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HomeMy WebLinkAbout1358 Eby Creek Rd - 193929201008T OUNTY Owner Gerald Rose DEPARTMENT OF ENVIR� =NTAL HEALTH Box 811 6th & Broadway Eagle, Colorado 81631 PERMITO 5� (this does not constitute • a building or use permit) Address emhB aiim 333 Wadsworth - Wheat Ridge 30033 Location Eby Creek Road, Eagle Licensed Contractor Self * Conditional Construction approval is hereby granted fora 1500 gallon X Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 18 minutes 750 sq. ft. absorption area per bedroom 187.5 sq . f t . # of bedrooms 4 x187. 5 sq. ft. minimum requirement NOTE: Post on property. Call for final inspection. May we suggest a minimum of 750 sq. ft. of leach field. Date September 25. 1975 Inspector rik W. Edeen 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. �// Septic 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 ��— 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 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 L ­1- ENVIRONMENTAL HEA"I P.O. BOX 811 PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Name of Owner: Phone: Address of Owner: o 0 Is facility within boundaries of a city/town or sanitation district? Location of P�oposecl System: Legal Discription: Type of Struc�ure: Single Family Dwelling'( Other:. '9 -No.' Bedrooms Water.Supply": Private We'll Location: Ae Distance From' leach field: Size of Lot: Public Water Supply; An appropriate plat plan must accompany site inspection for, this app K tidn showing required information. (See attached sheet.) The individual sewiigo Will bei constructed 'and installed in accordance with the regulations governing individual sewage systems within Eagle County, and ihall comply with',"House Bill 1553 CRS 66-14, 1973� Payment shall be made to the Eagle County Treasurer. Permit, upon approval of t4is 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 Name, address, and telephone of person responsible for design of system: The undersigned acknowledges that the above information ix hoa and that false information will invalidate the oppUco+iohorsubsequent permit. / SIGNATURE {]FAPPLICANT: Date: �� (This application becomes invo""6m.�onthafrom above 6o+a.) ' HEALTH DEPARTMENT USE ONLY Per�colation Information:- / Permit No. ----�eeRecei pi.�^= File: - APPLICATION IS: APPROVED( ) DENIED _ The ouoveindividual disposal system was installed by BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. Dote' 8onihzrion:--___ ,-AGLE COUNTY ENVIRONMENTAL HEAL INDIVIDUAL SEWAGE.DISPOSAL SYSTEM PERMIT ROUTE SLIP Name Date t:e erre I'MALItL 11waber Location Please review the attached application and return it and this completed form to the Environmental Health office within 6 working days. Planning: File Number Yes No Reviewed By Date Complies with: Subdivision Regulation Zoning Regulations Recommend Approval Comments. - bounty Engineer: Roads Grading: ' Drainage Recommend Approval r L%�%(� �a gy Comments: Building Department: Set Backs Site Access Other Recommend Approval ! r: OLI P 0, .1-ATION TES' P E _U',, I T N 0 . OWNEJI:_': .Street Address or Legal. Description: T-',,�­c of Dwellin : . AND SITE, i N,,irilber of Beclrooms: F F. E - SO . 0 0 DO NOT W,,),TPE BEL077 THIS LINE Date of Test: !� r 4 ?—Jq - 7 T' Depth of Hole: Diameter: /2 Type of. soil: Location of Test Hole: Test hole was presoaked from: (Time) (Date) To: (Time) . Date: LIMIT'S Oi FAIJ IFRATE 1 2 3 1 2 3 .1 2 3 .1 2 3 12-1100 12 11 12', 1 IZ 11 2r± 11W /2 2- q YZ -20 1z i,� 30 3 Percolation --Rate: 142 1-1P I Site has been reviewed and teste for or percolation rate. DISAPPROV-AL Date: We recorinend: APIPJ."OVAL & NOTE: Plot plan shoi.,-ing boundary lines, location of proposed buil-ling or buildings CD and design of septic system must be submitted j.',4 th Ap plication for Permit to Construct. The back of this form may be used to show plot plan and design of system. By: Sanitarian P. 0. Box 811 Telephone (303) 328-7718 Eagle, Colorado 81631 An- 3 3 3 3---a-�- �2 3 7-,;zUd 3 15� -F, L Lit � v 0057-Eby Creek Road Eagle JOB NAME— 1358 Eby Creek Road Rose JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED CqJU Ili -(�ej :2� d �' X Fj PERMIT # 57 , OWNER: Gerald Rose LOCATION: Eby Creek Road - Eagle (6.8 acres) INSTALLER: Owner SIZE OF TANK: 1,500 gallons DWELLING: 2 single family - 4 bedrooms x 187.5 sq.ft. PERC RATE: one inch/18 minutes (750 sq.ft.) suggest a minimum of 750 sq.ft. of leach field. Finalized: 7-01-76 By: Erik Edeen JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS OF SELLING PRICE NET PROFIT JOB FOLDER Product 277 �p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Printed In U.S.A.