HomeMy WebLinkAbout1094 Polar Star Dr - 210904101007INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N2 0723
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: William Startzer Telephone: 524-9780
Address: 155 Eagle St._- Gypsum, CO 81637
System Location: 1094 Polar . Star Drive - Upper Kaibab Subdivision
Licensed Installer: W-Y Construction (Bruce Yeik) License Number:.85-10—I
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 5 Minutes
Absorption area per bedroom 165 Sq. Ft.
Number of Bedrooms 3 X 165 Sq. Ft. minimum requirement per bedroom -
equals 600 Total Sq. Ft. minimum requirement
Special Requirements:
Date: October 7, 1985 Environmental Health Officer: Sid Fox
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: 7 1 5 SQ. FT. 42' x 17'
INSTALLED SEPTIC TANK: 1000 GALLONS; 45 DEGREES; 172 FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: Bill Yeik/William Startzer PHONE: 524-9780
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: Install an elbow in the septic tank bei-ween rnmpnrtmantc
Provide a dimensioned "as built" site plan.
(Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when
work is completed.)
DATE (Final Approval) 4/25186ENVIRONMENTAL HEALTH OFFICER: Sidney N.. Fox
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
Name of Applicant: William Startzer
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Owner
Same
Amount Paid: $200.00 Receipt Number: C0378 Date: 9/27/85 Cashier: Gail Parker
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPLICATIO`N FOR INDIT'IDUAL SE. AGE DISPOSAL SYSTEM PE1.`1IT
PER:`IIT APPLICATION FEE:
NAME OF OWNER:
ADDRESS:
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P.O. Box 850
Eagle, Colorado 81631 No.
$150.00 328-7311 PERCOLATION TEST FEE: 850.00
NAME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTDI (if applicable):
PHONE: S— 24
PHONE:
ADDRESS: PHONE:
I:;:: INSTALLATION OF S i l';SL�1: �J I {,ar�� i Wf )iJ r, JC F <<
Licensed Installer (see attached list): YES-_ NO
ADDRESS : PAQ �)t! 2-AOL PHONE:
PERMIT APPLICATION IS FOR: New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: ,.
Street/Rural Address:
Lot Size:
Legal Description:
M.
BUILDING OR SERVICE TYPE (check applicable catego
Residential - Single Family
( ) Residential - Duplex
( ) Residential - Triplex
NUMBER OF PERSONS: 4
WASTE TYPES (check applicable categories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
po*) Garbage Disposal
(% Automatic Washer
( ) Other
TYPE
OF
INDIVIDUAL SEWAGE
DISPOSAL SYSTEIM PROPOSED:
Septic Tank
( ) Composting Toilet
(
)
Vault Privy
Greywater
(
)
Pit Privy
( )� Aeration Plant
(
)
Other
( ) Residential - Quadplex
( ) Commercial (state usage)
NUMBER OF BEDROOMS:
( ) Dwelling
(�) Transient Use
�1 Dishwasher
( ) Spa Tub
( ) Incineration Toilet
( ) Chemical Toilet
( ) Recycling, Potable Use
( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO
IS SYSTL1i1 DESIGNED FOR LESS THAN 2,000 GALLONTS PER DAY: YES ) NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES, NO ( )
(I � Yet, see attached tuacstewaten 6.Eow rceduc ti.on methods)
NOTE: The EnvZtonmenta2 HeaP.th 06{ieeA may rcedu.ee the negwiAed ab5orcpti.on area upon
app,tovat o% an adequate wastewterc 6tow Aeduction ptan.
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by cmmunity water,ive name of supplier: -'•" g2oyp aL151
SIGNATURE:
----i�(,,1 - - - - -- ��C�11 - --------- DATE- - - - - - - - - - - - --
INFORMATION BELOW/ TO BE FILLED OUT BY ENVIROMIJENTAL HEALTH OFFICER:
GROUND CONDITIONS: Perceent Ground Slope
Depth to Bedtoeh (pen 8' Pno6ite Hote) 1
Depth to GrcoundtvateA Tabte /
SOIL PERCOLATION TEST RESULTS:_ S^' A.uiuta pen cnch in Hote # 1
Al i.nuta pert inch to Hof-e 02
iklinuta pet .iitc L to Hote #3
FINAL DISPOSAL BY:
K) AbsoApt, oA Tteneh, Bed arc Pit ( ) EvapotAamspiAcWon
( ) Above Ground D.,speMaZ ( ) Sand FiZteA
( ) Unde/tgtound DZspeAzae ( ) Wastecvatek Pond
( ) Othe t
Amvuytit Paid: Receipt Nutnbe-'c Gr.3'7 Date: f �-
NOTE: Site Plan must be attached to'application.
(Env. Health Department - Rev. 4--07-83)
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
October 7, 1985
William Startzer
155 Eagle St.
Gypsum, CO 81637
RE: ISDS Permit #723
Dear Mr. Startzer:
Enclosed is your ISDS Permit #723 for property located at.
1094 Polar Star Drive - Upper Kaibab Subdivision in Eagle, Colorado.
The information on.the permit application indicates that the system
will be installed by W-Y Construction. Therefore, they will be
responsible for the installation of the system.
This yellow copy of the ISDS Permit must be posted on the
installation site. You must call our office for final inspection
before covering any portion of the installed system. lie can be
reached at 328-7311, Ext.. 238.
If you have any questions or concerns regarding this matter,
please contact our office.
Sincerely yours,
Gail Parker, Secretary
Environmental Health Office
EAGLE COUNTY
/gP
Enc.
cc: W-Y Construction
.*.
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
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328-8730
EAGLE COUNTY, COLORADO
November 25, 1991
Bankers Mortgage, Inc.
