HomeMy WebLinkAbout169 Deer Trail Dr - 239122303003 - 0041ENVIRONMENTAL HEALTF,
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Name of Owner: i7 Phone:
Address of Owner. ` �'' (-> 41-7 Lci
Is facility within boundaries of a city/town or sanitation district?
Distance to nearest sewer system:}
PERMIT FEE $25.00
Location of Proposed System:
Legal Discription: 1,24�/ c / f J P C /" "57
Type of Structure: Single Family Dwelling (/x-) Other: No. Bedrooms 127
Water Supply: Private Well ( ) Location: Distance From leach field:
Size of Lot: / %'�`�" a Public Water Supply:
An appropriate plat plan must accompany site inspection for this application show.ing,,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
Percolation Information:' 0
Tank Capacity: 757C2 gal. (minimum), e-
Absorption Area: Sq. ft. (minimum)
REMARKS:
/0 ® 0
Permit No. :
Fee Receipt: & l.% — 4
File:
APPLICATION IS: APPROVED ( LDENIED
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: -
v
OLE
3
i.'1 .d'O.,',.' ION TEST "% VD 'SITL 11'TSIPEGTION tET ;50 .0 f -
Street rddress or Lebal Description
Type o Dwel1inr-: of Pedro✓iP.S:
DO NOT WRZIT31 DELOs THIS LINE
Date of Test: Depth of hole: Di ameter:Zi� Type of soil: Ceti
Location of. Test Hole:
Test 'hole was presoaked. front: To:
Date:
(Time) (Date) (Time
# 7.
2
3
1
2y
3
1
2
3
1
2
3
/
2-;2-7
; 3a
�
..
11
to
16,
210
110
Percolation Rate: Zl./ ?•IPI
Site has been reviewed and tested for percolation rate.
We recorimend: API' ,OVAL } DISAPPROVAL ( ) Date:
NOTE: Plot plan 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 shoe plot plan and design of system.
Dy:(_��.
Sanitarian
P. 0. Box 811
Telephone (303) 328-7718 Eagle, Colorado 81631
0041-Lot 20 Red Table Acres
JOB NAME-
0169 Deer Trail Drive Melby
JOB NO.
Ago
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
PERMIT #
OWNER: Ken
LOCATION:
INSTALLER:
SIZE OF TANK:
DWELLING:
PERC RATE:
(suggest a
41
Melby
Lot 20 - Red Table
Owner
750 gallons
Single family - 2
one inch/20 minutes
minimum of 600 sq.
((r � � �
Acres (one acre)
bedrooms x 300 sq.ft. = 600 sq.ft
(600 sq.ft.)
ft. of leach field)
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
rindrlZea: IU-ZS-/b
by: Les uouglas LDER
Pdrited In U.S.A.