HomeMy WebLinkAbout29 Kirk Ln - 210904203003AI
\NVIRONMENUL HEALTH \
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Name of, Owner: I`VeG! �r�r /����YC� V E Phone: ��%�� - :�(o(Ai
Acl&ess of Owner: 1_ o 2-2
)' n -A l r k
Is facility, within boundaries of a city/town or sanitation district? CiU
Distance to nearest sewer system ----
Location of Proposed System: Cott. 51 C
Legal Discription: `. 0 % -,2. y /�a 6 L
Type of Structure: Single Family. Dwelling ( L,-)'Other. No. Bedrooms
Water Supply: Private Well ( ) Location: 7 C) L,-- % /�� �P�Distance From leach field:
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:
a
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit.
SIGNATURE OF APPLICANT: r- -/ t''� =�< i r� Date:
(This application becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information: Permit No. �_.. i
Tank Capacity: 1 71. (minimum) Fee Receipt
Absorption Area: ' �/� f ! _ Sq. ft. (minimum) File:__ i Y
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:
OLE
0
PE i::v0 . ^,TION TL•' 'T <+1D ^ �.�.• -Nc P EUT . / .
i'...v.'.,.lrl' i'IU 9T,TI:7
Street Address or Legal. Description:
Tv',c,. O_ Dwc,ilin Sj' / � I� IT '17ber of e� Y' tiu_ :elGO__S:
DO NOT W2,ITIE BELO'r' THIS i.,Ii•;E
Date of Test:-- /' Depth of dole: Diameter: %Zit
Type of soil.:
Location of Test Hole:
Test hole was presoaked from: To:
(Time) (Date) (Tine) Date:
.;
r.TgT :? N
I^h:,i Fc OF FATII:
L.�T'r
1
2
3
1
2
3
1
2
3
1
2
3
MA
-1
174.
1650
0
Z
l
l
f /V
2-2
Percolation ,ate: ���-�1- I
Site has been reviewed and tested i t percolation rate.
'7e recornu:iend: APP.,OIda ( DISxiPP i ;OVa( ) Date:
NOTE: Plot Man shooing boundary Lines, location of proposed building:or l;uildings
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:
Sanitarian
P. 0. Boy 811
Telephone (303) 328-7718 Ea;le, Colorado 51631
14C Fee-weu
CUSTOM BUILDING
JAMES C. CRAIG
476-5425
Box 114 Vail, Colorado 81657
mil- 13-?T
0 A <,O�
AAAA SEPTIC PUMPING
2788 Gypsum Creek Road io
GYPSUM, COLORADO 81637
Phone 524-9524 .
15 8 6 accompanied by this bill. `Thank`You
PRODUCT 609 � Inc.. Groton. Mm 01471.
JOB NAME
JOB LOCATION
0055-Lot 29 Kaibab
i
0029 Kirk Lane Carlin
JOB NO.
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
(444 0 !
(�-
co w1p C
PERMIT # 55
OWNER: r
LOCATION: Lot 29 - Kaibab (2 acres)
4L
INSTALLER: Owner
SIZE OF TANK: 1,000 gallons
DWELLING: single family - 2 bedrooms x 400
PERC RATE: one inch/20 minutes (800 sq.ft.)
I
suggest a minimum of 800 sq.ft. of leach field.
i
Finalized 9-10-75 by: Les Douglas j
On,GROSS
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC.COSTS
TOTAL JOB COST
PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 277 @ NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Printed In U.S.A.
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