HomeMy WebLinkAbout312 Strohm Cir - 211106405027INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N® 0747
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: Chris and Diann Haynes Telephone: 926-3632
Address: P.O. Box 131 / Edwards, CO 91619
System Location: 312 Strohm Circle — Gypsum, CO
Licensed Installer: Owner Tnstal 1 ed 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:
Date: June 11, 1986 Environmental Health Officer: Erik 1)4-1% " 4,
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: 4�00 SQ. FT.
INSTALLED SEPTIC TANK: GALLONS;. �� DEGREES(
FEET
DESIGN ENGINEER OF SYS ET M: A s
I0 ?Z;W
INSTALLER OF SYSTEM: ` ` PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE:
YES
INCOMPLIANCE
PROPER MATERIALS AND ASSEMBLY:
YES
WITH PERMIT REQUIREMENTS:
YES 0-
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENT
YES NO
COMMENTS: �1�-�
li (Any item checked NO requires correction before final approval of system is made. Arr nge c ion when
work is completed.)
DATE (Final Approv4L ENVIRONMENTAL HEALTH OFFICER:
DATE (Re -Inspection) ENVIRONMENTAL HEALT14 OFFICER:
RETAIN WITH RECEIPT RECORDS
PERMIT
'of Applicant: Chris & Diann Hynes Name of Owner: Same
it Paid: $200.00 Receipt Number: 1741 Date: 6/1/86 Cashier:
Gail Parker
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPLICATION.FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P.O. Box 850
Eagle, Colorado 81631
PERMIT APPT.TCATTnN FF.R
NAME OF OWNER: 6-0 �LI S �A ft y w l� I >`
ADDRESS: PCBC)�
NAME OF APPLICANT (if different from owner): `
ADDRESS:
DESIGN ENGINEER OF SYSTEM (if applicable):
ADDRESS:
aCA8
No.
T FEE: $50.00
PHONE: 1 Q(" - a c� �
PHONE:
PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
Licensed Installer (see attached list): YES NO
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: (A New Installation. ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Street/Rural Address: '3 1 21 _<'-r en m
Lot Size:
Legal Description:
BUILDING OR SERVICE TYPE (check applicable category):
( Residential - Single Family ( ) Residential
( ) Residential - Duplex -
( ) .Commercial (staatete usage) _
( ) Residential - Triplex
NUMBER OF PERSONS:
WASTE TYPES (check applicable categories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
( ) Garbage Disposal
( Automatic Washer
( ) Other
TYPE
OF INDIVIDUAL SEWAGE
DISPOSAL SYSTEM PROPOSED:
(
Septic Tank
(
)
Composting Toilet
(
) Vault Privy
(
)
Greywater
(
) Pit Privy
(
)
Aeration Plant
(
) Other
NUMBER OF BEDROOMS:
( /) Dwelling
( ) Transient Use
(__Y Dishwasher
( ) Spa Tub
3
( ) Incineration Toilet
( ) Chemical Toilet
( ) Recycling, Potable Use
( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (�f
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES ( ) NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES (' ) NO ( )
(I6 yeas, see attached waztewaterc stow Aeduction methods)
NOTE: The Envitonmentat Heatth 044ieet may rteduce the neguiud abZoApti,on a&ea, upon
apprcovat of an adequate wastewateA 4tow rcedueti.on plan.
SOURCE AND TYPE OF WATER SUPPLY. ( ) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system: V\(-)
If supplied b . water,
PP y community y , give name of supplier: � YF'S"'�? ��L
SIGNATURE: ;;��JU� ' DATE: 5 -
- - - - - - - - - - - - - - -''- - - - - - - - - - - - - - - - - - - - - - - - - = - - - - - - -
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAeent G&ound Stope
Depth to Bedrock (pert 8' P>tojite Hole)
Depth to G&oundwateA Tabte
SOIL PERCOLATION TEST RESULTS:. Minuta peA inch in Hote 1
Mtnute�s peA inch to Hote #2
Minutes peA inch to Hole #3
FINAL DISPOSAL BY:
( ) AbzoAption Ttench, Bed ok Pit ( ) EvapotAawspvrati,on
( ) Above G&ound Di6peAza2 ( ) Sand Fitters
( ) UndeAgtound Dt6peAzat ( ) Wa6tewateA Pond
( ) Others
Amount Paid; 'Q.6o Receipt Numbers Date: (941 ��(o
--
---------------------------------------------------
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
Date: November 7, 1986
Chris Haynes
P.O. Box 131
Edwards, CO 81632
RE: Final of ISDS Permit # 747
This letter is to inform you that the above referenced ISDS
Permit has been inspected and finalized. Enclosed is a copy
to retain for your records.
If you have any questions regarding this permit, please contact
the Eagle County Environmental Health Office, P.O. Box 179,
Eagle, Colorado 81631. Phone: (303) 328-7311, Ext. 227.
Sincerely,
Eagle County Community Development
Environmental Health Office
/9P
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
TOWN OF GYPSUM INSPECTION REQUEST
P.O. BOX 237
PHONE: 524-7514, 524-7515 TOWN OF GYPSUM
DATE / �lO JOB NAME
TIME RECEIVED AM PM CALLER
❑ OTHER ❑ PARTIAL. LOCATION 1 1 � ,
READY FOR INSPECTION
MON TUE WED THUR FRI AM PM
COMMENTS:
APPROVED ❑DISAPPROVE D ❑ RE NSPECT
1 ❑ UPON THE FOLLOWING CORRECTIONS:
CORRECTIONS
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO.
OWNER:
LEGAL DESCRIPTION:
.RURAL ADDRESS:
TYPE OF DWELLING:
r
�0-S �'%7 • ��%�% NUMBER OF BEDROOMS:
i _
DATE OF PERCOLATION TEST: SG— TYPE OF SOIL: S C6
TEST HOLES PRE-SOAKED: YES NO
1
TIME
2 3
+I
1t
WATER DEPTH
3
2-`.3
1! INCHES
1
-- _
OF FALL
2
3
72
RATE
PERCOLATION RATE: / 0 r2 oe-
RECOMMENDED MINIMUM SEPTIC TANK SIZE:
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
Environmental Health Officer
COMMENTS:
Rev. 5/31/84
Date
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
CD�ris Oi�2�Urt�,�S
Date ou red
3%Z �'/oh eir. U App i i cation-fl
ocati n
Please review the attached Individual Se: -rage Disposal System Permit Application and return
it with this completed form to the Environmental Health Office,
PLANNING: Complies with - .. YES . Nn .R wTCLrCn Qv
EPIGINEER: Complies with -
Roads :
Grading:
Drainage:
Recommend Approval:
COMMENTS:
EMVIRON�MENTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
COi•''I.IENTS:
YES NO REVIE'VIED BY DATE
YES NO I REVIE14ED BY
DATE
JOB NAME
0747 Haynes Bertroch SUb #3
312 Strohm Circle
JOE$ r4Q
BILL TO
DATE STARTED DATE COMPLETED DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
-- - TOTAL LABOR
PERMIT #747 INSURANCE
SALES TAX
MISC. COSTS
OWNER: Chris and Diann Haynes
LOCATION: 312 Strohm Cir. / Bertroch Sub.
INSTALLER: Owner
SIZE OF TANK: 1000 gl.
DWELLING: Res. Single Fam. - 3 bedroom
PERC RATE: 1 inch in 10 minutes
ABSORPTION AREA: 600 s.f.
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
FINALIZED: 10/01/86 BY: Erik Edeen NET PROFIT
a , Printed in USA
LDER