HomeMy WebLinkAbout614 Paseo - 239127308002 - 0063n
PERMIT NO.
Name of Owner:
Address of Owner:
ENVIRONMENTAL HEALTR
P.O. BOX 811
EAGLE, COLORADO 81631 PERMIT FEE $25.
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Is facility within boundaries of a city/town or sanitation district?
Distance to nearest sewer system:
Location of Proposed System:
Legal Discription: \ r 11)
Type of Structure: Single Family Dwelling ( Y) Other:
00
Phone: 4? ,
No. Bedrooms J
Water Supply: Private Well ( ) Location: rDistance From leac field:
Size of Lot: i c �_ `C�� Public Water Supply:� ��LQ
't
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 f/15r53 CRS,
66-14, 1973. Payment shall be made to the Eagle County Treasurer' Perm it, upon approNal of this application `m`ay be
obtained at the Eaglestyr_sanitari`6n'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 undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit. (�
SIGNATURE OF APPLICANT:(►. �C ti e �. +� n� Date: ��� \ l�•
(This application becomes invalid 6 months from above date.)
Percolation Informat
Tank Capacity:_�
Absorption Area:. —
REMARKS:
HEALTH DEPARTMENT USE ONLY
Permit No. �.
r
_ gal. (minimum) Fee Receipt; � I h`'-2
Sq. ft�'(minimum) File: _ _ %_1 , 40
1111s17
t
APPLICATION IS: APPROVED ( ) j. 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:
0063-Lot 2 Unit 2 Aspen Mesa Estates
Sherlock —'
JOB NAME
JOB NO,
Ina I nreTlnnl
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
PERMIT # 63 F4a4�htl i Z_' r - -��I
OWNER: �� G �v�� t' ��� vc..IL
LOCATION: Lot 2 - Unit 2 - Aspen Mesa Estates
(1.28 acres)
INSTALLER: Owner
SIZE OF TANK: 1,250 gallons
DWELLING: single family - 3 bedrooms x 266 sq.ft.
PERC RATE: one inch/25 minutes (800 sq.ft.)
suggest a minimum of 800 sq.ft. of leach field
TOTAL LABOR
INSURANCE
!
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
Rio OF SELLING PRICE
NET PROFIT
I IIQI IGCU: `F-LU-/f)
By: Erik Edeen i
ALDER
Printed in US.A.