HomeMy WebLinkAbout189 Kirk Ln - 2109042030024 ENVIRONMENTAL HEALTH 7- 5 e--e
,
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO $ 5 0
201
Name of Owner:`Ja l�)EES � W 7 `� LI E y Phone: �h� �l p �p
Address of Owner: 2 7r1F—K- GP(;, C 6' 2 A , '�
Is facility within boundaries of a city/town or sanitation district? �y
Distance to nearest sewer system: / A!/Z-e
Location of Proposed System: L d 7 2 `% - �iPiB119e
Legal Discription: GT 2-7 - Ar,gJRit�
Type of Structure: Single Family Dwelling ( e/) Other: No. Bedrooms
Water Supply: Private Well ( ) Location- fir �` S> A%snce From leach field: G
Size of Lot: 1�� �� Public Water Supply: I T I 6—(-
pP Y�
An appropriate plat Elan must accompany site inspection for this application showing required information. (See
attached sheet — a— in ividual 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 namber. No approval will be given on any system without final
inspection.
Name, address, and telephone of person responsible for design of system: 75 GN
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit. %
SIGNATURE OF APPLICANT: Date:
app cation becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information:
Tank Capacity:
Absorption Area:
REMARKS:
gal. (minimum)
Sq. ft. (minimum)
Permit No —
Fee
Fee Receipt:��
File:
APPLICATION IS: APPROVED ( 1�-' DENIED ( )
The above individual sewage disposal system was installed byZV�-�4a'c-�
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT.
/
Date: '' � � J �Sanitarian:
r
OLE
d
PE :;COLA TION 'TEST AND SITE T? :PECTIOI7
PE ', IT 1\70.
O1,-7NE. •
Street Address
or Legal
Descriotion: ,,,/G7
T e of D:011211g
.sec o
S//1 le �/i�f77�d y Nuir bo` of- ''- ns-
DO NOT 672ITE BUM` THIS LINE
Date of Test:
'rd�
Depth of 101e:��� Diameter: Type of
soil:
Location of Test
Hole:
��' (� '` u,-i._,�
_J
Test hole was
presoaked
from: to:
Date:
(Time} (Date) (Time)
T.. -i�
r'TAT ,i'' nF`. TH
I:.1CILi:S OF TALL
# 1
2
3
1
2
3
1
2
3
1
2
3
LI
Percolation Late: ?-IPI
Site has been reviewed and tested for percolation rate.
We -recommend: APPi.OtTAE. �DISftPPDate:
NOTE: Plot flan showing boundary lines, location of proposed building or build:i:igs
and design of septic system must be submitted t-71th Application for Permit to Construct.
The back of this form may be used to show plot plan and design of system.
By
- -- Sanitarian
P. O. Boy; 011
Telephone (303) 323-7718 Eagle, Colorado 81631
,cos rvae--
0044-Lot 27 Kaibab
27 Kirk Lane Guffey
JOB NO.
m
7hf, Jda4��d
B LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
o
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 277 @ NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS. 01471 JOB FOLDER Pdrited In U.S.A.
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT REPAIR PERMIT
Eagle County Department of Environmental Health PERMIT N® 0770
P.O. Box 850 - 550 Broadway
ORIGINAL PERMIT #44 Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927-3823
YELLOW COPY OF PERMIT MUST PLEASE CALL FOR FINAL INSPECTION BEFORE
BE POSTED AT INSTALLATION SITE COVERING ANY PORTION OF INSTALLED SYSTEM
Owner: James R. Guffev Telephone: 328-6340
Address: P. 0 Box 732, Eagle, CO 81631
System Location: 189 Kirk Lane - Eagle, CO - 1— rj
Licensed Installer: W. Y. Construction License Number:
Conditional installation approval is hereby granted for the following:
Minimum requirements: Gallon Septic Tank or Aerated Treatment unit
Absorption area of dispersal area computed as follows:
Percolation rate: Inch in Minutes
Absorption area per bedroom Sq. Ft.
Number of Bedrooms X Sq. Ft. minimum requirement per bedroom -
equals Total Sq. Ft. minimum requirement
Special Requirements: Rolm raoj'6 G Gk Ups fawyG16-01 b__1 4.r$ -Fl-�-I l eo SQ
Date: // 6 — & G Environmental Health Officer: � 42Lt4
CONDITIONS:
1. All installations must comply with all requirements of the Eagle County Individual Sewage Disposal System
Regulations, adopted pursuant to authority granted in 25-10-104, C.R.S. 1973, as amended.
