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HomeMy WebLinkAbout42 Blue Creek - 239127106006 - 0669ISEAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED INSPECTION BEFORE COVERING Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTION OF INSTALLED SYSTEM 328-7311 or 949-5257 or 927-3823 PERMIT NO. N ° 66.9 OWNER: Andy Schwaller ADDRESS: 0042 Blue Creek Overlook - P.O. Box 1184 SYSTEM LOCATION: 0042 Blue Creek Overlook - Basal. Basalt, Colorado 81621 LICENSED INSTALLER: Owner LICENSE NUMBER: **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 sq. ft. No. of Bedrooms 3 x 220 sq. ft. minimum requirement per bedroom = 660 total sq. ft. minimum requirement. SPECIAL REQUIREMENTS: DATE: August 24, 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: sq. ft. 10 Installed Septic Tank: f JaX gallons. Degrees: `2Feet: Design Engineer of System: Installer of System: Phone: Septic tank cleanout to within 12" of final -de r aerated access ports above grade? Yes o Proper materials and assembly? Yes Compliance with permit requirements? Yes No Compliance with County/State regulations requirements? Yes No COMMENTS: r (Any item checked "No" requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) DATE:'-- Z INSPECTOR: RE -INSPECTION DATE: INSPECTOR: RETAIN WITH RECEIPT RECORDS PERMIT NO. (y-0- 661 CHARGES 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: Andy Schwaller Name of Owner: Andy Schwaller Amount Paid: $200.00 (8/01/84) Receipt Number: C-0181 Cashier: Lorraine Funke White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner RAPPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. .- ADDRESS: NAME OF APPLICANT (if different from owner): 6j°'SALJ" ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF_ SYSTEM: Licensed Installer (see attached list): YES © NO ADDRESS: �. � u SA-N CQ c� !(p 2I PHONE : �727 -3coz s PERMIT APPLICATION IS FOR: (�) New.Tnstallation -( ) Alteration ( ) Repair LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Street/Rural Address: C' Lot Size:* Ac Legal Description: ,o-r BUILDING OR SERVICE TYPE (check applicable categor )- ( ) Residential - Single Family ( ) Residential - Quadplex ( ) Residential - Duplex ( ) ( ) Commercial (state usage) Residential - Triplex NUMBER OF PERSONS: / WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( ) Garbage Disposal (1F) Automatic Washer ( ) Other NUMBER OF BEDROOMS: - (x) Dwelling ( ) Transient Use ( ) Dishwasher ( ) Spa Tub TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTE-1 PROPOSED: (l!) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet ( ) Vault Privy ( ) Gre ater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use (y) Other Lr-AC.1a h ELZ ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO Od) IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES (%) NO WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO 2 (IS yes, see a ,cached tvaatewateA 4tow Aeduction methods) NOTE: The Envikonmentat Heatth 064icen may Aeduce the tequiAed absonpti.on area upon appAova,2 06 an adequate tva6tavateA 6.2ow Aeduction plan. SOURCE AND TYPE OF WATER SUPPLY: ( ) Well (y ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: PO AS, F, If suppliedby communit wat give name of supplier: 4Q%A SIGNATURES - �, DATE: - - - - - - - J �L - - - - - - - - - - - - - - - - - - - - INFORtfATION BELOW TO BE FILLED OUT By ENVIRONMENTAL HEALTH OFFICER: - - - GROUND CONDITIONS: PeAcent Gnound Stope 7" Grp Depth to Bedtco ch. (pets 8' PAo 4it e Hot e) 7 Depth to G)LoundwateA Tabte SOIL PERCOLATION TEST RESULTS: AiinutU pets .cn tin HoZe a 1 -- uM 7,V -f i.nute s pen inch t0 Hote # 2 Uinute,s pen inch to Hote #3 FINAL DISPOSAL BY: Abzonpti.on TAench, Bed on Pit ( ) Evapot&an6PiAati.on ( ) Above Gnound Dizpetrsat ( ) Sand FiZte t (,, ) UndeAgnound D.c spe tzat ( j Wa�stewateA Pond Oth.eA Amount Paid: aoo • 0 a Receipt NumbeA C - Q g ( Date: -8 OT SiteP�a�nmr��sbeatahed�t.®�aP1FC� o (Env. Health Department - Rev. 4-07-83) PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $50.00 ISDS APPLICATION NO. 2006 OWNER: Andy SchwaUeA LEGAL DESCRIPTION: 0042 Blue Creek Ovektook - Lot 20 - Mtn. Meadow Ranch - 2nd Fiting RURAL ADDRESS: 0042 B.2ue Cteek Ovetitook TYPE OF DWELLING: Singte Fam ty NUMBER OF BEDROOMS: 2-3 DATE OF PERCOLATION TEST: TYPE OF SOIL: TEST HOLES PRE-SOAKED: YES _ NO A&uc WATER DEPTH INCHES OF FALL .� d PERCOLATION RATE: r2 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.CZ -0 lal 6 Environmental -Health Yfficer Date rnnennrn1--c . Rev. 5/31/84 JOB NAME: qa Shte— &e6-, LD l o'20 /l7- n dieGZdzZ.0 ;l'PwCk JOB Nlll� . �... . a391a-71o0oor BILL TO DATE STARTED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL 01 TOTAL LABOR INSURANCE PERMIT NO. 669 _ SALES TAX OWNER: Andy Schwaller MISC. COSTS P.O. Box 1184 Basalt, CO 81621 LOCATION: 0042 Blue Creek Overlook - Basalt (Lot 20 - Mtn. Meadow Ranch) 2nd F. INSTALLER: Owner TOTAL JOB COST SIZE OF TANK: 1,000 gallons 200 degrees - 45 feet DWELLING: Single family - Eng. Designed GROSS PROFIT 700 sq.ft. - absorption area LESS OVERHEAD COSTS % OF SELLING PRICE Finalized: 11-21-84 By: Erik Edeen NET PROFIT LDERPrinted ,n US.A. 4. CLJ+)ILh. _ -�. _ t�A 2 -- - t1�ac.}or.3 L oT :20 % OUAT-A- 1J- AZA�WS �4-pv'c4 Aut3 �• Cv c-7-; r Fo k Sczzx".br AW0/,o" Scm mcz oN QF 92V. ,t, LoT `: !��a� _�►.► _Na�cc�, _ T-O?- To CGOT-k 0,0,TGti TANKS