HomeMy WebLinkAbout11146 Hwy 6 - 211104200004EAGLE CC 'TY DEPARTMENT OF ENVIRONMEf /L HEALTH
Box 811 6th & Broadway
PERMIT MUST BE POSTED ON LOCATION CALL FOR FINAL INSPECTION PRIOR TO
Eagle, Colorado 81631 COVERING ANY PART OF SYSTEM
PERMIT N. O (this does not constitute
4 6 8 a building or use permit)
Owner PAUL MAYNE
System =wti 11146 Highway 6
Licensed &rmua Installer: KEN SCHULTZ, SCHUT,T7, CON TR c"TTnN
* Conditional Construction approval is hereby granted for a 1,000 gallon EMERGENCY REPAIR PERMIT
xx Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows: MINIMUM REQUIREMENTS:
1 750
inches in 15-20 minutes sq. ft. 750 sq. 1,000 gallon septic tank
Pere rate estimated ft. leach field
absorption area per bedroom 250 sq. ft.
# of bedrooms 3 X 250 sq. ft. minimum requirement
May we suggest
Date October 8, 1980
FINAL APPROVAL OF SYSTEM:
Inspector 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. za�"-::, --,
111_S tic Tank cleanout to within 12" of final grade or aerated access ports above grade.
per materials and assembly. _5
h
Adequate absorption (or dispersal) area. Z_
equate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements. c.2 —5-ly.',-17.
/�
Date g�` QC-1 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, 3.29 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
hnth_
PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES
31 It- 4 949-5257 927-3823
_ N
v' ✓i ES; NVIP.ONMENTAL HEALTH
w BOX 850
EAGLE, COLORADO 81631
PERMIT FEE _ $75 PERCOLATION TEST FEE _ $50
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
NO.
NAME OF OWNER:���
ADDRESS: PHONE: S2
NAME OF APPLICANT (IF DIFFERENT FROM OWN R):
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTEM (IF APPLICABLE):
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: 4"n Ydjk
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: ( ) New Installation ( ) Alteration () Repair
LOCATION OF PROPOSED FACILITY: County 1�6-1_ Lot Size J �
City or Town, if within City or Town Limits /f
LEGAL DESCRIPTION:
STREET (RURAL) ADDRESS: (o
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALL S PER DAY? ( ) Yes ( ) No
BUILDING OR SERVICE TYPE: (Check applicable category)
Residential - Single-family dwelling ( ) Residential - Triplex
( ) Residential - Duplex ( ) Residential - Quadplex
( ) Commercial - State usage
# Persons # Bedrooms ?�
WASTE TYPES: (.Check all applicable)
( ) Commercial or Institutional O Dwelling ( X ) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use ( X ) Dishwasher
( ) Other ( X ) Automatic Washer
SOURCE AND TYPE OF WATER SUPPLY: (>�) Well ( ) Spring ( ) Creek or Stream
Give depth of all wells within 200 feet of the system:
If supplied by community water, give name of supplier:
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM -PROPOSED:
(jJ 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
Signatu
Date Z6 9 — 8 d
* * * * * * * * * * * * * (4 ' 0' * * * it * * * * * * * * Y .
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER d000 y u ll? 2
GROUND CONDITIONS: Percent Ground Slope:
Depth to Bedrock (per 8' Profile Hole):
SOIL PERCOLATION TEST RESULTS:
Q-76,-- � 7,
Depth to Groundwater Table:
Minutes per inch in Hole No. 1
Minutes per inch in Hole No. 2
Minutes per inch in Hole No. 3
FINAL DISPOSAL BY: (r Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( Underground Dispersal ( ) 'Wastewater Pond
( Other
REPAIR PERMIT APPLICATION
FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS ;
r
A permit fee of $75. shall be charged for alteration, enlargement, or any repair
involving alteration of an existing sewage disposal system. This fee is authorized
by Eagle County Individual Sewage Disposal System Regulations adopted and effective
March 27, 1980.
For minor repairs of less than $100 for maintenance of the individual sewage
disposal system, no fee shall be required.
A percolation test fee of $50 shall be charged for all new leach fields on repair
permits. Percolation testing may be waived at the discretion of the Environmental
Health Officer on certain repair cases where prompt action must be taken.to prevent
a:.-tealth hazard.
IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW SYSTEM SHALL BE INSTALLED,
COMPLYING WITH ALL CURRENT REGIULATIONS. If A NEW SYSTEM IS REQUIRED, ALL FEES ARE
APPLICABLE.
DESCRIPTION OF PROBLEM/MALFUNCTION:
4Aec�r
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: LA-vu k ,,` ✓\, S ;
DATE PRESENT SYSTEM WAS INSTALLED
PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT:
SITE PLAN BEL0W SHOWING PRESENT SYSTEM COMPONENTS: Mn2,
OWNER 01
ADDRESS
APPLICANT:
ADDRESS:
DATE: i 6 1►
0468 11146 Hwy 64/. , �-}�
JOB NAME - �. C���I5p-11CC��i
Parcel # 211104200004,E
JOB 'NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
I �iI Oii r�
i 1)a�
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL .LABOR
INSURANCE
SALES TAX
MISc. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% 'OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 �p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471
JOB FOLDER
.
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