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HomeMy WebLinkAbout3033 Upper Cattle Creek Rd - 239127100004 - 0008EAGLE CC TY DEPARTMENT OF ENVIRONMEV-11_ 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 ; I 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 FINAL APPROVAL OF SYSTEM: Inspector No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is appro7eptic . r to covering any part. Tank cleanout to within 12" of final grade or aerated access ports above grade. Proper materials and assembly. L.I/ Adequate absorption (or dispersal) area. Z'Adequate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. (�� I ;�� Date S K Inspector CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations, adopted pursuant to authority -ranted 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 I- -.I- `NVIRONMENTAL HEALTH PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $2 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 5 0� ' `' w. Name of Owner: 0c " //77 t Phone - Address of Owner: , > Is facility within boundaries of a city/town or sanitation district?A. ` Distance to nearest sewer system:. '_.' Location of Proposed Legal Discription: Z Type of Structure: Single Family Dwelling ( Other: No. Bedrooms Water Supply: Private Well (') Location: Distance From leach field: Size of Lot: 7 J"7 Public Water Supply: PP Y: 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 » Percolation Information: r -Z:� Permit No L � Tank Capacity: gal. (minimum) Fee Receipt: Absorption Area: Sq. ft. (minimum) File: �i REMARKS: I 2 P 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: ` »� g� —/S Sanitarian: I L- - .C�Z�.----' OLI r� 0 r- " S PEL-Uf-IT �-To. 1 N.E 'S't-rect Address or I'legal. Descr-;-,ot-ion: Tyl-, TITS I f dj 5Z-14 - Z-. Sate of Test: Deipth of 'hoie- 2;/2 M ac,.,,ctcr:-/a. Type of soil": -Y Location of Test Hole: Test hole was presoaked `roar: (Time) To: JJ a L c (Time) M, FAI�F. 2 3 2 3 2 A 4 C? 7- 2-Z !I (b- I 1 00 Percolation late: Site has been revi e-,Ted and tested, For p rcoi, tj.,ojj r, for � c .-I . Lte T- mmi e n d T- 21-7,5 w" 7 Ne reco "0 -1 -� S- A P P 0 1-1 Date: NOT'",: Plot boulArla-v 1417es, 1) ;C(! 'L)l J- bu-1 and d, es i n o scpt-ic s :-,-,us Ni i.icntion for. PelumiL to ConstriAct. The back of this form -,M�1Y be Ls('- d 11-0 show plot plan and desiSn of system. B-v: 1). 3-0<- 811 Telephone (303) 320-7718 Eagle, Colorado 81631 4p'— JOB NAMEr 3 P, JOB LOCATION G ' , r x ....: tdal 'fix BILL TO ON - DATE STARTED DATE COMPLET a ff _PATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT L.000/ JOB FOLDER Product 277 ®O NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 Printed in U.S.A. i N (5 Z- 17-107-1—IZ- 101,11" ZCTI 0o