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Home My WebLink About5.5 Miles E of State Bridge - Elbert Cisco - 0003EAGLE ANTY DEPARTMENT OF ENVIRONM,r- TAL HEALTH Box 81 I 6th & Broadway Eagle, Colorado 81631 PERMIT (this does not constitute a building or use permit) 0 wner System Location Licensed Contractor Conditional Construction approval is hereby granted fora gallon Septic Tank or — Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Pere rate inches in minutes s q. ft. absorption area per bedroom H of bedrooms _X sq. ft. minimum requirement May we suggest Date Inspector FINAL APPROVAL OF SYSTEM: No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approve prior to covering any part. Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. V/ Proper materials and assembly. Z Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date Inspector G-1 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 111, 3.24 requires 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 both. u PERMIT NO. APPL Name of Owner: Address of Owner: ENVIRONMENTAL HEALI, � �� P.O. BOX 811 EAGLE, COLORADO 81631 f f PERMIT FEE $25 00 TION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Is facility within boundaries of a city/town or sanitation district? Distance to nearest sewer system: Location of Proposed System: Legal Discription: Type of Structure: Single Family Dwelling (, ) Other: No. Bedrooms Water Supply: Private Well ( ) Location: Distance From leach field: Size of Lot: Public Water Supply: — 1 An appropriate plat plan must accompany site inspection for this application showing required information. (See attached sheet.) The individual sewage disposal system will -be constructed and installed in accordance with the regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS 66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be obtained at the Eagle County sanitarian's office. Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone 328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final inspection. Name, address, and telephone of person responsible for design' of system: The undersigned acknowledges that the above information is true and that.„false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICANT.- = --- Date (This application becomes invalid 6 months from above date.) HEALTH DEPARTMENT USE ONLY - P° Percolation Information: �` Permit No s 5:. u, r Tank Capacity: gal. (minimum) Fee Receipt _ - Absorption Area: Sq. ft. (minimum) File: REMARKS: {' x APPLICATION IS: APPROVED ( ) DENIED The above individual sewage disposal system was installed by, AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. Date: Sanitarian: Px:_',CO:.,ATIGiv' T.:ST ��IyD SITE 'UNSPECTIONi % FEE C0 % Street Address or Legal. Description: Te o Dtaell;n•; Ae r of DO idOT 1,d :ITS THIS I:INE 'Date of Test:` Depth of hole: Di a,leter: tP Type of7 ' soil: � Location of Test Hole: Test hole was presoaked from: To: (Time) (Date), (Time} Date. JLl ` T ',r -- - t.T,,A.T7P T)7RP-f O1; F .z,I, +1 ��.. r t' 1 2 3 �i 1 2 3 2 3 1 2 3 �1 i�t- CID, 2 TC° ' t 2 s Percolation Rate: Site has been reviewed and tested for percolation rate. - We recorz-end: APPROVAL C DT' &%PpROVAL ( ) Date: `� — /13 NOTE: Plot plan s ;o:•:inu ho nda y lines, location of proposed building or buildi.lus and desif-n of septic syste.- must be submitted wiApl)l.ication for Permit to Construct. The back of this form may be used to show plot plan and de si-ri of system. By: , Sanitarian P. O. BOX 811 Telephone (303) 328-7718 Eagle, Colorado 81631 EAGLE C INTY DEPARTMENT OF ENVIRONM' TAL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 PERMIT (this does not constitute a building or use permit) Owner System Location Licensed Contractor * Conditional Construction approval is hereby granted for a gallon Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate inches in minutes sq. ft. absorption area per bedroom # of bedrooms x sq. ft. minimum requirement May we suggest Date - `' Inspector FINAL APPROVAL OF SYSTEM: 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. Septic Tank cleanout to within 12" of fi al grad or aerated access ports above4fade. Proper materials and assembly. Adequate absorption (or dispersal) area Adequate compliance with permit requirements. , Adequate compliance with County and State regulations/requirements. Date 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, 3.24 requires 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 003-Star Route Bond 5.5 E of State JOB NAME _�— Bridge Cisco JOB OB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED Cis co ad° to 6ge Easy st3pp COST SU Epp Sq - JOB MMARY 51,2 AA es so, (,\,jf\ev �\se 6r000s V bTOTAL SELLING PRICE NO, Res.den dotes c�l�pTOTAL MATERIAL VA \yw, �v RP(RP(E p SqA V3-Ak TOTAL LABOR 613 0 INSURANCE A SALES TAX MISC. COSTS jo TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT JOB FOLDER Product 277 ®,D NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Printed In U.S.A.