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HomeMy WebLinkAbout52 McCoy Rd - 168906101002EAGLE('`LINTY DEPARTMENT OF ENVIRONK'ITAL HEALTH 1EMODEL TO EXISTING SYSTEM Box 811 6th & Broadway Eagle, Colorado 81631 PERMIT N9 216 Owner School District — RE 50 J System Location McCoy, Colorado Licensed Contractor . Clark Ewi * Conditional Construction approval is hereby granted fora 1,000 gallon XX Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate inches in minutes sq. ft. absorption area per bedroom # of bedrooms May we suggest x sq. ft. minimum requirement Date August 29, 1977 Inspector FINAL APPROVAL OF SYSTEM: (this does not constitute a building or use permit) Erik W. Edeen 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. ok Septic Tank cleanout to within 12" of final grade or aerated access ports above grade. ok Proper materials and assembly. ok Adequate absorption (or dispersal) area. ok Adequate compliance with permit requirements. ok Adequate compliance with County and State regulations/requirements. Date August 30, 1977 Inspector Erik W. Edeen 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 1'_+w REMODEI.(—O EXISTING SYSTEM — NO ENVIRONMENTAL HEALTH P.O. BOX 811 PERMIT NO. 5Ei� EAGLE, COLORADO 81631 PERMIT FEE $25.00 / APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT N? 445 � Name of Owner: }0//�Z rg_7 _ zP ,C% J_ Phone. 3 24 6 3 a Address of Owner: �l4rIE-t Is facility within boundaries of a city/town or sanitation district? N4> Distance to nearest sewer system: -a 1 M f L E S Location of T2 Proposed System: `%flA/fl' % Z5 Few G'L✓��'%"df lf//�''�i/ . M ('6DY S(yi' ee—1 Legal Discriptian: ,� edr6OAq 4%/�% IIO IAI U&C 7.''. /r A/, E. 41 ©� � �� 5 F.3%ev Type of Structure: Single Family Dwelling ( ) Other: ✓tLld&ZIAIAZx 14 No. Bedrooms Water Supply: Private Well (X ) Location: Gil g/�E Gl'/� C /F�F't` D�istanc�f/ooCe From leach field: A0207fi7- Size of Lot: ��/�iPDXf/►�/'3��Y � A ��i9� Public Water Supply: �/���/�' / CZ_Z rY 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 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: eIRoelc The undersigned undersigned acknowledges that the above information is true and that false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICANT:` e ate: (This ap ation becomes invalid 6 months from above date.) HEALTH DEPARTMENT USE ONLY Percolation Information: Tank Capacity: 4922]� gal. (minimum) Absorption Area: Sq. ft. (minimum) REMARKS: Remodel to existing system — no fee APPLICATION IS: APPROVED ( x ) DENIED Permit No._ Fee Receipt: File: The above individual sewage disposal system was installed by Clark Ewing AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. Date: August 29, 1977 Sanitarian: Erik W. Edeen, R.P.S. ENVIRONMENTAL HEALTH PERMIT NO. /6 �X 811 P.O. RADO EAGLE, COLORADO 81631 PERM, APPLICATION FOR INDIVIDUA VI GE DIS L SYSTEM PERMIT" Name of Owner i �r�l1S�/° f/iS/v*c / ' >` - ("� -- �' Phone e� ) Address of Owner:-1qCs _ �._'.C� L.C��: sf 9 Is facility within boundaries of a city/town or sanitation district? Distance to nearest sewer system:_fd-rrJlli9iU%,�: Location of Proposed System: Legal Discription: Type of Structure: Single Family Dwelling ( .X) Other: No. Bedrooms Water Supply: -Private Well Location: Distance From leach field: Size of Lot: �-T Z`C'Aei--< —t" Public Water Supply: %,"vAIE: An1aprpropriate plat Ian must acc�om a,ny si„�te inspection for, ,,this a p�lic�ation showi _ eguired information. (See attached sheet"`)�e. in ivid I --sewage disposal system will be constructed and installed in accordance with the regulations governingindividual 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, maybe obtained at the Eagle County sanitarian's office. Appointment for -;final inspection must be made prior to construction Fh�an#acting the inspecting sanitarian. [Phone 328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on anysystem without final inspection. 1 Named, address, and telephone of person responsible for design of system: ) C"�_....��•'�:/.fC �"�_.-t'.i'`.z�62--e:+'1. ���'X�cF.''� .�� f� � � tr G"�G�/`r�"1�it �/G `�s C, +'�'. `�i U � The undersigned acknowledges that the above information is true and that false information will invalidate the application or subsequent permit. SIGNATURE OF APPLICANT: Date: r'"i�'-r Date:C' (This apoication becomes invalid 6 months from above date.) HEALTH DEPARTMENT USE ONLY Percolation Information: _ �. C � p��� Permit No. Tank Capacity: /` _ C) c� gal. (minimum) Fee Receipt: I A(GU/71LGy Absorption Area: 7 ® S-, Sq. ft. (minimum) File: REMARKS: The above individual sewage disposal system was installed by AND HAS BEEN INSPECTED AND APPROVED BY `A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT. 4 d� Date: Sanitarian: ,m :OL F ,_ "7 `; "T^ (l P �.Dd/� OCI�a� Re 50 J School District Street Address or regal Description: McCoy Colorado 80463 nO NOT-r-i-m ���' r•.' it1S LINE DO Date of Test: -Depth of '_pole: Diameter: Type of sort: Location of Test bole: Test hole was presoaked from.: To: . (.Tine) (Date) (Time) Date: TF:� (i PTTi T ;{'t.�rr OF FALLTF 11 l 77r1 2 3 1 2 3 1 Z 3 1 2 3 10:46 10:53 1 42'Y 41'�= -FORMN -Lr�i�-- i 10 y 51 J 10 : 58 42, 42 10:56 11:03 42.3/ 42?; 11:01 11:08 n 43 5/8 42° 3/4 Percolation Rate: 'IPI Site has been -reviewed and tested for percolation rate. AV We recommend: APPROVAL ( ) DISAPPROVAL ( ) Date: NOTE: Plot plan showing boundary lines, location of proposed building.or buildings and design.: of.septic..system must b.e.submitted with Application for Permit to Construct. ' -The back -of this forru may be used to show plot Man and design of system, By: Sanitarian P. 0. Box 811 -alephone (303) 323-7718 Eagle, Colorado 81631 �-- EAG(COUNTY ENVIRONMENTAL HEAL(7' INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ROUTE FORM NAME )ate Refered /� Permit Number LOCATION Please review the attached application and return it and this completed form to the Environmental Health Office within 6 working days. PLANNING: File No, Yes No Reviewed by Date Complies with: Subdivision Regulations Zoning Regulations Recommend Approval Comments: COUNTY ENGINEER.: Roads Grading Drainage Recommend Approval Comments: BUILDING DEPARTMENT: Set backs Site Access Other Recommend Approval Comments: 0216-SE41 of NE4 of Sec % T2S R83W 1� JOB NAM; —McCoy SCHOOL STRICT RE 50Jer�'%�� JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED C/� I o000 i V J�l4ii JOB COST SUMMARY TOTAL SELLING PRICE -T - _- TOTAL MATERIAL PERMIT 2_ 16C- OWNER: School District - RE 50J LOCATION: McCoy, Colorado o _ T2S-R83W SEI-, of the NE ' of Sec. INSTALLER: Clark Ewin SIZE OF TANK: 1,000 gallons DWELLING: Schoole - lunch room PERC RATE: -modeling to existing system (no fee) Finalized: 8-20-77 By: Erik W. Edeen f—Z .. 1 j� l 6-0