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 structure not approved by the zoning and building
departments 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, 3.21 requires any person who constructs, alters or installs an Individual Sewage Disposal System to
be licensed according to the regulations.
s of 0 ±h e A -7 77H, e t Q-s T
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Eagle County Individual Sewage Disposal System
Regulations until the system is approved prior to covering any portion of the system. SEC L)2i fpa l Qe2m"
INSTALLED ABSORPTION OR DISPERSAL AREA: N 0(20 SQ. FT.
INSTALLED SEPTIC TANK: GALLONS; DEGREES;
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM:
PROPER MATERIALS AND ASSEMBLY:
COMPLIANCE WITH PERMIT REQUIREMENTS:
-i:� Zly
FEET
PHONE:.
1.7v 0 4('�
TION REQUIREMENTS:
(Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when
work is completed.) r
DATE (Final Approval) 28-L ENVIRONMENTAL HEALTH OFFICER:
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: James R. Guffev Name of Owner: Same
Amount Paid: 150.00 Receipt Number: 2543 Date: 11/4/86 Cashier: Christie Baldwin
Check #150
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
y
all
�Di T�:,T'^ FOR � � ��..:AL `i � .i \(, 7Ic"",C , f 'C---• '�c _, •.t T....
l ENV I R0,"'ENTA L iiEALTii OFF :CE - EAGLE COUNTY `
• P.O. �o:•: S 5 0
!r i Eagle, Colorado 81631 `O.
\ PEP -MIT APPLICATION FEE: S150.00 328-7311 PFRCOL:\TI0`: TFSi F 550.00
NAME OF OV,%ER: je214V-44
ADDRESS:,(��c 6/&3/ PIIO::E: 328- &34-0
NAME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGI::EER OF SYSTE.`I (if applicable) :
ADDRESS:
PHONE:
PM!E :
Al INSIALLATION OF SYSTE`1: W,Y. Co"SAICICALE7
Licensed Installer (see attached list): YES- X NO
ADDRESS: bbx 150 2-
PHONE: $24- 7S8r
PERMIT APPLICATION IS FOR: ( ) New Installation ( ) Alteration
LOCATION OF PROPOSED INDIVIDUAL SET.' GE DISPOSAL SYSTE'-f:
Street/Rural Address: /log ,�i� ati,� f t� _ Lnt 27 K
Lot Size: 2 aG,�
Legal Description:
BUILDING OR SERVICE TYPE (check aoplicable cate^orv):
(X) Residential - Single Family
( ) Residential - Duplex
( ) Residential - Tr_
olex
NUMBER OF PERSONS: :j
WASTE TYPES (check applicable cate^_ories):
( ) Co=ercial or Institutional
( ) Non -Domestic Wastes
(j() Garbage Disposal
( X) Automatic Washer
( ) Other
APE OF INDIVIDUAL SET -.AGE DISPOSAL SYS=-1 PROPOSED:
( Repair
i d*,d
( ) Residential - Quad�lex
( ) Co.-::::ercial (state usage)
NUMBER OF BEDROOIS: 2
( )4) Dwelling
( ) Transient Use
( X) Dishwasher
( ) Spa Tub
(
)
Septic Tank
(
)
Composting Toilet
(
)
Incineration Toilet
(
)
Vault Privy
(
)
Greywater
(
)
Chemical Toilet
(
)
Pit Privy
(
)
Aeration Plant
(
)
Recycling, Potable Use
(
)
Other Awch _r7'eC/
Recycling, Other Use
WILL
EFFLUENT BE DISCH_LRGED
DIRECTL`i P:TO ?JAT='RS OF THE
STATE:
YES ( ) NO (aC)
IS SYSTEM
DESIGNED FOR
LESS
T'dA J
2 , 000 GALLONS P E R D.;v -
YFS ( )
WASTEWATER FLO:J REDUCTION; PLAN: \0 ( )
YES ( ) NO (k)
(16 yes, See ativac,hea teas.iexLtet Stclo AedUCt C1;T methods
NOTE: The Env.c to;unentaL' Heae-fA O'�.iec matt reduce "Le-terju-,ted ab.sorLp,tion a,tea upon
QpptOVQZ Ua an adeGUCLtc Ccas LCXatZt 6&tV AeductCon p.ia;i.
