HomeMy WebLinkAbout458 Vicksburg Ln - 211108221002EAGLE (,UNTY DEPARTMENT OF ENVIRONtf�''TAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT MUST BE POSTED ON PROPERTY
Owner GARY BERTROCH
System Location TOWN OF GYPSUM
PLEASE CALL F%isFdToW&JJ&EtFt�;1ON
PERMIT N'O 222 a building or use permit)
Licensed Contractor Owner will be responsible for system
* Conditional Construction approval is hereby granted for a 1,000 gallon
XX Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate 1 inches in 10 minutes 600 sq, ft.
absorption area per bedroom 200 sq. ft.
# of bedrooms 3 x 200 sq. ft. minimum requirement
May we suggest 600
square
feet of drainage
field
Date September 30,
1977
Inspector
Erik W. Edeen, R.P.S.
FINAL APPROVAL OF SYSTEM:
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.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date JO �0/'71) Inspector
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
1-1-
OWItl
ENVIRONMENTAL HEALTH
P.O. BOX 811 PERMIT FEE $25.00
PERMIT N0.�2
EAGLE, COLORADO 81631
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO
Name of Owner:
Address of Owner:
Is facility within boundaries of a city/town or sanitation district?
Distance to nearest sewer system:
Location of Proposed System:
Legal Discription:
.�j _ �454
Phone: , /�(� 7
Type of Structure: Single Family Dwelling ( ) Other: 12"1le ,- No. Bedrooms 113
Water Supply: Private Well ( ) Location: Distance From leach field:
Size of Lot: / Gl—C%l.2_ Public Water Supply:
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.
0
Name, address, and telephone of person responsible for design of system: Ze ) %O C '
P 9 Y
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent perm' 7
9�zSIGNATURE OF APPLICANT: Date:
(This application becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information: A-1) I" ► Permit No. 222
Tank Capacity:_ (n 00 gal. (minimum) Fee Receipt: %
Absorption Area: t2�(_� Sq. ft. (minimum) File: _ �I- 77 AA I
REMARKS:
APPLICATION IS: APPROVED ( / 1-' DENIED
The above individual sewage disposal system was installed by 16
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATI OF THE EAGLE COUNTY HEALTH DEPT.
Date- ��, ���'� Sanitarian: X__�
EAGLE COUNTY ENVIRONMENTAL HEAL(
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ROUTE FORM
Ja��o c�
NAME
)ate Refered A Permit Number
CATION
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:
0222-S Of City Limits Gypsum
JOB NAME. 458 Vicksburg Lane BER OCH I "`� C�v JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
720�
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
o
&&v
PERMIT # 222
R� -CA V�-A ba �n Lac
OWNER: Gar'ertroch
LOCATION: Vicksburg Lane - South of
(one acre)
INSTALLER: Owner
SIZE OF TANK: 1,000 gallons
DWELLING: Mobile Home - 3 bedrooms x
Perc Rate: one inch/10 minutes (600
suggest 600 sq . ft of drainage field
City Limits
200 sq. ft.
sq.ft.)
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 Q® n r I rlct 1 1 Zea : I U—jU—
uy : - --1.
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