HomeMy WebLinkAbout21401 Hwy 6 - 193925202002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N® 0755
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: Terry Schaeffer
Address: P • 0. Box 204 - Vail, CO 81658
Telephone: 476-7356
System Location: 21401 Hwy 6 - Eagle Red Mountain Ranch
Licensed Installer: Self 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 300 Sq. Ft.
Number of Bedrooms 2 X 300 Sq. Ft. minimum requirement per bedroom
equals 600 Total Sq. Ft. minimum requirement
Special Requirements:
Date: �7= 2'2S'` 6,Environmental Health Officer:
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: 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: YES NO
PROPER MATERIALS AND ASSEMBLY: 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: Terry Schaeffer Name of Owner: SAme
Amount Paid: $200.00 Receipt Number: 2144 Date: 7/16/86 Cashier: E. Huenink
Check #1088
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPT T_CAT10 FOR T: "': T i AL SF:�AGF DISPOSAL S`:S- P7'`!T7
PERMIT APPLIC:;TIO\ FEE:
E�'VIRO.'`IENTAL HEALTH OFFICE - EAGLE COU11TY
P.O. Boy: 250
Eagle, Colorado 51631 No. awo
S150.00 328-7311 PFRCOL T ON TEST FEE: S50.00
NA.`LE OF OWNER: l��R�I SGNAFrF�K
ADDRESS: Q0x go'4 U•A PHO',E: �(7C - 7
NAME OF APPLICANT (if different from owner):
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTDT (if applicable):
ADDRESS:
4. PHONE:
P1;c;JV1V 1\LJ1ViVJtULL �J:: INSTALLATION OF SYSTEM: %`Poy �I 1'�`FF�=�
Licensed Installer (see attached list): YES NO_X_ .
ADDRESS:
- PHONE:
PER`fIT APPLICATION IS FOR: (X) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED P:DIVIDUAL SEb?AGE DISPOSAL SYSTE`f:
Street/Rural Address: ` 1 qO L 14wy # G
Lot Size: �23 ac-gES
Legal Description: RARLf:L L Rtkn On&. FAQ RA it a
BUILDING OR SERVICE TYPE (check applicable cate;orv_):
( Residential - Single Family
( ) Residential - Duplex
( ) Residential - Tr_ples
NUMBER OF PERSONS:
WASTE TYPES (check apolicable cate;ories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
(X) Garbage Disposal
(X) Automatic Washer
( ) Other
TYPE OF INDIVIDUAL =--AGE DISPOSAL SYSTEH PROPOSED:
( X) Septic Tank ( ) Composting Toilet
( ) Vault Privy ( ) Greywater
( ) Pit Privy ( ) Aeration Plant
( ) Other
( ) Residential Quadplex
( ) Co=mercial (state usage)
NUMBER OF BEDROOMS: 2
( ) Dwelling
( ) Transient Use
( Dish::asher
( ) 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 SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO (�)
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO
(I6 Yes, see attached teas teteatet SZcw .tedUCtion me,;lLeds) ( )
NOTE: The EnvZtojunertita' Heae-fL O'�.�ce,-L may educe .the •teoui,ted absMpti.on atea upon
app,tova.2 o5 an adequate teas.ie<cat2.t 5..otc Aeducttoa
SOURCE AND TYPE OF WATER SUPPLY: (X) Well
( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by communi water give name of supplier:
/Y // "V
•SIGNATURE DATE
---- ----�---------------------- -^ -----
INFORdfATION BELO TO BE FI OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAcent GAoujtd SZ.ope
Depth to BedLoeh (pet &' PAo6Zee Hole)
Depth .to Gtound'catet TabZe
SOIL PERCOLATION TEST RESULTS:. M tinu tCs pe)L c' tch in HoZe 7 1
Afinu tCs pets. inch .to HoZe # 2
iu ytu i Q,S pe%� iiLch tiv Ho.Ce # 3
FINAL DISPOSAL BY:
( ) AbsoAptioA TAejich, Bed o,t Pit ( ) Evapot=LspiAati.on
( ) Above GAeund D.tspersa2 ( ) Sand FU_te•t
( ) Undetg.tound D,ispmsae ( ) Was.tcceatc-t Pond
Amount PaLd: nn V ' /��
d00 Reccc;_,t � cu,jE�e.t Dale:
--------------- - - - - --- #----------------------
NOTE: Site Plan must be attached to'application.
(Env. Health Department - Rev. 4-07-83)
i
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO.
OWNER:
LEGAL DESCRIPTION:
RURAL ADDRESS: C% ��
TYPE OF DWELLING: NUMBER OF BEDROOMS.Z �
DATE OF PERCOLATION TEST: / —,/ —5-0 TYPE OF SOIL: C,Gt
TEST HOLES PRE-SOAKED: YES NO
TIME
11 2 3
2'Sq
WATER DEPTH
1 2 3
/Z
INCHES OF :F:A:L:LL:���RA�TE
1 2 3
IF
Z
1 2 3
'f 0
/
G
PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE:
RECOMMENDED MINIMUM LEACH FIELD SIZE: � G n / 2- X S (_
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
a,��q- ___
Environmental Health Officer
COMMENTS:
Rev. 5/31/84
Date
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
r' N aF, i
Date Routed
Location
Application 140.
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 - :'YES Nn -RFVTF,.mn Rv nnTr
Subdivision Regulations:
Zoning Regulations:
Recommend Approval:
COMMENTS:
BUILDING: Co
Building Pe
Buildi
Re
COMMENTS:
Con
with -
YES
I NO
REVIE!gED BY
DATE
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
YES NO REVIEWED BY DATE
ENVI ROI N' iENTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
YES
NO
REVIE14ED BY
DATE
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0755 Schaeffer Red Dint. Ran(.
,.SOB NAME, , 21401 Hwy 6
JOB Noy .
JOB LOCATION
BILL, TO
DATE STARTED DATE COMPLETED DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE No
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product.278 �p NEW ENGLAND BUSINESS SERVICE, INC„ GROTON, MA 01471 JOB FOLDER Printed in U.S.A.
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