SOURCE AND TYPE OF WATER SUPPLY: ( ) well ( ) Spr;ng ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give nave of supplier:
SIGNATURE: - - - - - - - - - - - - - ,- - - - - - - - - - DATE_ - - - - -
INFORtiATION BELOW TO BE FILLED OUT BY ENVIRON,'0.`TAL HEALTH OFFICER:
GROUND CONDITIONS: Peneent G.toujzd Slope
Depth ,to Bedtoeh (peL 8' P,to' ee. Hole)
Depth .to Guundaca te,t TabZe
SOIL PERCOLATION TEST RESULTS: AuLu.tcs pet inci i'it Hoye T 1
hfinu-tes pert ,inch .to Ho.ee #2
Ii (.jtLi.'e s peA (rtC�'L tip HoZe 03
FINAL DISPOSAL BY: -
( ) Aho-tptio;l TnencJi, Bed o.t Pit ( ) Evapo'tansPiAaUon
( ) Above Gnoujid DZSpe/'tsa.2 ( ) Sajzd FU_te-t
( ) Unde,tg,tound Dispeaaa.0 ( ) (UQS.L:�cQt; t Pond
n
l� �
4'a AmoujLt Paid: 75�Reccipt Nwnbc.t
NOTE: Site Plan must be attached to•application.
(Env. Health Department - Rev. 4-07-83)
FOR cE :HCE D:S=f;S,",L SST` ,S
A permit fee of S1!0.00 shall be charged for alteration, enlar7er.ent or any repair
involving alteration of an exist-inc, se,;;ace dis-osal syste�i. This `ee.is au norized
by Eagle County Individual Se:rane Disposal SvsLen Rer;uiations adopted and e==`ccive
Marc? 27, 1930. y
For minor repairs of less than S100.00 for maintenance of the individual se -dace
dis,:osal system, no fee shall be required.
A percolation test fee of $50.00 shall be charged for all nets !each fields on repair
permits. Percolation testing may be waived at the discretion of the Envirnn;nental
Health Officer on certain repair cases where prompt action must be taken to prevent
a he?, +-k
IF PRESENT SYS7 IS PP,E-EX STING, NON -CONFORMING, A NE!•I SYSTEM SHALL BE I.°;S' i=LEn,
CONPLYI�IG IWI T H ALL CURRENT REGULATI-OiIS. _ IF A NE;•I SYSTEi•I. IS REQUIRED, ALL F. E .. , ARE
APPLICABLE.
DESCRIPTION OF PRO BLE"/P•IALFUNCTION:
TYPE AND SIZE OF SYSTEM PRESS ITLY IN USE:
DA T E PREEENT SYSTEM IWAS INS T ALLED:
PERIMIT NUMBER FOR ORIGINAL SYSTEiI, IF A PERMIT WAS ISSUED BY THIS DEPARTiNENT: 71
SITE PLAN BELO14 SHO14IiIG PRESENT SYSTEM COMPONEINTS:
2
-70059,
40 � iyejd nv
J 2
�M
0!•INER OF SYSTEM:
ADDRESS:
APPLICANT:
ADDRESS:
DATE:
Joa NO
BILL TO
DATE CTADI.n
DATE COMPLETED
PFRMIT # 44
OWNER: James and Kay Guffey
LOCATION: Lot 27 - Kaibab (2.2022 acres)
INSTALLER: Ed Watson
SIZE OF TANK: 1,250 gallons
DWELLING: Single family - 4 bedrooms x 175 = 700 sq.ft.
PERC RATE: one inche/10 minutes (700 sq.ft.)
(suggest a minimum of 700 sq. ft. of leach field)
Finalized: 09-07-75 By: Les Douglas
vna�1—M, PAA V14/7
JOB FOLDER
PERMIT #770
aotz , b 0�{� **** R E P A I R P E R M I T
OWNER: James Guffey
LOCATION: 189 Kirk Lane - Lot 27, Kaibab Sub.
INSTALLER: W.Y. Construction
SIZE OF TANK: Existing 1250 gl.
DWELLING: Res. single fam. - 2 bedroom
PERC RATE:
ABSORPTION: 900 s.f.
FINALIZED: 11/06/86 BY: Sid Fox
vG — t c4 Z. v �3— 60 a—
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