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HomeMy WebLinkAbout20 Daggett Ln - 211120200005EAGLE ')UNTY DEPARTMENT OF ENVIRONP--NTAL 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: FINAL APPROVAL OF SYSTEM: No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved p1rior to covering any part. Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. Proper materials and assembly. equate absorption (or dispersal) area. .'�equate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date 7L Insoector ... .......... . . . . 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 hf)th- ENVIRONMENTAL HEALTF P.O. BOX 811 �• EAGLE, COLORADO 81631 PERMIT FEE 225.00 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT -ner: Phone. of Owner. Is facility within boundaries of "a city/town or sanitation di Distance to nearest sewer system:' Location of Proposed System:_ Legal Discription: ct? Type of Structure: Single Family Dwelling (,.-°') Other: No. Bedrooms Water Supply: Private Well ( ) Location: Distance From leach field: Size of Lot: Public Water Supply: �F- 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: JI The undersigned acknowledges that the above information is true and that false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICANT: —0- L2 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: " C" ° Sq. ft. (minimum) File: ,u r .. 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: 0LI PE UlIT I40. P1:._;COLATIL1'd TES O:Ti'�u_ . ffff c11.YrD SITTE zL,SPEc.;T IV!'i r Street Address ©r Legal Description:' ; TJ__,e of D[•.*ellin: 2�;;,l';er of DO 13OT T•T "ITE "M.-L •T THIS LINE -Date of Test: Depth of hole: Diameter:Type of -oil: Location of Test Hole: Test bole v.,as presoaked from: To: (Tine) (Date) (Time) Date: -r " 1 2 3 T.r�i i t :� T}-t�T�i j� 1 .. 2 3 11 IP•.TC'? T C OF IaT 1 1 2 3 IRAIRAj T 1 2. + 3 .. .. C-6j 1 f ! J..... i ' C ' fie.„. L� �? 4 ` 7 ,rfl� // I / T C, � g 7 �j . 1 Percolation Pate: / 121 Site has been reviewed and tested for percolation rate. We recorinend: APPx;OVAL ( } DISAIPPROVAL ( ) Date: —"`2_"7 ir`'OT%: Plot Ilan S FOP:in� i�OFlnd?�"y' lines, location of p'F:oposed building or buildiil�^�s and desic-n of septic syste 7 lutist be su: mi ttcd with Ap,'plication for Permit it to COn5trLFct. The back of this fora may be used to shoo plot pIan and design of system. . Dye . Sanitariati f . 0. Boy: 811 Telephone (303) 328-7718 Eagle, Colorado 81631 a. E7" LANE �rGATE aA1"F ki w 2 <14 / W / � c W so� 4 4v 0. tu SEp-rlc T Anrt< RES/DEUCE 00 i O z. _ 207 d LoC_A-'rlrJ N - 3_• Mi. 5o of Gypsum\ wrST S�nP- 0 c Co. ROAD '0 lot __ 0013-3 Miles S of Gypsum JOB — 0020 Dagget Lane Bratton � � JOB NO. JOB FOLDER Product 277 Qq NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 FOLDER Printed in U.S.A.