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HomeMy WebLinkAbout3 Miles W. of Eagle - Eagle River 1978 Trust - 00000000000APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT r` ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. i ©A, PERMIT APPLICATION FEE: $150.00 PERCOLATION TEST FEE: $50.00 NAME OF OWNER: % G L E PIj E A ) q,7 T R L 4 S-r- ADDRESS : O X� I I q CA-Q L E_ Ca PHONE: 3 2 fr 4 3 7/ NAME OF APPLICANT (if different from owner) : L ADDRESS: Pd / yy7 PHONE: 3 2r 4 3 7 DESIGN ENGINEER OF SYSTEM (if applicab e): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF_ SYSTEM: -jam( SG4 M (_TZ_ _ Licensed Installer (see attached list): YES NO ADDRESS: YPS L4 PHONE: PERMIT APPLICATION IS FOR: LOCATION OF PROPOSED INDIV Street/Rural Address: Lot Size: Legal Description: New.Installation -( ) Alteration SEWAGE DISPOSAL SYSTEM: BUILDING OR SERVICE TYPE (check applicable category): (ill Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( ) Garbage Disposal ( ) Automatic Washer ( ) Other TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( ) Repair ( ) Residential.- Quadplex ( ) Commercial (state usage) NUMBER OF BEDROOMS: ( ) Dwelling (X) Transient Use ( ) Dishwasher ( ) Spa Tub ( ) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet ( Vault Privy ( ) Greywater. ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use ( ) Other ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (�) IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO ( ) WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( ) (I 6 yeas , � ee attached wastewateA stow Aeduction methods ) NOTE: The Env it onmenta2 HeatP,th 066 ieen may Reduce the tequ uAed abSoApti on area upon appnova2 0� an adequate wasteeuateA 6tow tedueti.on plan. SOURCE AND TYPE OF WATER SUPPLY: (>4) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: 0 Qf- If supplied by commun' y water, give name of supplier: W Z--SIGNATURE--hEL -------------------DATE -5 �$-�---INFORtdATION TO BE FILLED UT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: PeAcent GAound Stope Depth. to Bedrock (peA 8' PAo4ite Hote) Depth to GAaundwateA Tabte SOIL PERCOLATION TEST RESULTS:. Afinutes pets inch in Hote 1 M.inute�s pen ,inch to Hone # 2 Minutes peA ,inch to Hote # 3 FINAL DISPOSAL BY: ( ) Abz oAption TAench, Bed oA Pit ( ) Evapottran6 p e Aati,on ( ) Above GAound Dizpeuusat ( ) Sand FitteA ( ) UndeAgnound Di6pex6at ( ) WastewateA Pond ( ) Other AmouvLt Paid: c� - Receipt NumbeA C C� I P ,; Date: NOTE: Site Plan must be attached to application. (Env. Health Department - Rev. 4-07-83) PERrr,LAT10N TEST FEE: SSO I.S.D.S. r.PP. = 0!•INER: LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF Dl-lELLING: # OF BEDRnnms : DATE OF PERCOLATION TEST: TYPE OF SOIL: TEST HOLES PRESOAKED? Yes No WATER DEPTH IINCHES OF FALL., H -■ _—_— _-:MIME _N11. • __ t MINVME IME� WE MEMMILIM ME PERCOLATION RATE: RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: Site has been revievied and tested for percolation rate. Date Environmental Health Officer COMMENTS: — GA 17 r-r," TELEPHONE 303/328-7311 Board of County Commissioners Ext 241 Assessor Ext 202 Clerk and Recorder Ext 217 Sheriff Eagle: Ext 211 Basalt: 927-3244 Gilman: 827-5751 Treasurer Ext 201 Administration Ext 241 Animal Shelter 949-4292 Building Inspection Ext 226 or 229 Community Development Ext 226 or 229 County Attorney Ext 263 Engineer Ext 236 Environmental Health Ext 238 Extension Agent Ext 247 Library Ext 255 Public Health Eagle: Ext 252 