HomeMy WebLinkAbout11 LaGrow Rd - 211103400053EAGLE( TY DEPARTMENT OF ENVIRONF,L HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT MUST BE POSTED ON PROPERTY PLEASE CALL FOR fti%J RPMR&
PERMIT NO 235 a building or use permit)
Owner Mary Aline Greenman
System Location Gypsum
Licensed Contractor . Owner will be responsible for design & installation
* Conditional Construction approval is hereby granted for a 750 gallon
XX Septic Tank or Aerated treatment unit. CONDITIONAL APPROVAL: This permi 1
Absorption area (or dispersal area) computed as follows: is approved for one system only &
one dwelli t
u.nit n y Perc rate 1 inches in 20 minutes 720 sq. ft.
, C
absorption area per bedroom TERR LL IGH ANNEREAGLE COUNTY
# of bedrooms x sq. ft. minimum requirement
May we suggest 12X60 drainage field r---
Date /':�4 7 7 Inspector��P
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved pyier 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. C /
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements. 1'7vsr•,y
s-A
G
Date f ✓ 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
L - mil_
PERMIT NO.
Name of Owner: -
Address of Owner:
ENVIRONMENTAL HEALTH
P.O. BOX 811
EAGLE, COLORADO 81631
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
PERMIT FEEoll'v0-
N. 4'70
Phone: Icy 6 .0 °L-
Is facility within boundaries of a city/town or sanit ation district?
Distance to nearest sewer system:
Location of Propc
Legal Discription:
Type of Structure: Single Family Dwelling ( ) Other c �� �' No. Bedroomg /
Water Supply: Private Well ( Location: Distance From leach field/
Size of Lot: &�d �T�A2 _ Z2 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.
Nam ,address, and telephone of person responsible for design of system: Z2z
The undersigned -acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit.
SIGNATURE OF APPLICANT: t /%' % ' Date:
(This application become invalid 6 months from above date.)
7 v HEALTH DEPARTMENT USE ONLY
Percolation Information: _�Iewxla. Permit No.
Tank Capacity: 41-00 gal. (minimum) Fee Receipt��- STIZ17
Absorption Area: 7 Sq. ft. (minimum) File: �� 7S-7 lqu4 a7
REMARKS: z&za21i a
APPLICATION IS: APPROVED ( / 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:
/ I/
EA("�' COUNTY ENVIRONMENTAL IiEAr--",i
m
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
s ROUTE FORM
o?�,�%'y NAME
.tee Refered Permit Number
LOCATION
)lease review the attached application and return it and this c `�l to for to
:he Environmental Health Office within G working days.1�
°�CANNING: File No, Yes No Review by '� Dat
Complies with:
Subdivision Regulations x // /
Zoning Regulations Ok l ` 12 �7 / 77
Recommend Approval 7
;omments:
4 14-
;OUNTY ENGINEER:
:omments:
Roads
Grading
Drainage
Recommend Approval
3UILDING DEPARTMENT:
Set backs
Site
Access a
)they
Recommend Approval
omments:
I # /z 3 /77
✓/ 3, - ,2 �
("NVIRONWIENTAL HEAL('i-i
J* e
BOX all * EAGLE, VOLORADO 81631 - PHONE [3031 3237718
BY EWE s ac
Form N-R73g The Drawing Board, Inc., Box 505, Dallas, T,,os
SIGNED,
DETACH AND FILE FOR FOLLOW-UP
ZC
I - M I.
0235-SE14 of SEZ Sec 3 T5S R85W 6th
.JOB NAM 0011 La Grow Rd GREENMAN Ei JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
10 Se�Ci
i� n - bS4 -Cv iS IS Q- ma
m5 Vy�i>�\ '66
_
tTire 0o
JOB COST SUMMARY
CX� � TOTAL SELLING PRICE
�J
TOTAL MATERIAL
I cccu,n,
PERMIT # 235 � 'Z�-�2
�'
OWNER: Mary A e GreenmY an
LOCATION: SE4 of the SE2 of Sec. 3 T5S, R85W - 6th pm
Gypsum (40 acres)
INSTALLER: Owner
SIZE OF TANK: 750 gallons
DWELLING: Two dwellings - mobile homes
PERC RATE: one inch/20 minutes (720 sq.ft.)
CONDITIONAL APPROVAL: This permit is approved for one system
only and one dwelling unit only.
TOTAL LABOR
lo
INSURANCE
SALES TAX
M ISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LEss OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
suggest iz x ou aralnaye IICiU/
Finalized: 9-6-78 By: Erik Edeen
-.-, 1'i\ 1 e2L1 nt1 llC Z
AEA-1
Printed in U.S.A