HomeMy WebLinkAbout313 Deer Trail Dr - 239127201011 - 0046PERMIT NO.
Name of Owner:
Address of Owner: _
ENVIRONMENTAL HEALTH m �.
P.O. BOX 811
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EAGLE, COLORADO 81631 PERMIT FEE $25,00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT : .4 MYO
Is facility within boundaries of a city/town orsanitation district? I(/ O
Distance to nearest sewer system: by 5 A l
Location of Proposed System: ® %` )(0 Y-e -5
Legal Discription: f ` 1 ► , / ��
Type of Structure: Single Family Dwelling ( X) Other: No. Bedrooms drm
Water Supply: Private Well ( ) Locatiori: Distance From leach field:
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Size of Lot: Public Water Supply; Cr�/i��?tItn/'f1l
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 se -wage systems within Eagle County, and shall comply with House Bill 1553 CRS
bb }4, 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 respo Bible for
n of system:
The undersigned acknowledges. that the above information is true and that false information will invalidate the
application or subsequent per
SIGNATURE OF APPLICANT: Date:
(This application becomes valid b onths'from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information::-' `a'- Permit No.
Tank Capacity: ° f gal. (minimum) Fee Receipt: WI. —Sr,
Absorption Area: Sq. ft. (minimum) File:
REMARKS: P'A44- -VAC?'
CF
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:—
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P'=. COur. IDN TL" ST AND SITi: INS "—T.IO`T / i F E- ;50 .00
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P_�?-SIT I0. G`'fi'I �L� ����✓ /L J'.� v �,
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Street Ilddress or Legal. Description:-- Z-07'-
T; _ c _. D •-el_! i.n J �.�;, j;;1'r e o = 3edrooms
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DO NOT ti12ITr '>E:�G?'I TI-IIS LINE
Date of Test:— /y Denth of hoIe: Diameter: 12 Type of soil:_
Location of Test Hole:
Test hole was presoaked from: � /z-> � To: � % �4,S7 Date:
(Time)(Date) (Time)
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Percolation ?ate: 7 , Mj?I
Site has been nevi et,,ed and tested for percolation rate.
- e recornend: APP,.I ` T ( l 1 DI P , j ( )' Date:
OdA� L_�.�< 1,OV1.3 3 "
NOTE: Plot Man showing boundary lines, location of proposed building, 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) 32 -7710
Sanitarian
P. 0. Boy; 811
Eagle, Colorado 81631
0046-Lot 16 Red Table Acr'-
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,JOB N,,qW 0313 Deer Trail Drive �_WZ�(9" U/
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DATE STARTED
DATE COMPLETED
DATE BILLED
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PERMIT # 46
OWNER: Robert Sewell
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LOCATION:. Lot 16 Red Table Acres ( one acre)
INSTALLER: Ownera
SIZE OF TANK: 1,000 gallons
DUELLING: Single family - 3 bedrooms X 250 sq.ft. = 750 sq.ft.
PERC RATE: one inch/25 mintues (750 sq.ft.)
(suggest a minimum of 750 sq. ft. of leach field)
Finalized: August 18, 1975
By: Erik Edeen
JOB FOLDER Product 277 �p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB F1
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