HomeMy WebLinkAbout101 Eagle Ct - 211106402006EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTHIE
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PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED
INSPECTION BEFORE COVERING Eagle, Colorado 81631 PE AT INSTALLATION SITE
ANY PORTION OF INSTALLED SYSTEM
328-7311 or 949-5257 or 927-3823 PERMIT NO. N ° 5 9 6
OWNER: Paul Hayes/Mike Simonds ADDRESS: 132 Broadway - Eagle, CO 81631
SYSTEM LOCATION: Lot 6 - Slaughter Subdivision - Cedar Lane - Gypsum, CO
LICENSED INSTALLER: Frimml Excavating LICENSE NUMBER: lDi7_B2_
**CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following:
MINIMUM REQUIREMENTS: 1,000 gallon septic tank or aerated treatment unit.
Absorption area or dispersal area computed as follows:
PERCOLATION RATE: one inch in ten minutes.
Absorption`Area per Bedroom 200 sq. ft.
No. of Bedrooms 3 x 200 sq. ft. minimum requirement per bedroom
600 sq.ft. total sq. ft. minimum requirement.
SPECIAL REQUIREMENTS:
DATE: /2-- .7--% 91'21 INSPECTOR:
**CONDITIONS:
I. 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: d(r---()Q sq. ft.
Installed Septic Tank: gallons.
Design Engineer of System: .4,�
Installer of System:-- `J 7"
/'% �'►�t � �-- Phone
Septic tank cleanout to within 12" of final grade or
aerated access ports above grade? Yes No
Proper materials and assembly? Yes No
Compliance with permit requirements? Yes k,-' No
Compliance with County/State regulations requirements? Yes No
COMMENTS: s ,eo jV_G.
v
(Any item checked "No" requires correction before final approval of system is made.
Arrange a re -inspection he 9 p when work is completed.(-�G
DATE: INSPECTOR:
RE -INSPECTION DATE: INSPECTOR:
CHARGES RETAIN WITH RECEIPT RECORDS PERMIT NO. NQ 596
Percolation Test = $50.00
Permit Fee (includes final inspection) _
ALL CHECKS OR MONEY ORDERS ARE TO BE
MADE PAYABLE TO: EAGLE COUNTY
Name of Applicant: Mike Simonds
Name of Owner: Simonds/P. Hayes
Amount Paid: 8200.00
Receipt Number: #1849
Cashier: Lorraine Funke
White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner
r
r
PE": �.,T EE _ $150
BOX E50
EAGLE. CCL00ZO G 101
FE- =
APPLICATION FOR 1NDI:'IDUAL.SE'.:AQ DISPOSAL SYS;E'•! PE':OIT
MANE 'OF OWNER: ` w`
NAME: OF APPLICANT (IF DIFFERENT FROM OWNER):
A05RESS:
r--
PHONE:
PHONE:
UPSIGN ENGINEER OF SYSTEM (IF APPLICABLE):
ADDRESS: PHONE:
-PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: A W\r'.\mN1
ADDRESS: 0 c& PHONE:
PFRIIIT APPLICATION IS FOR: ) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED FACILITY: County �T 00C Lot Size ALA
City or Tom, if ti•:ithin City nr T� cn Liri��svc
y LEGAL DESCRIPT ION:
STREET (RURAL) ADDRESS: \--INN e Cl is �
IS SYSTEM DESIGMED 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 - Quadpl ex
-( ) Commercial - State usage
Persons z Bedrooms 3
WASTE TYPES: (Check all applicable)
( ) Cori-imercial or Institutional — Dwelling (_) Garbage Grinder
( ) Non -domestic wastes ( ) Transient Use Dishwasher
Other Automatic flasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( } Spring ( ) Creek or Stream -
;..Give depth of all wells within 200 feet of the system: _
If supp., liedby community water, give name of supplier: -
1TYPE OF INDIVIDUAL SENAGE bISPOSAL SYSTEM PROPOSED:
Septic Tank ( ) Aeration Plant ( ) Chemical Toilet
.Vau L Privy L::wpost0 j u i it Recycling; Ps atil U_ c
..( ) Pit Privy ( ) Incineration Toilet ( } Recycling, Other Use
( ) Greywater ".( ) Other
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes No
C-s" Date
Signature �,,1� o� d-
--.
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent Ground Slope:
Depth to Cedrock (per 3' Profile hole):
SOIL PERCOLATION TEST RESULTS:
Depth to Groundwater Table:
Pi nu tes per inch in Hole No. 1
Pliflutes per inch in Hole No. 2
!1inutes per inch in Hole No. 3
FlNAL DISPOSAL BY: ( ) absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) ALove Ground Dispersal ( ) Sand Fi l ter
( ) Un'erground Dispersal ( ) Wastewater Pend
( ) 0 t"e r
l
Poo.00
PERCOLATION TEST FEE: $50
.A
I.S.D.S. APP. #
F F0WNER:
LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING: # OF BEDROOMS:
DATE OF PERCOLATION TEST: ��- TYPE OF SOIL:
TEST HOLES PRESOAKED? Yes No
14ATER EPTHIINCHES
OF FA LL►
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE:
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
Site has been reviewed and tested for percolation
rate.
Date Environmental eat icer
COMMENTS:
ITEM CORRECTED
NO'• REMARKS BY
Complies with the Control of Smoking Legislation Yes No
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I NSPE, "ED BY:, NAME RE CE I VED SY: NAME
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COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
A C T I V I T Y R E P 0 R T
Section
FILE REFERENCE: — -/,
INDIVIDUAL OR
ESTABLISHMENT:
ADDRESS:
NARRATIVE:
LETTER TO FOLLOW: OTHER RECOMMENDATIONS:
-0
DATE / 19
REPRESENTATIVE:
i
Code
County
6A
ES: 7 (Rev. 6-70-100)
61 it v w r 0 oL- v v (p
PROJECT
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project description
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PROJECT CONTACTS
PERMIT #596
documents enclosed
OWNER: Paul Hayes/Mike Simonds
LOCATION: Lot 6 - Slaughter Subdivision
a / Cedar i:ene - Gypsum
INSTALLER: Les Frimml o
SIZE OF TANK: 1,000 gallons �Q�re.z? •$
DWELLING: Residential - 3 bedrooms x 200 sq.ft. notes
PERC RATE: one inch/ten minutes (600 sq.ft.)
Finalized: 1-14-83 By: Erik Edeen '1°
4e,