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HomeMy WebLinkAbout307 Blue Creek Trl - 239127107001 - 0667IS�E COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLEASE'--, P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED INSPECTI� zNG Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTI, ZD SYSTEM 328-7317 or 927-3823 PERMIT NO. N ° 667 OWNER: 4elinek ADDRESS: P.O. Box 889 - Carbondale, CO SYSTEM LOCH 0307 Upper Cattle Creek Road - Carbondale, CO Sec 27 - T7S-R87 - Lot 1 LICENSED Ih, cLER: 4.202 acres ouatain Meadow anc wner 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 60 minutes. Absorption Area per Bedroom 300 sq. ft. No. of Bedrooms 3 x 300 sq. ft. minimum requirement per bedroom 900 total sq. ft. minimum requirement. SPECIAL REQUIREMENTS: DATE: July 6, 1984 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: 6 -r�._ sq. ft Installed Septic Tank: /ASd gallons. Degrees: Feet: Design Engineer of System: /UaAt/( Installer of System: Vt. `K e, Phone: Septic tank cleanout to within 12" of final grade or . aerated access ports above grade? Yes t,,_ No Proper materials and assembly? Yes 22 No Compliance with permit requirements? Yes_ 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: INSPECTOR:�� RE -INSPECTION ATE: INSPECTOR: CHARGES RETAIN WITH RECEIPT RECORDS PERMIT NO. N! 667 Name of Applicant: Paul Yelinek Percolation Test = $50.00 Name of Owner: Paul Yelinek Permit Fee (includes final inspection) = ALL CHECKS OR MONEY ORDERS ARE TO BE MADE PAYABLE TO: EAGLE COUNTY Amount Paid: $200 (6/26/84) Receipt Number: C-0166 Cashier: Lorraine Funke White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner j 0_ 1 i . J - - - Jf D -n �PER`fI APPLIC;T7� 71�0•.,,� - 3__0 NAME OF 0:^11'ER:: ADDRESS: A OF APPLIC:LtiT (if different fro-m u.aner) ADDRESS: PHONTE: DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PHO;IE: PERSON RESPONSIBLE FOR INSTALL:ITION OF SYSTEM:yL Z,Q�j;y/P /(:- eZj7U4') Licensed Installer (see attached list): YES NO X ADDRESS: PHONE: PER.`fIT APPLICATION IS FOR: New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED INDIVIDUAL SM[TAGE DISPOSAL SYSTEM: Street/Rural Address: 9,3D Lot Size: Legal Description: , p"_, -7 % z i BUILDING OR SERVICE TYPE (check applicable category): (x() Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes (yL) Garbage Disposal (x) Automatic Washer ( ) Other TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: () Septic Tank ( ) Composting Toilet ( ) Vault Privy ( ) Greywater ( ) Pit Priory ( ) Aeration Plant ( ) Other Off/ ( ) Residential - Quadplex . ( ) Commercial (state usage); NUMBER OF BEDROOMS: ( k) Dwelling ( ) Transient Use (}�) Dishwasher ( ) Spa Tub ( ) Incineration Toilet ( ) Chemical Toilet ( ) Recycling, Potable Use ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (j�) IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES () NO ( ) WASTE14ATER FLOW REDUCTION PLAN: YES ( ) NO ( ) (I 6 Ve/s , see attached ways tewateA 4tocv .teduct%on metiods ) NOTE: The EnvitonmentaZ Heaeth 064icetL mac/ keduee the tLequZted absotpti on area upon appuva.e o6 an adequate wasteeateA �Zow tLeduction p.ean:- SOURCE AND TYPE OF WATER SUPPLY: (x) Well ( ) S ring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If supplied by ommunity water, give name of supplier: / SIGNATURE: % DATE: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INFORMATION BELOW TO BE TLLED OUT BV ENVIRONMENTAL HEALTH OFFICER: <n GROUND CONDITIONS: Petceent GAound Stope Depth to Bedtoch (pet 8' P&o bite Ho.ee ) Depth to GtLoundwateA Tab.ee _42 SOIL PERCOLATION TEST RESULTS:. rQ M,�Piute�s pit inch in HoZe #1- 6or-� Minutes pen inch to Hote #2 an Minu e/s pets inch to Ho.ee #3 ( P1 Ab.so.,.ptc:on DLenck, Bed o.t Pit ( ) EvapottralLsp,&ta ion ( ) Above Guund DZspeua.e ( ) Sa;id Fie-tetl ( ) Undc.Lg,L0LWd D.Lpnsat ( ) Wastecc�gten Pond Amau,u Paid: Rccci.;�t Ncunb�t Date: l.� �- �.. t till A ` aOT�E Site Plankrnus;t �be��attached to application ;, (Env. Health Department -Rev. 4-07-83) NAME PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $50.00 ISDS APPLICATION NO. OWNER: LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DWELLING: �` i"7 .� NUMBER OF BEDROOMS: DATE OF PERCOLATION TEST: 7- 3 `— )� TYPE OF SOIL: TEST HOLES PRE-SOAKED: YES _ NO WATER DEPTH INCHES OF FALL ., I� • MAM U�3E��r�l Im��»����� PERCOLATION RATE: n RECOMMENDED MINIMUM SEPTIC TANK SIZE: r RECOMMENDED MINIMUM LEACH FIELD SIZE: © �C RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. C� A 9/ � . 7- Environmeiftal Health Officer Date COMMENTS: Rev.. 5/31/84` (� sac. Wf-- • rem .JOB NAME 0 � �T/ D moo JOB LOCATION _ .. BILL TO DATE STARTED DATE COMPLET DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL -- -- --- — - TOTAL LABOR Permit No. 667 INSURANCE OWNER: ppau1 yeli; P.U. Box Carbondale, Colorado SALES TAX LOCATION: 0307 Upper Cattle Creek Road MISC. COSTS Sec 27 - T7S - R87 - Lot 1 (4.202 acres) INSTALLER: Owner SIZE OF TANK: 1,250 gallons - 300 degrees; 20 feet DWELLING: Single family - 3 bedrooms X 300 sq.ft. PERC RATE: one inch/60 minutes - 900 sq.ft. leach field TOTAL JOB COST GROSS PROFIT Finalized: 7/24/84 By: Tom Boni LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT _DER Printed in U.SA s - - - - - - - - - - -- =- - __ i _ _ -_ - � -- _ _ f - _ _ _ _ - _ - _ ,- _ _� -, ,- i �°� _ - __ - , - _ •_- °_ -