HomeMy WebLinkAbout1528 Valley Rd - 211108400014EAGLE(")UNTY DEPARTMENT OF ENVIRON�'")TAL HEALTH
P.O. B-O� 850 MAJA 6th & Broadway
PERMIT MUST BE POSTED ON LOCATION
Eagle, Colorado 81631
PERMIT N® 455
Owner Dr. Herbert A. Wertheim
CALL FOR FINAL INSPECTION
(this does not constitute
a building or use permit)
System Location Barn at 1528 Gypsum Creek Road (Portion of Tr77.TWP5S,R85Wof 6thPM)
Licensed Contractor Larry Schultz
* Conditional Construction approval is hereby granted for a 750 gallon
XX Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate 1 inches in 30 minutes 300 sq. ft.
absorption area)pODURDUM to serve bathroom in barn
# of bedrooms x
May we suggest
sq. ft. minimum requirement
MINIMUM REQUIREMENTS:
750-gallon septic tank
-400 sq.ft. leach field
Ir
Date August 18, 1980 Inspector Erik W. Edeen
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.
Ix Septic Tank cleanout to within 12" of final gi4de or aerated access po s ove abade. .
.S _-fv.
1✓ Proper materials and assembly. G�Ch
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date CzU D Inspector
RETAIN WITH RECEIPT RECORDS 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, 3.26 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
both.
r PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES
328-7311 949-5257 927-3823
ENVIRONMENTAL HEALTH
_ BOX 850
EAGLE, COLORADO 81631
PERMIT FEE _ $75 PERCOLATION TEST FEE _ $50
-liPPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
NO. ;Z1 �
NAME OF OWNER: Dt 4e� A W P..1- �� ei;v
ADDRESS:
NAME OF APPLICANT (IF DIFFERENT FROM OWNER):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (IF APPLICABLE):
ADDRESS:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
ADDRESS:
PHONE: ecay f4pr_
PHONE:
PHONE:
PHONE:
PERMIT APPLICATION IS FOR: (X New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County L;;:/f0dj Lot Size pQ .44-d -
City or Town, if within City or Town Limits
LEGAL DESCRIPTION:.;,
STREET (RURAL) ADDRESS:
o� -N G*'
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? ( ) Yes ( ) No
BUILDING OR SERVICE TYPE: (Check applicable category)
( ) Residential - Single-family dwelling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex
( ) Commercial - State usage '34"
# Persons # Bedrooms
WASTE TYPES: (.Check all applicable)
( ) Commercial or Institutional ( ) Dwelling
( ) Non -domestic was es ) Transient Use
Other N
r
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring
Give depth of all wells within 200 feet of the system:
If supplied by community water, give name of supplier:
TYPE OF INDIVIDUAL SE1rJAGE DISPOSAL SYSTEM PROPOSED:
( Septic Tank ( ) Aeration Plant ( )
( ) Vault Privy ( ) Composting Toilet ( )
( ) Pit Privy ( ) Incineration Toilet ( )
( ) Greywater ( ) Other
( ) Garbage Grinder
( ) Dishwasher
( ) Automatic Washer
( ) Creek or Stream
Chemical Toilet
Recycling, Potable Use
Recycling, Other Use
WILL EFFLUENT BED C D TL` INT !,'.FRS OF THE STATE? ( ) Yes (, No
Signatore,� Date /� / �tIMP
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope: /��d �� ' v
Depth to Bedrock p (per 8 Profile Hole): Depth to Grounlaater Table:
SOIL P RCOLATION TEST RESULTS:' Minutes per inch in Hole No. 1
s Minutes per inch in Hole No. 2
LcJCijGcteo' — � c�
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
NAIKE
DATE REFERRED /' APPLICATION NO.
LOCATION
?lease review the attached application and return it and this completed form
Co the Environmental Health Office.
nNIIill C— Complies with: Yes No
Subdivision Regulations[
Zoing Regulations
Recommend Approval
-omments:
BUILDING Set Backs
tl/ Site Lle� /_lt 74
As -
Other
Comments:
FNGINEEP, :
Comments:
Recommend Approval
�xl
(not always ne
Roads
Grading
Drainage
Recommend A
PP9OB NAME
141, JOB "NO. . 4S T
JOB LOCATION
avrT-
BILL TO
DATE STARTED
12
DATE COMPLETED
I i\ I �- > _. 1 "I .--FT _
,0[Z---)�
/N—
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
1 TOTAL LABOR
Zv�y Scat-�nc� GwaC�i+ tTo
l6 INSURANCE
PERMIT #455
SALES TAX
OWNER: Dr. Herbert Werthei `� MISS. COSTS
}
LOCATION: Barn at
INSTALLER: Larry Schultz
SIZE OF TANK: 1,0000 gallons TOTAL JOB COST
DWELLING: Barn GROSS PROFIT
PERC RATE: one inch/30 minutes (300 sq.ft.)
LESS OVERHEAD COSTS
% OF SELLING PRICE
300 sq.ft. of leach field
NET PROFIT
Finalized: 8-20-80 By JoAnn Dei ghan Printed In U.S.A.
{ ILDER
4 tl
w
I.
MAP OF
--- WERTHEIM PROPERTY
BEING A PORTION OF TRACT 77
TWP. 5 S, R 85W OF THE
6 th P. M.
11
i
60
BRASS CAP WITNESS COR.
�t
f
208.71
MAYNE
A
A
.► PROP.
N
N
I
208.71
I
I
NET ACREA
I
I
t
4.
2oa. o0
a)
WjrCS
c FK�r
204.00
1
1
I
_ l
ICHATFIE
\' DITCH
I iaT�s Ruri;, b ind cs :lr re"i I. rea Lan'
Sarve or in the state of Colorado, do horebv
certify_- that this -,' at is ari accurate re--resen-
Cation of a fen: e anci ditch line sure; •lade .)
during �cLcher of 1979.
lat is an Troxi:r:ite same; intenO.ed n!'il`,'
an a roximjtP icrea-;e. No f,,_-e3tF'_
_?' cr lr 1S 1C"e!i rr i C lipii T) is 13t �:iO lC1
-: �t use�_3 t._,r a le ,a1 '_'.escriT)tion .
c' i�-L Zt`is L.�n�-` -: r`.re`_ Cr Late
ST 1330,86
E - 89.12 ACRES ±
z
O
0
0
CD
to
CD
m
N
v
ID
0
m
PIPE FOUND IN PLACE
(NO BRASS CAP)
a i a
AND BARTHOLOMEW
i0
O
i
Ewa riniI Distance
if,i. I l )
(2 5 6_7 0115"E
i
(3) 39` 37' 3C5"E 12 31 *+.
(5) S 70e19'35"F. 1)3.29% _t.
16
(7) 68°(5}5'28"E 34!6 911 ft.
BURK LAND SURVEYING CO.
GYPSUM, COLORADO
DATE OF SURVEY DRAWN BY
OCT. 1979
SCALE FILE NO,
I IN. = 200 FT.