HomeMy WebLinkAbout29570 Brush Creek Rd - 247308400003 - 0019EAGLE( 'INTY DEPARTMENT 01F ENVIRONMr-' TAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT (this does not constitute
a building or use permit)
/wner
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.
— [Z Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
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
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
tenth
PERMIT NO.
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P.O,BOX 8Yl
------- EAGLE, COLORADO 81631 --
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Name of Owner: ILL /`L Phone:
Address of Owner:
is facility within boundaries of 6
Distance to nearest sewer system:_�_
IX
Location of Proposed System:
Legal Discription: It/
Type of Structure: Single Family Dwelling Other:. -No. Bedrooms
Water Supply: Private Well
Location: Distance From leach field:_-`,'
Size of Lot: Public Water Supply:
An appropriate p|o, plan must accompany site inspection for this application showing required information. (See
othzcha6 sheet.) The individual sewage disposal oyoham will be constructed and installed in occunJonce�,vv*h the
regulations governing individual sewage systems within Eagle County, and xho|| comply with House Bill 1553 [RD
66-l4'l973.Payment shall 6emade +othe Eagle County Treasurer. Permit, upon approval ofthis application, may 6e
obtained at the Eagle County ooni+o,ion'o office.
Appointment for final inspection nmwu+ be made prior to construction by mwn+mcfnQ the inspecting sanitarian. [Phone
328-7718 between 8:3Qand 9:00 AM.] Refer to permit number. No approval will be given on any system without final
,inspection.
Nome o66,ean, and t 6 1e6r6une of person res ' ni6|efv, design of system: '
The undersigned acknowledges that the above information is true and that false information will invalidate the
application o, subsequent permit. _
^l
SIGNATURE OFAPPLICANT: D
(This application becomes inva(id 6 morttks from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information:
Tank Capacity: gal. (minimum)
Absorption Area: Sq. ft. (minimum)
Permit No.
Fee Receipt:
File:
~~
6
APPLICATION IS: APPROVED DENIED
The above in6kvi600| sewage disposal system was installed by
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT.
Sanitarian:
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PI :_ O'L,S.TI T' ST "J. SiT� icI� PECTIOI � FLL- 00
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PE'-iiT 140. C)f;P.c.'•` 1`-��17`tftlls j
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Street Address or Leal_ Descz iption;— j
1'_ e o+= Da*eli_n:` of
DO ltv r t,r \, TI-TIS LINE �
Date of Test —.S Depth of '-pole: Diatieter: Type oho
Location of Test Hole:
Test bole was presoaked from: To:
(Time) (Date.) ( n) Date:
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Percolation Pate: i-API
Site has been reviewed and tested for percolation rate.
We recon ?end: APP ;OVAL ( ) DISAID,Pi:OVAL (Date: ��
NOTE: Plot plan s'<oi•.ing boundary lines, location of pl:oposed building or buildizi�s
and design Of Sep tic S�7StE.E1 I:St be Si:% ?i ttcd w Lh AppIicn Lion for Perin-i t to Construct.
The back of this form may be used to show Plot Plan and desiGn of Systei?.
a
i35'
Sanitarian
P . 0. tio.c 811
Telephone (303) 328-7718 Eagle, Colorado 81631
JOB NAME t Les—AV�6:-�7�-Ao
MZTRLki�-t- -,e7OUDLES
08 LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
PERMIT # 19
4e,
OWNER: Arthur Bowles
LOCATION: Sec 8, T8, Range 83 - Spring Creek (200 acres)
INSTALLER: Owner
SIZE OF TANK: 750 gallons
DWELLING: - Cabin - one bedroom
PERC RATE: one inch/20 minutes
(suggest a minimum of 12 x 30 - 40 sq.ft. of leach field)
Finalized: 10-15-75 By: Erik Edeen
)LDER
JOB NO�
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL I I V111111111111111A
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
Printed in U.S.A.