HomeMy WebLinkAboutCrystal River Ranch - 218934300022 - 0454ISEAGL(.,. tOUNTY DEPARTMENT OF ENVIRO',_ )ENTAL HEALTH
PERMIT MUST BE POSTED ON LOCATION Box 811 6th &Broadway CALL FOR FINAL INSPECTION
Eagle, Colorado 81631
PERMITa 45[ (this does not constitute
a building or use permit)
Owner
HAROLD
System Location COTTONWOOD PASS ROAD - NEAR GARFIELD COUNTY line - T 6 S, R 87 W -
East ' of Section 3
Licensed q@glooftInstaller:
* 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 - 20 minutes 600 sq. ft.
absorption area per bedroom 200 sq. ft.
# of bedrooms 3 x 200 sq. ft. minimum requirement
May we suggest
Date August 12, 1980 Inspector
FINAL APPROVAL OF SYSTEM:
MINIMUM REQUIREMENTS:
1,000 gallon septic tank
600 sq. ft. leach field
Erik W. Edeen
No system shal be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approve rior to covering any part.
tic Tank cleanout to within 12" of final grade or aerated access ports a ove grade.
Zroper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date __� 0d 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, 3.28requires 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
hnth_
PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES
940, 5257
927-3823
328-7311
12
PERMIT FEE = $75
ENVIRONMENTAL HEALTH
BOX 850
EAGLE, COLORADO 81631
PERCOLATION TEST FEE = $50
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
NO. O / 7
NAME OF OWNER:
�
� r0� �
�e►1c��Y''
ADDRESS:
°load 11,3
0-o-v o ��Qa ) e
(� ��
�l(o PHONE:
NAME OF APPLICANT (IF DIFFERENT FROM OWNER):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (IF APPLICABLE):
PHONE:
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: � �c� l � pq_ r MCL K
ADDRESS: (, 0. d�v%C �f 7p I c�t:�21 llJ, g1(o.� PHONE:
PERMIT APPLICATION IS FOR: (INC) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County EcL_j to .Co. Lot Size 4P%�_
City or Town, if within City or Town Limits �1,C� 'A
LEGAL DESCRIPTION:
STREET (RURAL) ADDR
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? (SC) Yes ( ) No
BUILDING OR SERVICE TYPE: (Check applicable category)
(X) Residential - Single-family dwelling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex
( ) Commercial State usage
# Persons # Bedrooms j
WASTE TYPES: (.Check- al,l applicable)
( ) Commercial or Institutional. (?C) Dwelling ( ) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher
( ) Other ( Automatic Washer
SOURCE AND TYPE OF 14ATER SUPPLY: ( ) Well (aC) Spring ( ) Creek or Stream
Give depth of all wells within 200 feet of the system: a o VL e,
If supplied by community water, give name of supplier:
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(x') Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
( ) Vault Privy ( ) Composting Toilet ( ) Recycling, Potable Use
( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use
( ) Greywater ( ) Other
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes No.
Signature L"a_�4, � Date
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope:
Depth to Bedrock (per 8' Profile Hole):' / Depth to Groundwater Table:
SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole No. 1
Minutes per inch in Hole No. 2
Minutes per inch in Hole No. 3
FINAL DISPOSAL BY: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( Underground Dispersal ( ) Wastewater Pond
( Other
EAGLE COUNTY ENVIRONMENTAL HEALTH
ROUTE FORM
Df~ �� - �� r1Ai'�E/�
DATE REFERRED %�,' , Gti1 CAT N NO.
LOCATION
Please review the attached application and return it and this completed form
to the Environmental Health Office.
PL I'NINC Complies with:
Subdivision Regulations
Z
Xnc,
Regulations
c c
Recommend Approval
Comments:
BUILDING:
LI/
Other_
Comments:
Set Backs
Site L
Recommend Approval
F.NGTNEER- (not always necessary)
Roads
Grading
Drainage
Recommend Approval
Comments:
Reviewed By
PERCOLATION TEST
FEE: $50 O l
APPLICATION NO.
OWNER:
LEGAL DESCRIPTION: Co �� ��C/ / oy .
RURAL ADDRESS:
r
TYPE OF DWELLING: � �i � �(�1�y;i�� � /��u�� OF BEDROOMS:
O, ♦♦ ;: .. -� A n 'c n :. .. .. .: .4: is q: .: :: .. sc �- ;�
DATE OF TEST: , — �� TYPE OF SOIL:
TEST HOLES PRESOAKED: YES NO
I
TIME
WATER DEPTH
INCHES OF FALL
RATE
1
2
3
1
2
3
1
2
3
1
2
3
60/1
s
fss
2,' 3,5-
2/-2:-
d /,
�3
y
1%i
20
I
P
7-33
O
PERCOLATION RATE: "D /1,112,-�.,/�
SQUARE FOOTAGE PER BEDROOM: 2 W
TANK SIZE: G
LEACH FIELD SIZE: (000
Site has been reviewed and tested for percolation rate.
We recommend: APPROVAL [// DISAPPROVAL
DATE: 0- C2 " �;'O
EAGLE COUNTY
ENVIRONMENTAL HEALTH OFFFICER
- -Z�
0454 T6S R87W E1/4 of Sec 33
r
FEB NAME Cttnwd Pass Near Grf ld ct JOB NO... _
-JOB LOCATION
LOCATION
BILL TO
DATE STARTED
9 43An
DATE COMPLETED
�&y2rz_ t v 1'��. 1 !
PERMIT #454.
OWNER:
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
LOCATION: Cottonwood Pass Road - Near Garfield County
TOTAL JOB COST
INSTALLER: Cecil Boardman GROSS PROFIT
SIZE OF TANK: 1,250 gallons
DWELLING: residential 3 bedrooms x 200 sq.ft. LESS OVERHEAD COSTS
PERC RATE: one inch/20 minutes (600 sq.ft.) % OF SELLING PRICE
�� I
50 x 12 leachfield (600 sq.ft.) NET PROFIT ,�
►LDER Printed in U.S,A.
Finalized: 8-27-80 By: Erik Edeen
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