HomeMy WebLinkAbout313 Strohm Cir - 211106407004INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N2 0712
P.O. Box 850 - 550 Broadway
Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927-3823
YELLOW COPY OF PERMIT MUST PLEASE CALL FOR FINAL INSPECTION BEFORE
BE POSTED AT INSTALLATION SITE COVERING ANY PORTION OF INSTALLED SYSTEM
Owner:
John F. Huffman
Address:-P.O. Box 24 - Edwards, CO 81632
Telephone: 926-3229
System Location: 313 Strohm Circle - Lot 27. Fi 1 . 6. , Bertroch Sub, - Gypsum Colorado
Licensed Installer: Sel f License Number: - - - - - - - - - -
Conditional installation approval is hereby granted for the following:
Minimum requirements: 1000 Gallon Septic Tank or Aerated Treatment unit
Absorption area of dispersal area computed as follows:
Percolation rate: 1 Inch in 10 Minutes
Absorption area per bedroom 200 Sq. Ft.
Number of Bedrooms 3 X 200 Sq. Ft. minimum requirement per bedroom
equals 600 Total Sq. Ft. minimum requirement
Special Requirements: Note: 1000 gal. Polyethylene tank was used.
Date: August 220 1985 Environmental Health Office
CONDITIONS:
1. All installations must comply with all requirements of the Eagle 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 zoning and building
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 system is approved prior to covering any portion of the system.
INSTALLED ABSORPTION OR DISPERSAL AREA: 600 SQ. FT.
INSTALLED SEPTIC TANK: 1000 GALLONS; 10 DEGREES; 15 FEET
DESIGN ENGINEER OF SYSTEM: Owner
INSTALLER OF SYSTEM:
Owner
PHONE:.
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE: YES x NO
PROPER MATERIALS AND ASSEMBLY: YES x NO
COMPLIANCE WITH PERMIT REQUIREMENTS: YES x NO
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES x NO
COMMENTS: Polyethylene tank was installed
(Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when
work is completed.) �.. /% p �
DATE (Final Approval)8/22121; ENVIRONMENTAL HEALTH OFFICER J 9X
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: John F. Huffman Name of Owner: Same
Amount Paid: $200.00 Receipt Number: C0177
Date: 7/20/84 Cashier: L. Funke
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPT ICATIO„ OR I`;DT.'IDT'AL SE .'AGE DISPOSAL SYSTr PFRMI"
L E"VTRONME`:T.iL HEALTH OFFICi - EAGLE COUNTY
P.O. Box 850 'Q
Eagle, Colorado 81631 IT
PERMIT APPLICATION FEE: 8150.00 328-7311 PERCOLATION TEST FEE: $50.00
NAME OF OtdNER: )®d,[ F. 0 VFE-MAril
ADDRESS: lbO)t 7-'I EflwAdz e�' C_0�-� . �ai���l PHONE: OiIio- `5z2.9
NAME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (if applicable):
ADDRESS:
PHONE:
PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: \iF-iK.
Licensed Installer (see attached list): YES NO
ADDRESS: 6®x "Jo2- i,A6LC, V1-0 - PHONE:
PERMIT APPLICATION IS FOR: New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM
Street/Rural Address: 3 1 S �_.
Lot Size: 116 �t eta
Legal Description: [ram x'i F%Llk-14. 40<14 aj�,2DLot.N eiu�i, i,1fP�a?n� Ceco.
