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HomeMy WebLinkAbout354 Hardscrabble Rd - 211129100001EAGLF 'OUNTY DEPARTMENT OF ENVIROW-7-NTAL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 PERMIT NO (this does not constitute • a building or use permit) Owner EI TH BRENT System Location 4 miles south of Gypsum - Tract 101, Sec. 29, T. 52 S, R. 85 hest o the 6th PM Licensed Contractor Self * Conditional Construction approval is hereby granted fora 1000 X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 20 minutes 750 sq. ft. absorption area per bedroom 250 sq. ft. — # of bedrooms 3 x 250 sq. ft. minimum requirement May we suggest a minimum of 750 sq. Date June 16, 1975 FINAL APPROVAL OF SYSTEM: gallon NOTE: Please post on property. Call for final inspec- tion. ft. of leach field - 12 ft. x 70 ft Inspector 71,44 Erik W. Edeen 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. eptic Tank cleanout to within 12" of final grade or aerated access ports above grade. Proper materials and assembly. ' Adequate absorption (or dispers area. Adequate compliance with rmit requirements. J Adequate compliance w County and State regulations/requirements. "7., a % Date % Inspector z ^- RETAIN WITH RI CEIPT RECORDS AT CONSTRUCTION SITE * CONDITIONS: 1. All installation must comply with all req ments of the Coutydividual Sewage Disposal Regulations, adopted pursuant to authority granted in 25-10-i 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 e 6 months in jail or hnth � ) ��������A�����8 ��� ~_..~....~.....~~.....~~ ~.�~~"~"-__' P.O. BOX 811 PERMIT NO. EAGLECOLORAQO 81831 1 PERMIT FEE $25.001 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Name of Owner: Phone: Address of Owner: Is facility within boundaries of a city/town or sanitation district? Af Distance to nearest sewer system: Location of Proposed System: - Type of Structure: Single Family DvvoUin0 ( �^�) Other: No. Bedrooms VVote, Supply: Private Well ( x,) Location: Distance From [each fie|6:__/^�_�L__ Size of Lot: Public Water Supply: An appropriate plat o|on must accompany site inspection for this application showing ,oqvi,e6 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 vho|i comply with House Bill 1553 [RS 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 oonitorion'o office. Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone 328-7718between 8:3Mand 9:00AM.]Refer hopermit number. Noapproval will begiven nnany system without final inspection. ' Nome' o66naou, and telephone of person responsible for design of system: The undersigned o6^nn~ledoem that the information in true and that false information will invalidate the application orsubsequent permit. ' SIGNATURE OF APPLICANT: Date: (This application becomes invalid 6 months from above date.) , � . / Percolation Information: Tank Capacity: ,,-Absorption Area: HEALTH DEPARTMENT USE ONLY � Permit No Fee Receipt: File: — c � � 70 ~ REMARKS: —_gal. �(ninimum) H � 6�.(minimum) APPLICATION IS: APPROVED i�- ) DENIED The above individual sewage disposal system was inn/oUe6 by AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. Dote' Sanitarian: ADDRESS PERMIT NO. LEGAL DESCRIPTION LOT BLK ADDITION SITE AREA- So. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS. SHOW BUILDING, SITE, AND SETBACK DIMEN, SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES. SHOW LOCATION OF SURVEY PINS. SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE / GRAPH SQUARES ARE 5' X 5' OR 1"=20' j I/we certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. / NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE ©O NOT WRITE BELOW THIS LINE APPROVED :ISTRICT AS NOTED DATE =orm 200.1 9-69 INSPECTOR ME NGT -L0jT 0 PE-ZHIT 140. KEITHBRET 1, Street Address or Le' -'al Description: DO N'OT 'VIAME B3-71-U.-IT T11-TIS LINE LP -7 Date of Test:-6-' . � Depth of `role:' Diaiacter:- Type of soil: Location of Test Hole: Test hole was presoaked from: To: T e (Date) (Tii-.ie' ) Date: T T -7 TTAT-?R RPTUI OF �FALL Ir Tr tt 2 3 3 2 31 2 3 'eu /2- zs DI Percolation Late: HIL Site has been reviewed and tested for percolation rate. We recommend: AP P i' ZOVAL DISAPPROVAL Da te: NOTE: Plot olan shoi-.,in-C, boundary lines, location of proposed building or buildill�s and design of septic systef-, must be SUI,1-111-ittcd with Application for Permit to Cors't:7'ruct. The back of this form may be used to show plot plan and design of system C, By: Sani tar -[.an P. 0. Bo,-,,. 81.1 Telephone (303) 323-7718 Eagle Colorado 51631 0017-Tract 101 Sec 29 T5S P Brent JOB NAM mw aglocco -IR JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED , t y I� t,t.. ,_.. A&w4�z-'? Job COST SUMMARY G TOTAL SELLING PRICE TOTAL MATERIAL 00 TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL. JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT JOB FOLDER Product 277 Qp NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 Printed in U.S.A.