HomeMy WebLinkAbout3336 Valley Rd - 211120300023EAGLE UNTY DEPAkTMENT OF ENVIRONV ITAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT (this does not constitute
7 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 s q. 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 final grade or aerated access ports above grade.
Proper materials and assembly.
zAdequate absorption (or dispersal) area.
,Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date Inspector O'"'_
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 � 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
hnth -
ENVIRONMENTAL HEALTH
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631 1 PERMIT FEE $25_00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Name of Owner: v Vcv Phone:
Address of Owner: JV
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 Supp Y�vi
ly:
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. . r Y^ p Date
(This application becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information: �Permit No
Tank Capacity: _ gal. (minimum) Fee Receipt
Absorption Area: 45- Sq. ft. (minimum) File:
REMARKS: £r
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:
OLATIJ_', 1A!`.JA
AND SITyiS PEJTIO-NI
E- ti' 50.0 n•J j
Pn_U'._T
NOT
/g
�T'Tlt.i.._i• ,d J �3
Street
Address or Legal Description:
T,_ c f-� o
D;•rel�?n4,•
.r ;
� i���- ij;-,,t,c_ o{
s
DC i-1OT s.T .ITD BE' C;c; THIS IsIidT
Date of
Test: <
Depth of Tole: ' DianeterIZ
: Type
of soil:
DLf
Location of Test Hole: 4
Test hole was presoaked from:
-f, j - 2To:
(Tine) - (Date) (Tine) Date:; .
:-'r 1 ( 2 3
1 2
3
1 2 3
1 2 3
•,f
!
t_c
Percolation Rate:
Site has been reviewed and tested for percolation rate, .
We recorn?end: APPiZIOVAL ( -DISA PPRMc L ( ) Dater '
iti7OTE: Plot plan siloc•.ing bou-ttdar�. l nes
i_� , location of proposed building or build:ii.t?,s
and design Of Septic system must Si i7C SL:b ? LtCC T7i th p f.ic_ttion for Pe:ijit to Construct.
The back of this form may be used to show Plot ,plan and design of system.
By:
Sanitarian
P. 0. Boy; 011
Telephone (303) 3%t;-7715 Eagle, Colorado 81631
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0007-T5 R85W 6th PM Gypsum
JOB NAME 336 Gypsum Creek Rd Jones
ME MEEMEMM
JOB NO.
B LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
oll
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
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