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HomeMy WebLinkAbout832 Hooks Spur Rd - 246503200022 - 0678ISw� APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRON:IENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No.�1Cs((� PERMIT APPLICATION FEE: $150.00 PERCOLATION TEST FEE: $50.00 NAME OF OWNER: v ADDRESS: IV '/// Z % PHONE: q'2 %- y3,VZ NAME OF APPLICANT (if different from owner) : '�{,? (��`Z S4,, 4-e-- T ( Z 7 - 3 / 2!.s- ADDRE S S : `%� /.}� PHONE: DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF -SYSTEM: Licensed Installer (see attached list): YES NO ADDRESS: �� /� PHONE: `_77% ^ 3V9 PERMIT APPLICATION IS FOR: New.Installation'�( Alteration Repair LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Street/Rural Address: �7 I Lot Size: G IL Legal Description: AC_f ez, 3 A. 7 0/05�' . LDING OR SERVICE TYPE (check applicable category): Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes Garbage Disposal (p�) Automatic Washer ( ) Other TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: (p<) Septic Tank ( ) Composting Toilet ( ) Vault Privy ( ) Greywater ( ) Pit Privy ( ) Aeration Plant ( ) Other ( ) Residential - Quadplex ( ) Commercial (state usage) NUMBER OF BEDROOMS ( ) Dwelling ( ) Transient Use (�5q Dishwasher ( ) Spa Tub (x) WASTEWATER FLOW REDUCTION PLAN: ( ) ( YES ( ) NO , a ee attached =voustevaten 6Zow neduc Lion methods ) NOTE: The Envi) onmentaZ Health 066icen may neduce the tequi ted abaonpti.on oAea upon apptcova2 06 an adequate wa�stevaten 6Zow neduc ti-on plan. SOURCE AND TYPE OF WA ER SUPPLY: Well ( ) Springy ( ) Creek/Stream Give depth of 1 w lls wi n 0 feet of system: If supplied b omnity er .0ve name of supplier: ( ) 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 -SIGNATURE- ------ ----------- - -- - -- - DATE- INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: PeAcent Gnound Slope �OUPO Depth to Bedno ck. (pen 8' Pno 4it e Hot e ) Depth to GnoundwateJr -Table 57 S SOIL PERCOLATION TEST RESULTS:_ h nutea pen in tin HoZe ft hfi-nutea pen inch to Hote #2 Minutea pen .inch to Hot e # 3 FINAL DISPOSAL By: ( ) Abaonpti-on Tnench, Bed on Pit ( ) Above Gnound D.izpeAzae ( ) Undengnound D.i s pe&6 at ( 1 Others Evapot apvsPiAz ti-on Sand F.c P.ten Wa�stewateh. Pond Amount raw: %S-d .0 -U Receipt Numbers 02-0 Z_ Date: 7-/F-�� 4 NOTE: Site Plan must be attached to application. (Env. Health Department - Rev. 4-07-83) Q N I�" �IUIG-I�j'• ♦ w , Y r b f L ABC SEPTIC BOX 920: CARBONDALE, CcO LO MAO S 925 -1470 - 963 --3829 EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 November 14, 1986 M E M O R A N D U M TO: PROPERTY OWNERS FROM: EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE RE: EXPIRED INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMITS Our records indicate that your Permit # (07 has not had a final inspection of the individual sewage disposal system. If you do not have a current building permit, the above referenced permit has expired. Please contact the Eagle County Environmental Health Office at the following address and give us the current status of your septic tank system and/or arrange for a final inspection. Eagle County Community Development Environmental Health Office P.O. Box 179 Eagle, Colorado 81631 (303) 328-7311, Ext. 227 Your immediate response to this request will be greatly appreciated. Board of County Commissioners Assessor Clerk and Recorder Sheriff Treasurer P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 479 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 y. r- JOB NAME: JOB JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED • i i , C 1 , JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR PERMIT #678 INSURANCE SALES TAX OWNER: Basalt Bible Church (Parrish House) MISC. COSTS LOCATION: 1571 Hook Spur Rd. / Basalt INSTALLER: Ed Draeger SIZE OF TANK: 2 - 1000 gl. DWELLING: Res. Single Fam. 4 bdrm PERC RATE: N/A TOTAL JOB COST ABSORPTION AREA: Mound System GROSS PROFIT FINALIZED: 3/87 BY: Sid Fox LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT l_DER Printed in US.A, N N O NO N N CM ap L- N O N -0 O E N XII Cl) O O 0 ~J_� N -j 0 =I U0 00 C � E W N LL d' > < Q N W N NO •— O O C 1> N d' L co (a Cn O 0 O Cn Q O E O_ O O M +j u c � v > o E c a� 0 0 v 0 y Ln N � o � v a� � u`6o7 m c� •— m Cf E ff o - :3 U Q m U ro L1J �i c 0 U -a a> ro ro a� C c a� Q 0 0 E � 0 � o � U N r � - U � o ro 0 ° Lu w x O O CM N N n (13 O ON .> 2G5 U L.L H > 5 Q 00©0 UCL } c C, c c CIO 00 -�] L.L O O .J In - 71 L.L V I .- ..W1 col f ;y Od r' 17. O O ry J O ' > J L O O N C N LL LLI CL 0 cn ch N W N O O C5 i > N d -0 c O E < O U) a�i cn O E a O 0 &i c � v E c 0 0 0 v a�0i > v � o> � � N u a 0 L cq E cq m E .c m E o "M V �Uo Q rn .N � 0 U � rt+ 3 0 O � o U U m N d• LL F3 E > 3 c NUZ1Za