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HomeMy WebLinkAboutCooley Mesa Rd - 211103400015h EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH P 0 Box 850 - 550 Broadwa .:_n3t CALL FOR FINAL y PERMIT MUST BE POSTED 'INSPECTION BEFORE COVERING Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTION OF INSTALLED SYSTEM N° 558 328-7311 or 949-5257 or 927-3823 PERMIT NO. OWNER: Stewart & Adona McLain ADDRESS: P.O. Box 6 - Gypsum, Co SYSTEM LOCATION: Cooly Mesa Road (Tr 54; T5S; R85W of 6th PM LICENSED INSTALLER: Triple H. Construction (Randy Hill) LICENSE NUMBER: #103-82 **CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following: MINIMUM REQUIREMENTS: b0(7 gallon septic tank or — aerated treatment unit. Absorption area or di ersal area computed as follows: PERCOLATION RATE: inch in 7—\S' minutes. Absorption Area per Bedroom COO sq. ft. 6—,P ' sa�� No. of Bedrooms 2, xJ O sq. ft. minimum requirement per bedroom total sq. ft. minimum requirement. SPECIAL REQUIREMENTS: /`Zwi•z�/k-:z loo DATE: �'1 /% -SZ INSPECTOR: **CONDITIONS: 1. All installation must comply with all requirements of the County Individual Sewage Disposal System Regulations, adopted pursuant to authority granted in 25-10-104, C.R.S. 1973, as amended. 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 structure not approved by the building and zoning departments 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, 3.21 requires any person who constructs, alters, or installs an individual sewage disposal system to be licensed according to the Regulations. FINAL APPROVAL OF SYSTEM: No system shall be deemed to be in compliance with the Eagle County Individual Sewage Disposal System Regulations until the installed system is approved prior to covering any part. Installed Absorption or Dispersal Area: sq. ft. Installed Septic Tank: //QOU gallons. Design Engineer of System: .f/Z A - Installer of System: �tv �, /�� `i Septic tank cleanout to within 12" of final e or aerated access ports above grade? Yes No Proper materials and assembly? Yes Nja Phone: Compliance with permit requirements? Yesy No Compliance with County/State regulations requirements? Yes No COMMENTS: (Any item checked "No" requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) DATE: -_7 fig-' SZ INSPECTOR: RE -INSPECTION DATE: INSPECTOR: F'LLA1 )L KLiUf{N 1111J MKI 11111 I'll IN Y11UK Jl IL FLAN AND FEEL 5) 32Qv731''- g°9 5257 927-3523 ENVIRONIPENT L HEALTH BOX 850 EAGLE, COLORADO 81631 PERMIT FEE _ $150 PERCOLATION TEST FEE = S50 APPLICATIO+ FOR INDIVIDUAL SE!, -!AGE DISPOSAL SYSTEM, PERMIT NAME OF OWNER: Y + Mc I_ cam. i hl ADDRESS: `�. O X G- V A S u wL PHOMIE : S Q q- `� 70 NAME OF APPLICANT (IF DIFFERENT FROM 014NER) - ADDRESS: PHONE: DF.SIGN ENGINEER OF SYSTEM (IF APPLICABLE): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: y, Can -fir Tj%a/ ADDRESS: �1M e-c,- R�. �r S�w� PHONE: � ((� .%2 `1S PERMIT APPLICATION! IS FOR: (V) New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED FACILITY: County 9 (>< Lot Size C r,s City or Town, if within City or Town Limits LEGAL DESCRIPTION: -` I\ , Rakq �S w�5+ o��M STREET. (RURAL) ADDRESS: Cool��M <a IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? (�) Yes (.