Vail: 476-5844 Personnel Ext 241 Purchasing Ext 245 Road and Bridge Ext 257 Social Services 328-6328 EAGLE COUNTY Eagle, Colorado 81631 June 19, 1984 Eagle River Ranch P.O. Box 1199 Eagle, Colorado 81631 Dear Sir: This is to inform you that your ISDS Permit #663 has been finalized and signed off by Sid Fox and Erik Edeen, Environmental Health Officers for Eagle County, on June 13, 1984. I am enclosing a copy -of this permit for your records. Sincerely, tjo_t Z� r� Lorraine Funke, Secretary Environmental Health Office EAGLE COUNTY /if Enc. Tie: 427008. P.O. � � S.79005'02'�E. 287.79� to Car. 4 Tr g _ — _ ` rebor 43 Cap fou a/urr) — T n d \ to f^T \ \ a/ur c0 N - 3 _ O try .964 A c. rh oN "' M Al tU W.C. o ,� W.C. d' N o 0 0 EAGL o � T`2�,�/ 20� Irrigation _N co .. - Easement o - l S.78030�39" W. 303.01, S-78057�42W. 80.001 I I . I mommul 50 100 200 300 SCALE: I"=100' JOB NAME. JOB Nop . JOB FOLDER Product. 278 ¢as ® NEW ENGLAND BUSINESS SERVICE, INC„ GROTON, MA 01471 Printed in U.S.A.. JOB FOLDER 1} EAGLE COUNTY DEPARTPIENT OF ENVI W RONMENTAL HEALTH PLEASE C.-"-',L- FOR FINAL P. 0. Box 850 - 550 Broadway INUE r 114 BEFORE rn11rDTMC Eagle, Colorado 81631 ANY PRTION OF INSTALLED SYSTEM 328-7311 or 949-5257 or 927-3823 OWNER: Eagle River Trust (1978) SYSTEM LOCATION: Goldman House LICENSED INSTALLER: Ken Schultz PERMIT N0. No 673 PERMIT MUST BE POSTED AT INSTALLATION SITE REPAIR ADDRESS: P.-O. Box 1199 - Eagle, CO 81631 LICENSE NUMBER: 84-01 "CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following: MINIMUM REQUIREMENTS: gallon septic tank or aerated treatment unit. Absorption area or dispersal area computed as follows: PERCOLATION RATE: inch in minutes. Absorption Area per Bedroom No. of Bedrooms x sq. ft. sq. ft. minimum requirement per bedroom = total sq. ft. minimum requirement. SPECIAL REQUIREMENTS: Repair of Existing system - damaged by defective water softner. 900 sq.ft. of leach field plus diversion valve or distribution valve. DATE: 9/07/84 INSPECTOR: Erik Edeen "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: ? C� sq. ft. Installed Septic Tank: gallons. Degrees: Design Engineer of System: , Installer of System: UlfZ _ 190 Feet: 7 Phone: Septic tank cleanout to within 12" of final de or aerated access ports above grade? Yes No Proper materials and assembly? Yes N Compliance with permit requirements? Yes No Compliance with County/State regulations requirements? Yes No COMMENTS: 1% n �iSTtd 1f3ii jiuw aol /Jo` fNs At.(. Z ✓J - T` ' ')IAcco dAj Exit i N 6 ( owe-aFw -:6 a d o ui use c, F PL-oi (Any item checked "No" requires correction before final approval of system is made. Arrange a 71V pection when work is completed DATE: <� `b INSPECTOR: RE-INSPEC ON T : INSPECTOR: l / APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. 2,0 1116 PERMIT APPLICATION FEE: $150.00 PERCOLATION TEST FEE: 850.00 NAME OF OWNER: Eagle River 1978 Trust ADDRESS: P.O. Box 1199, Eagle, CO PHONE: 328-6371 NAME OF APPLICANT (if different from owner): Terrill Knight ADDRESS: p_0_ Box 1199.,am► Co PHONE: 328-6371 DESIGN ENGINEER OF SYSTEM (if applicable): NA ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF -SYSTEM: Licensed -Installer (see attached- list): Ken Schultz YES X Fk [IN ADDRESS: Gypstun PHONE: 524-9572 PERMIT APPLICATION IS FOR: ( ) New. Installation -( Alteration (X ) Repair LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Street/Rural Address: Goldman House Lot Size: 250 Acres Legal Description: NA BUILDING OR SERVICE TYPE (check applicable category): ( X) Residential - Single Family ( ) Residential - Quadplex ( ) Residential - Duplex ( ) Residential - Triplex ( ) Commercial (state usage) NUMBER OF PERSONS: 2 WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( X) Garbage Disposal ( X) Automatic Washer ( ) Other TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( X) Septic Tank ( ) Composting Toilet ( ) Vault Privy ( ) Greywater ( ) Pit Privy ( ) Aeration Plant ( ) Other NUMBER OF BEDROOMS: (X ) Dwelling ( ) Transient Use ( X ) Dishwasher ( ) Spa Tub 3 ( ) Incineration Toilet ( ) Chemical Toilet ( ) Recycling, Potable Use ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES ( ) ,No- _()FT___ WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( ) (I6 yeas, -See attached toastevate)L gZow reduction methods) NOTE: The Envikonmentae HeaLth 066icer may reduce the requited ab�sonption area upon appnovat 06 an adequate wa3tewatet 6tow teducti.on plan. SOURCE AND TYPE OF WATER SUPPLY: ( X) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: None If supplied by community water, give name of supplier: NA SIGNATURE: DATE: INFORMATION BELOW TO BE FILLED OUT By ENVIRONMENTAL HEALTH OFFI ER: GROUND CONDITIONS: PeAcent Ground Slope Depth to Bedrock (pen 8' Pno4ite Hote) Depth to GnoundwateA Tabte SOIL PERCOLATION TEST RESULTS:. Afinutu pen inch cn Ho._e 'l M.i.nutes per .inch to Hote #2 FINAL DISPOSAL By: Minutes pen .inch to Hote #3 ( ) Ab6onption Trench, Bed on Pit ( ) EvapotAansp &ati.on ( ) Above Ground DizpeAzat ( ) Sand FitteA ( ) Undengtound Dispensat ( ) Wastewater Pond ( 1 Other Amount Paid: toi T0.0 0 . Receipt Numb er 10 lot Date: 9 -0 S -25 4 NOTE: Site Plan must be attached to application. (Env. Health Department - Rev. 4-07-83) 1 'kt TELEPHONF, 303/328-731' i Board of County Commissioners Ext 241 Assessor Ext 202 Clerk and Recorder Ext 217 Sheriff Eagle: Ext 211 Basalt: 927-3244 Gilman: 827-5751 Treasurer Ext 201 Administration Ext 241 Animal Shelter 949-4292 Building Inspection Ext 226 or 229 Community Development Ext 226 or 229 County Attorney Ext 263 Engineer Ext 236 Environmental Health Ext 238 Extension Agent Ext 247 Library Ext 255 Public Health Eagle: Ext 252 Vail: 476-5844 Personnel Ext 241 Purchasing Ext 245 Road and Bridge Ext 257 Social Services 328-6328 EAGLE COUNTY Eagle, Colorado 81631 September 24, 1984 Eagle River Trust P.O. Box 1199 Eagle, Colorado 81631 Dear Sir: This is to inform you that your ISDS Permit #673 has been finalized and signed off by Sid Fox on September 18, 1984. I am enclosing a copy of this permit for your records. Sincerely, f� Lorraine Funke, Secretary Environmental Health Office Eagle County /1 f Enc. JOB NAME JOB NO. BILL TO DATE STARTED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR PERMIT No. 673 INSURANCE. EAGLE RIVER TRUST (.1978) P.O. Box 1199 SALES TAX Eagle, Colorado 81631 MISC. COSTS LOCATION: Goldman House (repair of existing system) INSTALLER: Ken Schultz - 84-01 SIZE OF TANK: N/A 190 degrees; 75 feet DWELLING: Single family three bedrooms PERC RATE: N/A TOTAL JOB COST GROSS PROFIT Finalized: 9/18/84 By: Sid Fox LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT LDER Printed in U.S.A. 6 7 � � � e � v 0 o� 2 H p�( V _ 3 \r Q I . , GARAGIC PC 1.7 r = �' �`st'!7%n ^ � -n v ... -'i - � LLl/I ��w�-xs.^-^it- 1 LAP d'arww sues � i Ac 45,4 Ir 4 % TiP.9C T 4S � i THE L+xc F+CCMiHE" P.7r..E IZ> 1-14£ rRopo-r-D rP-A1L_crK is 0K T R:!, NL>Q:T-o SrOE: pf j '_—'EWEk UNE IN SA s[. T �rl -AMC �E.VATIt�N�. 1