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HomeMy WebLinkAbout316 Strohm Cir - 211106405032-_j Box CSC EAGLE, COL0rA_-_0 E1631 FE:,CCL:�T 1';:l TEST FEE = SSO APPLICATION' FOR iiIDIVIDUAL SE:,7XE DISPOSi,L SYSTE" PER'.'.I T _NAME 'OF 01•I;IER: ADDRI-:SS : ? 2— NA NE OF APPLICANT (IF DIFFjRENIT FROM 01-INER): ADDRESS: DF.SIGN ENGINEER OF ADDRESS: -PERSON RESPONSIBLE ADDRESS: TENXIF, APPLICABLE): .10. ! %%n %t, S -�7 PHONE: PHONE: PHONE: IR INSTALLATIO"I OF SYSTEI1'1: PHONE: PERNIT APPLICATION IS FOR: ( ^lew Installation ( ) Alteration LOCATION OF PROPOSED FACILITY: County "26t Ye_ Lot Size City or Town, if within City or Toin Limits LEGAL DESCRIPTION: r , %�S ��� Z­�T STREET (RURAL) ADDRESS: IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? (✓� Yes ( ) No BUILDING 0 SERVICE TYPE: (Check applicable category) Repair 3 ee)' 1g:121g-s i / 4L C� 46C/ ( Residential - Single-family dwelling ( ) Residential - Triplex ( ) Residential Duplex ( ) Residential - Quadplex ( ) Commercial - State sage # Persons ��i' # Bedrooms WASTE TYPES: (Check all applicable) -- ( ) Commercial or Institutional (v.) Dwelling Garbage Grinder ( ) Non -domestic wastes ( ) Transient Use ( � Dishwasher ( ) Other (� Automatic Masher SOUP,CE A'1D TYPE OF 14ATER SUPPLY: ( ) Well ( ) Spring ; ( ) Creek or Stream -% 4 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: ( Septic Tank ( ) Aeration Plant ( ) Chemical Toilet - - _ .,_.t11 ,vau1L Pv•_I i IVy •t � iui�� vJL ii�J iUil:. 1. -1 ?i-'.f�ilg, �L. i.. CIV �' i•JC ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greywater ( ) Other `WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes ( t`rN o Signature Date 0 INFORMATION BELO!•I TO BE FILLED OUT BY EiIVIRDiIIIE"IT!1L HEALTH OFFICER GROUND CONDITIOIS: Percent Ground Slope: �^ Depth to Bedrock (per 8' Profile Hole): Depth to Groun.a•iater Table: SOIL PERCOLATION TEST RESULTS: �� Ninutes per inch in Hole No. 1 X0 Minutes per inch in Hole No. 2 Minutes per, inch in Hole No. 3 FINAL DISPCSIL BY: ( absorption Bed or Pit ( ) Evanotransoiration ( ) Above Ground Dispersal ( ) Sand Filter ( ) Un�ergrour.d Dispersal ( ) :•laste:'iater Pond ( ) 0 t:,er PERCOLATION TEST FEE: $50 9 7� I.S.D.S. APP. OWNER: �i `l � m � s O�� � -2 LEGAL DESCRIPTION: 192,fL l� % 7 63iZ? RURAL ADDRESS: 7` TYPE OF DWELLING: # OF BEDROOMS: DATE OF PERCOLATION TEST: g 6 TYPE OF SOIL:�l<�-� TEST HOLES PRESOAKED? Yes No 4,--- E- /jr)C-F - WATER DEPTH INCHES OF FALL MEEM- MEN PERCOLATION RATE: (� RECOMMENDED MINIMUM SEPTIC TANK SIZE: 1��5 RECOMMENDED MINIMUM LEACH FIELD SIZE: rz> cps-,,� RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: C eo, H,P Site has been reviewed and tested for percolation rate. Date Environmental eat icer COMMENTS: = F ��� ACC sZi LOAN INSPECTION FORM LOCATION: to _.. f t���,• REQUESTOR:_ COPIES TO: BILL TO: 9e 4e 9c 4c 4c �c �c 9!r �c 4c 9c 3r * �c 3r -9c 4e -�c 9c 9c �'c •9c �'e 9c �c � � 9e 3c ',c 4c 4c �'c * 4e ISDS PERMIT # , � 79 INSPECTION INFORMATION: • � Sri � --� � � _ - U DATE: INSPECTION DONE BY: J LOAN INSPECTION REQUEST FORM LOCATION: PARCEL NO: PROPERTY OWNER: W REQUESTOR: /dT�� I-71-% /y AA 57L S&: e ZSl DATE RECEIVED: COPIES TO: ISDS PERMIT NO: NO ISDS RECORD FOUND: INSPECTION INFORMATION: EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 4 May 13, 1987 Jim Mackintosh P.O. Box 500 Gypsum, CO 