HomeMy WebLinkAbout184 Annabelle Kuntz Ln - 211117101003EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway
INSPECTION BEFORE COVERING Eagle, Colorado 81631
ANY PORTION OF INSTALLED SYSTEM
328-7311 or 949-5257 or 927-3823 PERMIT NO. ► ::
OWNER: Claude & Karen Wood ADDRESS:
SYSTEM LOCATION: 1 3/4 miles up Gypsum Creek toad
LICENSED INSTALLER: Owner
PERMIT MUST BE POSTED
AT INSTALLATION SITE
Box 41" - gypsum, CO 81 i.31
�a
LICENSE NUMBER:
**CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following:
MINIMUM REQUIREMENTS: 1,250 gallon septic tank or aerated treatment unit.
Absorption area or dispersal area computed as follows:
PERCOLATION RATE: one inch in 5 minutes.
Absorption Area per Bedroom 187 sq. ft.
No. of Bedrooms 4 x 187 sq. ft. minimum requirement per bedroom
_ 750 sq.ft. total sq. ft. minimum requirement.
SPECIAL REQUIREMENTS: Maintain 100 feet from irrigation ditch.
DATE: 5/10/83 INSPECTOR. Richard Pylman
**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. 2 2,x 3 -''
Installed Absorption or Dispersal Area: sq. ft.
Installed Septic Tank: /--1-5"0 gallons. Degrees:. 0 Feet: 30
Design Engineer of System:
Installer of System: 2rx 0�7 ZZ Phone:
Septic tank cleanout to within 12" of final grade or
aerated access ports above grade? Yes No
Proper materials and assembly? Yes X No
Compliance with permit requirements? YesNo
Compliance with County/State regulations requirements?/ Yes X No
COMMENTS:
{Any item checked "No" requires correction before final approval of system is made.
3213 7111
E I I T
BOX IC-50
4V 00
EAGLE COLOrl;xr_0 816141
PER-e'IT rc
APPLICATION FOR
1NIDIVIDUrIL SE';:r-riE DISPOSAL
SYSTE" PE7-,!.'IT
��.
� 0 C)
'OF
k6c rest
NAME OINNER:
42
ADDRTL-.'SS r_74"I<
t;//,Z
5 e"', A0
PHONE
5--.2 y - '2 '7 r
gyp
NAMf-_ OF APPLICANT
(IF DIFFERE,'IT FROM
MINER):
ADDRESS:
PHONE:
DESIGN ENGINEER OF SYSTEM (IF APPLICAGLE)
ADDRESS: PHONE:
-PERSON RESPONSIBLE FOR INSTALLATION OF SYSTE',": 5'(__
ADVESS: PHONE:
PERMIT APPLICATION IS FOR: Mew Installation Alteration Repair
LOCATION OF PROPOSED FACILITY: County Lot Size 5-- A
City or Town, if within City or Tovin Limits
ct,
LEGAL DESCRIPTION: C1 e JQ 54eet (�!A a su-,
STREET (RURP.L) ADDRESS: Va &cz
IS SYSTEIM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? ('16) Yes No
BUILDING OR SERVICE TYPE: '(Check applicable category)
Residential - Single-family dwelling Residential - Triplex
Residential - Duplex Residential - Quadplex
Commercial State usage
Persons 57 Bedrooms
WASTE TYPES: (Check all applicable)
Commercial or Institutional (;K Dwel I i ng Garbage Grinder
Non -domestic wastes Transient Use Dishwasher
Other 6< 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:
O Septic Tank Aeration Plant Chemical Toilet
NaIJIL P-rivj/ •k ,J -') _1- L i t, y I i I %Z, L Pit Privy Incineration Toilet Recycling, Other Use
Greywater Other
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? Yes (X) No
-.-Signature Date
INFORMIATION BELM-1 TO BE FILLED OUT BY ENVIRMN[ENTAL HEALTH OFFICER
GROUND CONDITIONS: Percent r,round SloPe:
Depth to 'bedrock (per 8' Profile Hole): Depth to rirour-,-�,.,jater Table:
SOIL PERCOLATION TEST RESULTS: Pinutes per inch in Hole No. I
FINt"1 DISr-CS,",L BY
tlinUteS per inch in Hole No.
!1inutes per, inch in Hole No. 3
Absorption Trench, n
Ced or Pit Evanotransoi ra t-ion
Above Ground Dispersal Sand Filter
Un--'2rground Dispersal '.,!aste,,-jater Pond
0 t :, -2 r
op
v
V,
Pori.
%3tq
8
P
V
� +J
q.l
PERCOLATION TEST FEE: $50
I.S.D.S. APP. -
J.
OI;NER: ��^v..?a,
,LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING: Il # OF BEDROOMS:
DATE OF PERCOLATION TEST: ���1�� TYPE OF SOIL:;
TEST 'HOLES PRESOAKED? Yes x No
WATER DEPTH
PERCOLATION RATE: _S
RECOMMENDED MINIMUM SEPTIC TANK SIZE: �®
RECOMMENDED MINIMUM LEACH FIELD SIZE: `7
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: jc6'
Site has been reviewed.and to percolation rate.
Date En i ohm tal HealtlftOfficer
COMMENTS
i)50 r1ld-,
o° 3vr''a
LOCATION:
PARCEL NO:
PROPERTY OWNER:
REQUESTOR:
DATE RECEIVED:
COPIES TO:
ISDS PERMIT NO: _
INSPECTION INFORMAT
LOAN INSPECTION REQUEST FORM
7511
I
******* **************
NO ISDS RECORD FOUND:
VISUAL IN NON OF PREMISES:
DATE: 3ZEC
p-__
NOT FEASIBLE DUE TO WEATHER CONDITIONS:
APPARENTLY FUNCTIONING SATISFACTORILY: Ye S
NOT FUNCTIONING OR NOT EXPECTED TO FUNCTION SATISFACTORILY AS
EVIDF
A MESSAGE FOR:
FROM
OF
PHONE - 77�/77
AREA CODE NUMBER EXT.
❑ TELEPHONED ❑ CAME TO SEE YOU
DATE
� .M.
TIME ry M.
❑URGENT
❑ RETURNEDYOUR'CALL
MESSAGE: ❑ PLEASE CALL ❑. \NANTS TO SEE YOU ❑ WILL CALLAGAIN
SIGNED-Z
3/w f 'f
0615 Wood 1 3/4 Miles
:JOB NAME; Gypsum Crk Gypsum Crk
Gypsum
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BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
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JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
��"''��� ��AA�� 'j �1W Pile
PERMIT # 615
&ck
OWNER: vyj f �4 �� ���� ���
LOCATION: 1 - 3/4 miles up Gypsum Creek Road
------ ST 100 ac76
INSTALLER: Owner
SIZE OF TANK: 1,250 gallons - Degrees 0° Feet -30
DWELLING: Residential - 4 bedrooms x 187 sq.ft.
PERC RATE: one inch/5 minutes (750 sq.ft.)
COMMENTS: Unable to maintain 100' from ditch - 50' approved
site. • h ,i��
on
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD.COSTS
% OF SELLING PRICE
NET PROFIT
.- V i . --
-
Finalized: 5/16/83
By: Erik Edeen
LDER
Printed in U.S.A,