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HomeMy WebLinkAboutBearcat Lodge West Squaw Creek - 000000000000INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT N® 0750 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: Howard E. Colville, Ralph James, III, Charles H. FosterTelephone:- (915) 592-0290 Address: 1029 Broadmoor, El Paso, Texas 79912 System Location: West Squaw Creek, Edwards, CO Licensed Installer: Hoe & Grow, Inc. License Number: Conditional installation approval is hereby granted for the following: Minimum requirements: Gallon Septic Tank or Aerated Treatment unit Absorption_ area of dispersal area computed as follows: Percolation rate: Inch in Minutes Absorption area per bedroom Sq. Ft. Number of Bedrooms X Sq. Ft. minimum requirement per bedroom - equals Total Sq. Ft. minimum requirement Special Requirements: Date CONDITIONS: Health Officer: 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: SQ. FT. INSTALLED SEPTIC TANK: DESIGN ENGINEER OF SYSTEM: GALLONS; DEGREES; FEET INSTALLER OF SYSTEM: PHONE: SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR AERATED ACCESS PORTS ABOVE GRADE: PROPER MATERIALS AND ASSEMBLY: YES NO YES NO COMPLIANCE WITH PERMIT REQUIREMENTS: YES NO COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES NO COMMENTS: (Any item checked NO requires correction before final approval of system is made. Arrange a re -inspection when work is completed.) DATE (Final Approval) ENVIRONMENTAL HEALTH OFFICER: DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER: RETAIN WITH RECEIPT RECORDS PERMIT Name of Applicant: Howard E. Col vi 11 e, Ral ph James NJA; of Owner: Same Charles H. Foster Amount Paid: 1200.00 Receipt Number: 2092 Date: 6-30-86 Cashier: E. Huenink Check #14084 White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner �aT ICAi'_^' FOR I;;E:': ID- Sr::.-\C- DISPi�S_\L 5':$- fir. ^.rTT f E:;VIRO::`1ENTAL 11EALT11 OFFICE - EAGLE Ct'L::;:Y P.O. Boy: 230 r Eagle, Colorado 81631 No. PERMIT APPLICATION FEE: 8�1,50 "00 328-731I PFRCOL:\TION TEST FF : °S50.00 C NAME OF OI..r%ER: ADDRESS: NAME OF APPLICANT (if different from owner): ADDRESS: DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PLx; �;1v i<1..- _o'0ibL_ INSTALLATION OF SYSTE:•1: Licensed Installer (seeratt ched list ,)/: ADDRESS: �, P- l�� E� GGG'G�Y�L[-� PHONE: PHONE: YES _X NQ S-IZ 3 PHONE: PERMIT APPLICATION IS FOR: ("�) New Installation LOCATION OF PROPOSED INDIVIDUAL SE14AGE DISPOSAL SYSTEM: Street/Rural Address: Lot Size: Legal Description: BUILDING OR SERVICE TYPE (check applicable cateaorv):Oa ( ) Residential - Single Family GX) Residential - Dualex ( ) Residential - Tr--jles NUMBER OF PERSONS: WASTE TYPES (check apolicable cate;ories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( ) Garbage Disposal ( ) Automatic Washer ( ) Other TYPE OF INDIVIDUAL =-,AGE DISPOSAL SYSTEM PROPOSED: (x ) Septic Tank ( ) Composting Toilet ( ) Vault Privy ( ) Greywater ( ) Pit Privy ( ) Aeration Plant ( j Other ( ) Alteration ( ) Repair J � ( ) Residential.- Quadple- 10/1- ( ) Con-::ercial . (state usage) NUMBER OF BEDROOMS: 00 Dwelling ( ) Transient Use (K) Dish::asher ( ) Spa Tub ( ) Incineration Toilet ( ) Chemical Toilet ( ) Recycling, Potable Use ( ) Recycling, Other Use WILL EFFLUENT BE DISCH.LRGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (x ) IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES (5C) NO ( ) WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO ( } (IS Ye,S, See attached tvas tewatet S.ecty Aeduc-lion methods) NOTE: The EnvZ1Lo,une,2ta(' Heaft,'z 03'3'.icet mach ALeduce the -teou-i red ab.soAptcon atiea upon app,tovae o6 an -adequate teas texa-tet S-(..G'ty teductton ,p'.P-a;?. SOURCE AND TYPE OF WATER SUPPLY: ( ) TATell Q() Spring ( ) Creek/Stream Give depth of all wells within'200 feet of system: If supplied by community water,,/give name of supplier: SIGNATURE: DATE: 015/ SNy p g �G - - - - - - - - - - - - - - INFORtiATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Peneent GAou,zd Slope Depth .to Bedtoeh (peA 8' PAo'Zft Hole) Depth to GAOun&a te,,L TabZe SOIL PERCOLATION TEST RESULTS:. d'i;L te-s pe/c .cnch in Ho�_e Ki Mi.nutn peA inch .to Hole #2 1tiL_L u.tes pe i.zc,'z tic ffoCz #3 FINAL DISPOSAL BY: ( ) Abso.tptioil TAe,zeh, Bed o,,c Pit ( ) EvapottanspiAatc:on ( ) Above GAound DZSpe/`,Sa.L' ( ) Sand FiLtc.t ( J Unde -Lg,Locutd Dispe,,usae ( ) Was -cxate'c Pond Amount Pacd: °� � �DcI SOD —• Recui.;_Tt Ntu»be.'t Date: �-`�-g� - - - - - - - - - - - - - - - - - - - - - ems- � �DB - - - - - - - - - - - - - - - - - - - NOTE: Site Plan must be aitached to -application. (Env. Health Department - Rev. 4-07-83) EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE ,� Name Date Routed �. , Appiication f4o Lo'c`at1oh j Please review the attached Individual Sewage Disposal System Permit Application and return it with this completed form to the Environmental Health Office. PLANNING: Complies with - Subdivision Regulations: Zoning Regulations: Recommend Approval: COMMENTS: ' BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: YES Nn R17VT7mt:n Rv .,�T� CA MAN YES I NO I REVIEWED BY DATE ENVIROIT DENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: YES NO REVIE14ED BY DATE l,Vl'II'I LI11 J. -�,- 4, �,- , & F-N�l r c 0 z m 0 1 � O En� 10 b O +iZ4 3 w � b � W F-I I- 4 � � H (1) U) U U p Cd w 3 ti 00 I Jj o w u1 N O SW Q Z m 0 Z w',A LLI LL 11' n a 0 i z 6 2 O U z ui U m w m 2 z z m z g W� z z N 6 W O a m a