Successors and/or Signs
918 N 7th
3rd Floor
Grand Junction, CO 81501
725 CHAMBERS AVE.
P.O. BOX 179
EAGLE, COLORADO 81631
FAX (303) 328.7207
RE: Water supply and sewage information for property located at:
1094 Polar Star Drive
Upper Kaibab Subdivision
To Whom It May Concern:
A review of the County records indicates that on April 25, 1986,
the sewage disposal system was permitted under Permit No. 723,
inspected and approved in accordance with County Individual
Sewage Disposal Regulations. The system consists of a 1000
gallon septic tank and 715 square feet of absorption area.
The water supply to this residence is from the Town of Eagle, a
community water system. The community water system is inspected
on a regular basis by the Colorado Department of Health and to
the best of our knowledge complies with current drinking water
standards.
If you have any further questions concerning this inspection,
please feel free to call me at 328-8730.
Respectfully submitted,
Roger Boyd
Environmental Health Assistant
RB:ckc
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
April 28, 1986
William Startzer
155 Eagle St.
Gypsum, CO 81637
Dear Mr. Startzer:
This is to inform you that your ISDS Permit # 723 for property
located at 1094 Polar Star Drive, Upper Kaibab Subdivision, has
been inspected and finalized by Sid Fox on April 25, 1986. However,
you still need to provide a dimensioned "as built" site plan.
Please respond to this request as soon as possible.
I am enclosing a copy of this.permit for your records.
Respectfully,
-t4y�Ajzo&�
Gail Parker, Secretary
Environmental Health Office
EAGLE COUNTY
/gP
Enc.
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
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO. a06CA
OWNER: I I-A'
rn artzQ,
LEGAL DESCRIPTION: V
RURAL ADDRESS:
ICOgL4
TYPE OF DWELLING:
NUMBER OF
BEDROOMS:
v
DATE OF PERCOLATION TEST: /V - 2 - g S' TYPE OF SOIL: lj i /� Cj00r17, T
TEST HOLES PRE-SOAKED: YES A_ NO
TIME
WATER DEPTH
INCHES OF FALL
RATE
1
2
3
1
2
3
1 2
3
1
2
3
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE:
RECOMMENDED MINIMUM LEACH FIELD SIZE:
pi,_
/ooc)
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: 1(j
SITE HAS BEEN REVIE14ED AND TESTED FOR PERCOLATION RATE.
Environm Heal t ffice Date
COMMENTS:
Rev. 5/31/84
EAGLE COUNTY ENVIROrJ;•'ENTAL HUILTH OFFICE
\AA I I I ar�S-� ar -der
(PJame) .
Dat R uted
n)lc3► S4c�_,, Rd App i i cati on fJ
Locazionj
Please revie,:r the attached Individual Se,:iage Dispo al System Per;�it Application and return
it with this completed for^ to the Environmental Health Ofr"ice.
PLANNING: Complies with - YES NO REVIEIIED BY
DATE
Subdivision Regulations:
Zoning Regulations:
C/
Recommend Approval:�ps
COINIi"IEINTS :
BUILDING: Complies with - YES ( i10 I REVIE-;ED B'(
DATE
Building Permit Applied For: d1x
Building Permit Issued: I/
Recommend Approval:
c01•ILIEnTs:
ENGINEER: Complies with - YES NO ( RE`.'IE:-iED BY
Roads: DATE
Grading:
Drainage: M
Recommend Approval: —
CO, ?MENTS :
Er1VI1r)ON,'4E'1T, L HEALTH
Comp!ies wJth - YES ( NO REVIE1-JED BY
Floodplain Permit necessary: DATE
I.S.D.S. Regs. Ccmpliance:
Recommend Approval:
COi•"•IEiJTS:
rr i d
86 ' 6"
r
W id OL'4LOT 31AtS,bZ•00N
7 99 * WE
M-al
0723 Startzer
1094 Polar
JOB NAME,, Starr Drive
JOB NO.
r;
ina r nrtertnn�
BILL TO
-
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
PERMIT #723
OWNER: William Startzer
LOCATION: 1094 Polar Star Drive - Kaibab Sub.
INSTALLER: WY Construction
SIZE OF TANK: 1000 gl.
DWELLING: Res. Single Fam. - 3 bedroom
PERC RATE: 1 inch in 5 minutes
ABSORPTION AREA: 715 s.f.
FINALIZED: 04/25/86 BY: Sid Fox
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.
County Systems Cleaners Reporting Form
(Please Print)
Name of Systems Cleaner +
Name of Service
Date of Service 19,
Date of System Installation
Property Owner , Telephone # � 32 7 —
Property Address j
Lot
Block
Subdivision
Estimated Tank Size / F)cp Tank Material
# of Manholes 9, Depth to Manhole Covers 'j 1
Estimated Volume Pumped lap # of Compartments
Sludge Thickness inches Scum Thickness; inches
Baffle or Sanitary Tee in Place? Inlet _Outlet UNK
Effluent Filter in Place? Y ✓ N (Required after 6/2000)
Dosing Mechanism Pump Siphon _None
Dosing Mechanism/Alarm Functioning Properly? Y _,/ _N
Higher Level Treatment System? Y __Lx N If Yes -Type
Previous Pumping Date, if known/
Location of Septage Disposal
N
General Comments (include any signs of failure and all work done in addition to pumping
Ich (Location of T nk)
IL 'TA ty-�
Under section 8.1 of the Summit County OWTS Regulations, holders of a Systems Cleaner License must report to the Environmental Health Department each OWTS
which is cleaned, serviced or inspected not more than thirty (30) days after such service is performed. In addition, report within 7 days of service the location of any
leaking septic tank or surfacing waste water that is found.
I certify that, to the best of my knowledge, the above information is true and correct.
Signed -Date ��