RECEIPT RECORDS
RECEIPT a
PERMIT NO. 1 3 1 9
CHECKN
Incomplete Applications Will NOT Be Accepted
(Site Plan MUST be attached)
)C)
ISDS Permit # .7; 1
Building Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. 0. BOX 179
EAGLE, CO 81631
328-8755/927-3823 (Basalt)
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* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
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PROPERTY OWNER:
fl iam 62
R4 PPwVtr NJ
MAILING ADDRESS:
7. 0.
GbC 7S i�---i4Q z
W631
PHONE: 9ZG
APPLICANT/CONTACT PERSON:-��t7b1r1�D GI�aL92T PHONE: t46-2-44/
LICENSED SYSTEMS CONTRACTOR: PHONE: 9Z4'71¢8
COMPANY/DBA: t-4Iq ADDRESS: ®. @ore Z-6is3 AvoN (fe, f 16Zb
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PERMIT APPLICATION IS FOR: ('�,q NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description:
Tax Parcel Number: 211( - 021 - 00Q7 Lot Size: 3s;Z:;- Ae
Physical Address:
BUILDING TYPE: (Check applicable category)
CX) Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
TYPE OF WATER SUPPLY: (Check applicable category)
(h) Well ( ) Spring ( ) Surface
( ) Public Name of Supplier:
Number
Number
Type _
of Bedrooms :7
of Bedrooms
*These systems reg}r#�e� d sigry by a Registered Professional Engineer
SIGNATURE: �� Gf Date: /9!4
************ ******************************************** ****************
AMOUNT PAID: oJ60-Da RECEIPT #: I �61 LO / DATE:
hI glq�
CHECK #: 1 F5 4 ! CASHIER:
i
(2) 24' .' PIPES
CAPTION A
�;
' l '
WATER WELL
rEXISTING GRAPE/�
/
i
�f NEW GRADE
-_-
SEWAGE TANK
I FIELD
-- I
LOT 6
EA SITE PLAN SCALE:
ISDS PERMIT ; )319
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER: (�Uf%rl�LaNj
LEGAL DESCRIPTION:
MAILING ADDRESS:
TYPE OF DWELLING: .5. NUMBER OF BEDROOMS , Z
�r:rx��r���rvc**.*xx�t�rx �r,t�rrtrr*�tx�rrr,rxx�r�r�r�rxa�sr
TEST HOLES PRE-SOAKED: YES_ NO
TIME WATP.R nP.PTH Twt urc nr raT.T. Dnmr
1
2
3
1
2
3
1
2
3
1
2
0'
�
I
Z�
- ,
j
�
2-
2'
31
ILi
5
t,s
5
33
5
4'
ti
11
0
1 ,'75
1, a5
l d
v
�
z, �
6'
5:
40
5
.5
S
7�
.15,D
r)
5
a'
>
5Le
50
J0,o
YtiC> r, I`kA^.k
Time to drop last inch
PERC RATE: LA 5•e_ I MINIMUM SEPTIC -TANK- S-L
MINIMUM LEACH FIEL� yI2E . Z 5 �Jl
11
PERC TEST/DONE
rev. 6/90ks
DATE:
ricer
_ 4Y[ I 5c,
LD
5
-) . I T
COO
P.QA I arQ��
� c•• �CA-c>Ys C_O
I1 PM1on M �r7J
—WATER WE
I - y_[_x�sTNG GRA9E' i _-
1 1 -�
— `— -
--SCWACaE TANK
---I.EACN FIELD
LOT
6 - -
.%�. Fc E.A.._-,._, i : E-. P_l A N - a _Z ,
TRANSMISSION REPORT
THIS DOCUMENT WAS CONFIRMED
(REDUCED SAMPLE ABOVE - SEE DETAILS BELOW)
** COUNT **
TOTAL PAGES SCANNED 2
TOTAL PAGES CONFIRMED : 2
*** SEND ***
NO.
REMOTE STATION
START TIME
DURATION #PAGES
MODE RESULTS
�—
- -f ----
1
8323517
1..-�2-97
1'30" 2/ 2
EC COMPLETED
I9600
--
TOTAL 0:01'30"
2
NOTE:
No.:
OPERATION NUMBER 18
1800BPS SELECTED
EC
ERROR CORRECT
G2 G2 COMML'\'ICATION
PD
POLLED BY REMOTE. SF
STORE N FORWARD
RI
RELAY INITIATE
RS RELAY STATION
MB
SEND TO MAILBOX PG
POLLING A REMOTE
MP
MULTI -POLLING
RM RECEIVE TO MEMORY