BUILDING OR SERVICE TYPE (check applicable category):
( Residential - Single Family ( ) Residential - Quadplex
( ) Residential - Duplex ( ) Commercial (state usage)
( ) 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:
NUMBER OF BEDROOMS: 2-
( ✓j Dwelling
( ) Transient Use
( ✓) Dishwasher
( ) Spa Tub
( ✓)
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 (ate NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO (�)
(I j Va , see attached wastewateA 6tow tcedue Lion methods)
NOTE: The Envi/Lonmenta.2 Health 044iceA may tceduee th.e tteguited absotcpt%on atcea upon
apptwvat o4 an adequate cvastewatet 6.2ow tceduction ptan.-
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( )
Give depth of all wells within 200 feet of system: _
If supplied by community water, give name of supplier:
Spring ( ) Creek/Stream
try♦'-WM WAT>:CL `WPQ V
SIGNATURE: DATE: �1'-" t'`' q , 01 $y
-INFORMATION-BELOW-TO BE FILLED O By ENVIROMAJENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAcent Gtcound Slope
Depth to Beduck (pen 8' PAo4ite Hote)
Depth to Gtcoundwatett Table
SOIL PERCOLATION TEST RESULTS: Minute,6 pet inch in Ho.ee 1
Minu to pets inch to Hot e # 2
M.Lnute/s pets inch to HoZe #3
FINAL DISPOSAL BV:
( ) AbsoApt%on Ttceneh, Bed otc Pit ( ) Evapottawspitcation
( ) Above Ghound DZspeUa2 ( ) Sand Fittet
( ) Undetgttound DispeAzat ( ) Wastavatetc Pond
( ) Othet
Amouwt Pocid: 4;L, C) , Receipt Numbetc `"" Date:
A 4 be`aah�edtoappl�cat�on t
-I— Qo —2
4
(Env. Health Department - Rev. 4-07-83) ,
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
-
Name
Da e Ro to
�13 w(A Gyu App i i cati on-14c
Location
Please rev.ie�a the attached Individual Seiage Disposal System Permit Application and return
it with this completed form to the Environmental Health Office.
.� Complies with - YES NO REVIE;,!ED BY DATE
Subdivision Regulations: i..
Zoning Regulations:
GV .
Recommend Approval:
COMMENTS: '
Complies with -
Building Permit Applied For:
YES ( NO ! REVIE!•!ED BY
DATE
Building Permit Issued:
Recommend Approval:
�/
I
.COMMENTS:
ENGINEER: Complies with
YES NO REVIE'ED BY
DATE
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
Comp ies with -
Floodplain Permit Necessary:
YES
NO
REVIEWED BY
DATE
I.S.D.S. Regs. Compliance:
Reco.;.mend Approval:
I
C0;'i-tEiJTS:
e
a PERCOLATION PEST 4
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO `C)a
OWNER: Cs
LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING:NUMBER OF BEDROOMS:_
DATE OF PERCOLATION TEST: li; — G V 5-
TEST HOLES PRE-SOAKED: YES L/
_TYPE OF SOIL:
NO
TIME
WATER DEPTH
INCHES OF FALL
RATE
1
2
3.
1
2
3
1
2
3
1
2
3
/ L r
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE: / _
RECOMMENDED MINIMUM LEACH FIELD SIZE: o-c o
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
Environmental Health Officer
COMMENTS:
Rev. 5/31/84
Date
1,6Ssf
�ww
T
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
August 26, 1985
John F. Huffman
P.O. Box 24
Edwards, CO 81632
RE: ISDS Permit #712
Dear Mr. Huffman:
This is to inform you that your ISDS Permit #712 for property
located at 313 Strohm Circle - Lot 27, Fil. 6, Bertroch Subdivision -
Gypsum, Colorado has been inspected and finalized by Erik Edeen on
August 22, 1985.
I am enclosing a copy of this permit for your records. If you
have any questions or concerns regarding this matter, please contact
our office.
Sincerely,
Gail Parker, Secretary
Environmental Health Office
EAGLE COUNTY
/gp
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
0712 Huffman Lot 27 Filing 6
:JOB NAME Bertroch Sub 313 Strohm Circle
JOB N4, ,._.
BILL TO
DATE STARTED DATE COMPLETED DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
-- -- — - -_- -. TOTAL LABOR
PERMIT #712 INSURANCE
SALES TAX
OWNER: John F. Huffman
MISC. COSTS
LOCATION: 313 Strohm Circle - Gypsum, CO
Lot 27, Fil. 6, Bertroch Subdivision
INSTALLER: Self
SIZE OF TANK: 1000
DWLLING: Single Family Res. TOTAL JOB COST
.PERC RATE: 1 inch in 10 minutes
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
FINALIZED: 08/22/85 BY: Erik Edeen NET PROFIT
-DER Printed in U.SA
ME
t
6,