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HomeMy WebLinkAbout482 Paseo Rd - 239127304006 - 0032EAGLE ,NTY DEPARTMENT OF ENVIRONMr AL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 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 sq. ft. absorption area per bedroom # of bedrooms May we suggest Date x sq. ft. minimum requirement FINAL APPROVAL OF SYSTEM: Inspector (this does not constitute a building or use permit) No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system is approved p for to covering any part. eptrc Tank cleanout to within 12 of final grade or aerated access ports above grade. Proper materials and assembly. ' Adequate absorption (or dispersal) area. Adequate compliance with permit requirements. Adequate compliance with County and State regulations/requirements. Date ✓` (/ 7 Inspector 42��,5 A44 IQ" 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 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 - 6 months in jail or hnth ENVIRONMENTAL HEALTH P.O. BOX 811 PERMIT NO. EAGLE, COLORADO 81631 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Name of Owner: Kassco Realty Corporation Phone: Address of Owner: 0500 102 Rd . , Ca rbondp 1 e, Colorado 816'- PERMIT FEE $25.00 Is facility within boundaries of a city/town or sanitation district? Distance to nearest sewer system: m i_1 es Location of Proposed System: Lot 72 of Unit I First Filing, Aspen Mesa Estates, Eagle County Legal Discription: Lot 72 of Unit I First Filing, Aspen Mesa Estates, Eagle County Type of Structure: Single Family Dwelling (" ) Other: No. Bedrooms Water Supply: Private Well ( ) Location: Distance From leach field: t-� F Size of Lot: Public Water Supply: 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. �.n SIGNATURE OF APPLICANT: 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:. Sq. ft. (minimum) File: REMARKS: 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: .OL E - P;��:C OLt-MDN TEST AND SITE `NS PECTIOIN / FEE- t•0 nn y5• i Street Address or Legal Description: `— 9 %Z Type o i D-ve11in-N " be DO NTOT WRITE D :LO THIS LINE Date Of Test: rei?t�h of holeDiameter:Tit evi Soil: Location of Test Hole: Test Hole was presoaked from: TO; (line) (Date) (Time) Date: l TT' - I ,7C T-,„ RPTH I :.l;CHES OF FA L• P.ATR: 7r ]. 2 3 1 2 3 1 2 3 i 1 2 3 2-f l 4/ - / 1746 r Y . 3� ^� 157 0 151,U Percolation ?ate: 1.211 Site has been reviewed and tested for percolation rate. We reco-n nend: AP'P«OVAL• ( ) DISAPPROVAL ( ) Date: NOTE,: Plot plan showing boundary lines, location of proposed buildin;.or buildings and design of septic system must be submitted with Application for Permit to Construct. The back;, of this form may be used to show plot plan and design of system. By: Telephone (303) 328-7718 Sanitarian P. O. Bo; 811 Eagle, Colorado 81631 STANDARD BACTERIOLOGICAL WATER G 4�� Esc o Colorado Department of'Health ✓ TEST k 4210 East 9lth Avenue -Denver 80220 *'a 'Phone 388 6111 ~ 1 RESULTS Sample taken: Date Name ofy xY a 1 rt Supply County' ( ) Type of Supply: `/� (}Yi Private (J/r Well t v Source: MF Municipal •' Surface �:� per 10i i ) Food Establishment ( ) Raw Water LB V Sample Token by: �/i� Chlorine %l0 tiY2-CFi eG 24 48 Residuals m �l Fd Information (�� �1 m gG8 mc all 7 24 Return Report SPC r ''3�i r •, � � WWW r1i>> _��i, R��1 MPN 11��q, pp,, ��tt Address EI�I% U1> Itl 'UTA CI SAMPLE IS. p p v CB g City StateEAGLE [> SEE REVERSE SIDE FORLAB-MICRO r 1061970 (LOOM) ©MSampling IrIStrUCtiOnS'' - :-.ACTORY FOR Te resubmit 0032-Lot 72 of Unit 1 Filing 1 AME _ p JOB NAIL 0482 Paseo Rd Reno 1- 2.39 JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED �Q SUMMARY OV '10 V WERE �„�RICE 0.,�'e E �� , �xte�stan V\, CG I,, JA et PERMIT # 32 - V I2 OF roae plb�ne Plea A"'_ OWNER: K�-#�-& ; C--o rpo-ra ttoTr— �� I k C ��y CAS ( K 'f �'4�O �O5��,ISM f LOCATION: Lot 72 - Unit I (1st Filing)- Aspen Mesa (1.19 CA '� Oso, YO CAtiti Esta. '� acres) INSTALLER: Owner ry SIZE OF TANK: 1,000 gallons DWELLING: Single Family - 3 bedrooms x 250 sq.ft. = sS99 Me 750 PERC RATE: one inch/5 - 40 minutes (750 sq.ft.) sq.t OPetetoc (suggest a minimum of 750 sq. ft. of leach field) a 3�1 _ a.--A-)-j _ 04 - 00 % L _ �L�� _wCYca N r'120FIT �� vy PlccUKr Job Finalized: 9=10=75 By: Les Douglas / Printed in U.S.A.