` No BUILDING -OR SERVICE TYPE: (Check applicable category) (v) Residential - Single-family dwelling ( ) Residential - Triplex ( ) Residential - Duplex ( ) Residential - Quadplex ( ) Commercial - State usage # Persons 3 # Bedrooms +� WASTE TYPES: (Check all applicable) ( ) Commercial or Institutional ( V.) Dwelling ( ) Garbage Grinder ( ) Non -domestic wastes ( ) Transient Use ( ) Dishwasher ( ) Other ( Automatic Washer SOURCE AMID TYPE OF WATER SUPPLY: (V/) Well ( ) Spring ( ) Creek or Stream Give depth -of all wells within 200 feet of the system: 00 If supplied_,by community water, give name of supplier: TYPE OF INDIVIDUAL SE14AGE bISPOSAL SYSTEM PROPOSED: (�) Septic Tank ( ) Aeration Plant ( ) Chemical Toilet f' .'?aU! 1 Fr !vy ihr JLii J iUi i i � I' Re_.ycI Iily, } vt QLi,C vj ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greywater ( ) Other WILL EFFLUENT BE DISCHARGED DIRECTLY INTO I4ATERS OF THE STATE? ( ) Yes (t/) No Signature o-�� '� �� � ����An�r YVIC 1"U"% f L k INFORMATION BELO!4 TO BE FILLED OUT BY ENVIRmrENTAL HEALTH OFFICER GROUND CONDITIONS: Percent around Slope: Date �lula�.Z 3 (0j 8z Depth to Bedrock (per 8' Profile Hole): Deptli.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 ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE Stewart & Adona McLain Name 4-01-82 Date Routed 925,Cooly Mesa Road (Tr 54; TSS; R85W of 6th P.M. Application No. Location Please review the attached Individual Sewage Disposal System Permit Application and return it with this completed form to'the Environmental Health Office. PLANNING: Complies with - YES NO REVIEWED BY DATE Subdivision Regulations: Zoning Regulations: Recommend Approval: H ,q 2 COMNi�NTS : n BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGI� 1 1� EER: Complies with - Roads: Grading: Drainage: Recommend Approval: YES NO REVIEWED BY DATE COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: YES NO REVIEWED BY DATE COMMENTS: PERCOLATION TEST FEE: $50 I.S.D.S. APP. # OWNER.' LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DUELLING: //C),-, -.- # OF BEDROOMS: a DATE OF PERCOLATION TEST: �>� --y��`-- �, TYPE OF SOIL: C"'° Si, TES HOLES PRESOAKED? Yes j No TIME WATER DEPTH INCHES OF FALL RATE 1 2 3 1 2 3 1 2 3 1 2 3 4'/0 ZS 3 3� / '/ 6; z D 2 3 3 Z 2 3 Z.S N2, t� zS ` 3j Z_ Oct �� K �e PERCOLAT ION RATE: S �% / �% ->-/ L�� RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: O d RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: �' © O Site has been revievied and tested for percolation rate. 3- z- cz Date Environmental Health Officer COMMENTS: �.-•�/-/ CJ -2 S� r / 41, \3) t qlg:� �-� `�C.�i�..�.,��-�.�`es�..� � _ems•-� a i..�.�,.,..5�.� .1.��-�:. j . � �s. t,i � _�.tt `.. 's^+• ` �L.aC CA..� _�.M.Zy� ''�.!'� � i aRF : R 14 EIMROHMENTAL HEALTH 0558 M6-144-P, Cooly Mesa Colly �_N, f �..I• -� �/ JOB NAME Mesa 2111-034=00-015 �L�l���A�alf�� IT w P CIE' J r BILL TO DATE STARTED DATE COMPLETED DATE BILLED 764 I Cco6 N" W I Aac� JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL qq iw �X PERMIT #558 -- OWNER: Stewart & Adona McLain LOCATION: Cooley Mesa Road INSTALLER: Randy Hill SIZE OF TANK: 1,000 gallons DWELLING: Residential - 2 bedrooms x 300 sq.ft. PERC RATE: five inches/25 minutes Gyp Soil l 600 sq . ft.) TOTAL LABOR lo INSURANCE SALES TAX Mlsc.cOSTs TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT Finalized: 4-19-8L by: triK taeen DER Printer! in U.SA.