81637 RE: Loan Inspection for property located at 316 Strohm Circle, Lot 5, Fil. 6, Bertroch Sub., Gypsum, CO Dear Mr. Mackintosh, All loan inspections are completed under the authority of the Eagle County Building Resolution, Section 3.09.03-A(7), adopted by the Eagle County Commissioners on October 8, 1985. An onsite inspection of the sewage disposal system on May 13, 1987 revealed that the system appears to be functioning properly with no apparent problems. This septic system was finalized on September 13, 1982 under Eagle. County Permit No. 579. Potable water is supplied by the Town of Gypsum Community Water Supply. Enclosed you will find an invoice in the amount of $25.00, the fee for this loan inspection. If you have any questions concerning this inspection, please contact our office. Sincerely, Erik Edeen Environmental Health Officer EAGLE COUNTY /gP Enc . P. Board of County Commissioners Assessor Clerk and Recorder Sheriff Treasurer P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 479 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 k:OMMLINITI DEVELOPMENT DEPARTMENT EAGLE COUNTY, COLORADO April 30, 19912 RicY> Travis 316 Strohm Circle Gypsum, CO 81637 500 BROADWAY P.O. BOX 1 ?9 EAGLE. COLORADO 3163 1 FAX (303) 323.712Li, RE: Water supply and sewage disposal inspection for property located at: 316 Strohm Circle Gypsum, Co 81637 Dear Tr avls : Al. loan inspections are completed under the authority of the Eagle County Building Resolution, Section 3.09.03, A(7), adopted by the Eagle County Commissioners on October 8, 1985. On _April 30, 1992, this department conducted a site inspection of the above referenced property. The inspection was: requested by you for she purpose of evalu;�.ting the existing condition of the oIl-site wastewater disposal and Water supply systems. A review of the County records indicates that: On September 13, 1982, the sewage disposal system was permitted .inder Permit !dumber 579, inspected and approved in accordance with County Individual Sewage Disposal Regulations. The system consists of a 1,250 gallon septic tank and 720 square feet of abso_ption area. A visual inspection of the ground surface indicated that the system is apparentl==unctioniilg s;.tisfactorily at this time. obviously, this does not guarantee the continued satisfactory performance of the system. Thy water supply to this residence is from the Town of Gypsum, a communit-y water system. The community water system is inspected on a regular oasis by the Colorado Department of Health and to the best of our kiiowlec.gt �oiTiplies With urI'cllt dr inr:lllg water s talldar d If y3u have any f'.irther questions concernincr this inspection! piease fe�-free to call me at 328-875 5 or write. Respectfuli� Stibmitted, 11�"lr�n:.,i&nta1 Health AEsistaii . JOB NAME i BILL TO DATE STARTED DATE COMPLETED DATE BILLED ' b ; 6zo GG JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL ------ - - ------ -- -- - -- u $ PERMIT #579 < OWNER: LOCATION: Lot 5 - Filing #6 - Bertroch Subdivision OOOSI& Strohm Circle INSTALLER: Gary Bertroch SIZE OF TANK: 1,000 gallons DWELLING: Residential - 4 bedrooms x PERC RATE: one inch/20 minutes minimum 600 sq.ft. of absorption area. TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT ` , : `,) 032- DER Printed in U.SA . 6 Finalized: 9-13-82 By: Erik Edeen N