HomeMy WebLinkAbout2037 Brush Creek Rd - 210909100005EAGLE 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. N2 687
OWNER: Michael & Linda Walck ADDRESS: 2037 Brush Creek - Eagle
SYSTEM LOCATION: 2037 Brush Creek Road (5 acres)
LICENSED INSTALLER: LICENSE NUMBER:
**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 sq. ft.
No. of Bedrooms x sq. ft. minimum requirement per bedroom
total sq. ft. minimum requirement.
SPECIAL REQUIREMENTS:
EMERGENCY REPAIR PERMIT r
DATE: 10/22/84 INSPECTOR
**CONDITIONS:
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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.
Installed Septic Tank: gallons. Degrees: Feet:
Design Engineer of System:
Installer of System: i ke W aAcl Phone:
Septic tank cleanout to within 12" of final grade or
aerated access ports above grade? Yes No
Proper materials and assembly? Yes No
Compliance with permit requirements? Yes No
Compliance with County/State regulations pquirements? Yes No
(Any item checked "No" requires correction before final approval of system e.
Arrange a re -inspection when work is completed.)
DATE: 10a U INSPECTOR:
RE -INSPECTION DATE:- INSPECTOR:
RETAIN WITH RECEIPT RECORDS PERMIT NO. No- 61
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: N/A - Fee Waived
Receipt Number: Minor Repair
Cashier:
White and Pink Copies Environmental Health Department Green Copy - Applicant/Owner
APPLICATION FOR IN
PERMIT APPLICATION FEE:_ $150.00
NAME OF OWNER: :
SEirA E ISPOSAL SYSTE`1 PER`tIT
EN-VIRONMENTA-e HEALTH OFFICE - EAGLE COUNTY
P.O. Box 850
Eagle, Colorado 81631 No. e; :Is O
328-7311 , PERCOLATION TEST FEE: $50.00
ADDRESS: 0 Lk S Lt l�l� e (� PHONE: % 7.3 �
NAME OF APPLICANT (if different from owner): S!kM F_
ADDRESS: &N.K E_ PHONE:
DESIGN ENGINEER OF SYSTEM (if applicable): �.
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
Licensed Installer (see attached list): YES-
ADDRESS:
-
N0
PHONE:
PERMIT APPLICATION IS FOR: ( ) New Installation
(
)
Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Street/Rural Address: a.0 a,n y,L-4--a
Lot Size: LV, C&
Legal Description:
BUILDING OR SERVICE TYPE (check applicable category):
( ) Residential - Single Family
(
)
Residential _ Quadplex
( X) Residential - Duplex
(
)
Commercial (state usage)
Residential - Triplex
NUMBER OF PERSONS:
NUMBER OF BEDROOMS:
WASTE TYPES (check applicable categories):
( ) Commercial or Institutional
(
)
Dwelling
( ) Non -Domestic Wastes
(
)
Transient Use
( ) Garbage Disposal
(
)
Dishwasher
( ) Automatic Washer
(
)
Spa Tub
( ) Other
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
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 (X)
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( )
(Ij Ya, see attached wastavateA Slow Aeduetion methods)
NOTE: The Envi onmentae Heatth 066.ieeh. may tzeduee the Aegu Aed absoApti.on area upon
appAova?_ o6 an adequate wastewateA 6tow tcedueti..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:
SIGNATURE:��� DATE:
--------- 4--6-_- - - - - - - - - - - - - - - - - - - - -
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAcent Gnound Slope
Depth to Bed,7,ock (pen 8' P&o 6i to Hole)
Depth to Gtcoundwate,,. Table
SOIL PERCOLATION TEST RESULTS: inute/s pen inch in Hot-e I
Af inuta pets inch to Hone # 2
Minutes pets .inch to HoZe # 3
FINAL DISPOSAL By:
( ) Ab6oAption Tench, Bed otc Pit
( ) Above Gtcound DZspeAzat
( ) Undag,7ound D.ispeuae
( ) Othet
Amount Paid:
Receipt Numbett
( ) Evapot anspitation
( ) Sand Fittek
( ) Wastewatett Pond
i irmm��;oTn M.
�V 2
(Env. Health Department - Rev. 4-07-83) YJ
r w (z-
Date:
REPAIR PERMIT APPLICATION
FOR INDIVIDI-1:1 SE114AGE DISPOSAL SYSTEMS
A permit fee of $150.00 shall be charged for alteration, enlargement or any repair
involving alteration of an existing sewage disposal system. This fee is authorized
by Eagle County Individual Sewage Disposal System Regulations adopted and effective
March 27, 1980.
For minor repairs of less than $100.00 for maintenance of the individual sewage
disposal system, no fee shall be required.
A percolation test fee of $50.00 shall be charged for all new leach fields on repair
permits. Percolation testing may be waived at the discretion of the Environmental
Health Officer on certain repair cases where prompt action must be taken to prevent
a health hazard.
IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW -SYSTEM SHALL BE INSTALLED,
COMPLYING WITH ALL CURRENT REGULATIONS. IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE
APPLICABLE.
DESCRIPTION OF PROBLEWMALFUNCTION:
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE:
DATE PRESENT SYSTEM WAS INSTALLED:
PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: #
SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS:
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OWNER OF SYSTEM: /�) i li-e. v1 CQ/4 (/(JAIl C A-,
ADDRESS: -N�, c, sC /o g2 E�+C I P C 01- 0- S- I 3 i
APPLICANT: ry',
ADDRESS:
DATE: i b 1 S -y `{
�-OU&fi
:JOB NAME, aD �� �rus�� C.�2ef -- P JOB NO, I Lo
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
a -o
JOB COST SUMMARY
TOTAL SELLING PRICE
PERMIT NO. 687
OWNER: Michael & Linda Walck
2037 Brush Creek - Eagle
LOCATION: 2037 Brush Creek - Eagle
INSTALLER: Mike Walck
SIZE OF TANK: - EMERGENCY REPAIR
LEACH FIELD REPAIR OF BROKEN PLASTIC
Finalized: 10/26/84
(5 acres)
PIPE
By: Sid Fox
TOTAL MATERIAL
j
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
_DER Printed in U.S.A