HomeMy WebLinkAbout630 Scotch Creek - 211105200051A EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
PLEBy�SE 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. N c 67 0
OWNER: Dave Hartle
SYSTEM LOCATION:
PERMIT MUST BE POSTED
AT INSTALLATION SITE
ADDRESS: 629 Trail Gulch Road - Gypsum, CO
629 Trail Gulch Road
LICENSED INSTALLER: Ted Reynolds LICENSE NUMBER: 84-19
**CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following:
MINIMUM REQUIREMENTS: 750 gallon septic tank or aerated treatment unit.
Absorption area or dispersal area computed as follows:
PERCOLATION RATE: inch in minutes.
Absorption Area per Bedroom '_�,c> sq. ft.
No. of Bedrooms 2 x `gyp sq. ft. minimum requirement per bedroom
total sq. ft. minimum requirement.
SPECIAL REQUIREMENTS: 10 x 10 x 10 dry well (
e4l
DATE: August 31, 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: Cf)-z/-- sq. ft.
Installed Septic Tank: -75- C) gallons. Degrees: 2_;> C2 Feet:
Design Engineer of System: 6,,—
Installer of System: �e
Septic tank cleanout to within 12" of final grade or
aerated access ports above grade? Yes 6�-No
Proper materials and assembly? Yes �No
Phone:
Compliance with permit requirements? Yes � /
Compliance with County/State regulations requirements? Yes No
COMMENTS:
Ct
1-7
(Any item checked "No" requires correction before final approval of system is made.
Arrange a re -inspection when work is completed.)
DATE: �4 INSPECTOR:
RE -INSPECTION DATE: INSPECTOR:
RETAIN WITH RECEIPT RECORDS PERMIT NO. N,0_ 670
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:
Name of Owner:
Amount Paid:
Receipt Number:
Cashier:
Ted Reynolds
Dave Hartle
$200.00 (8/31/84)
C-0194
Lorraine Funke
White and Pink Copies - Environmental Health Department Green Copy - Applicant/Owner
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P.O. Box 850
Eagle, Colorado 81631 No. 0LO CA
PERMIT APPLICATION FEE: $150.00
NAME OF OWNER:
ADDRESS:
NAME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF
ADDRESS:
e
(if applicable):
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
Licensed Installer (see attached list): YES Z
ADDRESS:
PERMIT APPLICATION IS FOR: ( New Installation
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Street/Rural Address: Pm e3 %_ , 'V"
Lot Size:
Legal Description:
BUILDING OR SERVICE TYPE (check applicable category):
(A-) Residential - Single Family
( ) Residential- Duplex
( ) Residential - Triplex
NUMBER OF PERSONS: ,2--
WASTE TYPES (check applicable categories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
( ) Garbage Disposal
( ) Automatic Washer
( ) Other
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
PERCOLATION TEST FEE: $50.00
PHONE:
PHONE: ,� lk -- �Z J,2,;r—
PHONE:
-NO
PHONE:
( ) Alteration ( ) Repair
O Residential - Quadplex
( ) Commercial (s-tote usage)
NUMBER OF BEDROOMS:
(✓� Dwelling
( ) Transient Use
( ) Dishwasher
( ) Spa Tub
(Qjf
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 (�f
(I4 yeas, .see attached wastewateA 4tow Aeduc ion methoA)
NOTE: The Envi onme►titat Heatth 044iceA may &educe the uqui .ed abzo&pt%on a&ea upon
apptovat o4 an adequate wa6tewateA 4tow teducti.on plan.
SOURCE AND TYPE OF WATER SUPPLY: ( -) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier: C'Y� _
S I GNATURE :% DATE:
- - - - - - - - - - - -
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent Guund Stope
Depth. to BeAock (peA 8' P&o4ae Hole)
Depth. to GAoundwate& Table
SOIL PERCOLATION TEST RESULTS: b nuta peA inch in Hole 1
Minutm peA inch to Hote # 2
M nu tm peA inch to Hote # 3
FINAL DISPOSAL BY:
( ) Abzo&ption Tench, Bed oA Pit ( ) Evapothansp-vcat%on
( ) Above G&ound Dizpeusat ( ) Sand Fi?-ter
( ) Undecgtound Dizpeusat ( ) Wcustewate& Pond
( ) OtheA
Amount Paid: 'at>O. p O Receipt Number O 1 CA Date:
g--A�t-H
(Env. Health Department - Rev. 4-07-83)
O:-!NER:
LEGAL D
RURAL
ADDRESS:
TYPE
OF DUELLING: �,�,-�'�_
OF BEtopm,?S:
DATE OF PERCOLATION TEST: ` �7'� TYPE OF SOIL:
TEST HOLES PRESOAKED? Yes No
TIME
WATER DEPTH
INCHES OF FALL
RATE
- 1
2
3
1
2
-3 !
1
2_
3--
1
2
3
Lo
eso
2-
In=rn,
a
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE: `%
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMIUM SQUARE FOOTAGE PER BEDROOM: 2
Site has been reviewed and tested f perc ationrate.
Date Environmental Tlealth Officer
COMMENTS:
S
u
GYPSUM SANITATION DISTRICT
P. O. BOX 247
GYPSUM, COLORADO
PHONE -- 524-7515
Mr. Erik Edeen, R.P.S.
Enviornmental Health Department
Eagle County
Box 850
Eagle, Colorado 81631
Dear Mr. Edeen:
i I • �
- } i
rjV
The Gypsum Sanitation District is unable to provide sanitary
sewer to Mr. Dave Hartle at 629 Trail Gulch Road, at this time.
The Gypsum Sanitation District Board of Directors hereby give
their permission to Mr. Hartle to repair the septic tank that is
on his property.
If you have any questions about this please call me.
Sincerely,
41�j�Richard Turge, President
Gypsum Sanitation District
Board of Directors
cc
Dave Hartle
51F
,JOB NAME, �ra.! t4 i4 IZTL C,
!!l n 6a0 0
Joe- imo� 70
OB LOCATION
BILL TO
DATE STARTED DATE COMPLETED DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
--- — -- -----
PERMIT N0. 670
OWNER: Dave Hartle
629 Trail Gulch Road
Gypsum, Colorado 81631
LOCATION: 629 Trail Gulch Road - Gypsum
INSTALLER: Ted Reynolds
SIZE OF TANK: 750 gallons 270 degrees/60 feet
DWELLING: single family - 2 bedrooms x 300 sq.ft.
PERC RATE:' one inch/10 minutes
600 sq.ft. - leach field
High ground water in area
Finalized: 9/10/84 By: Erik Edeen !LDER
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
-
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
Printed in U.S.A.