HomeMy WebLinkAboutEnd of Cattle Creek Rd - 23910300009 - 0760ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N� 0760
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: H. R. McGeHee
Address: Rt 2, Box 28, Marietta, Oklahoma 73448
System Location:
Telephone: 405-276-2751
Licensed Installer: 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 2 X Sq. Ft. minimum requirement per bedroom -
equals Total Sq. Ft. minimum requirement
Special Requirements:
Date: 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: 000 GALLONS; DEGREES; FEET
DESIGN ENGINEER OF SYSTEM: N
INSTALLER OF SYSTEM:
PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR /
AERATED ACCESS PORTS ABOVE GRADE: YES O
PROPER MATERIALS AND ASSEMBLY: YES _CO
COMPLIANCE WITH PERMIT REQUIREMENTS: YES �f
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:
Name of Applicant
H. R. McGehee
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Owner: Samp
Amount Paid: 50.00 150.09teceipt Number: 2034 Date: 6 16 86 Cashier: Gail Parker
Check #917 & 918
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
ApaT TCATTn. FOR T',".;, TAL SF.�AG- 01S?0S'tiL :':S' P7' !T"
ENV RON'MENTAL HEALTH OFFICE - EAGLE COL"':TY
l r
P.O. Box 230
(r Ea., -le, Colorado 81631 No. aw
PERMIT APPLICATION FEE: 8150.00 328-7311 PF.RCOL\TION TEST FEE: S50.00
NAME OF OIA'ER:
ADDRESS:a �PHONE: 4-/&,5- a776 - Z7S'1
NAME OF APPLICANT (if different from owner): p
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTEM (if applicable):
ADDRESS:
PLnJl1L4 IivSiALLATION OF SYSTEM:
Licensed Installer (see attached list).
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: (� New Installation ( ) Alteration ( ) Repair
/� PHO':E:
A� 'h
YES NO ✓
LOCATION OF PROPOSED INDIVIDUAL =--AGE DISPOSAL SYSTE`1:
Street/Rural Address:
Lot Size: 3S G295
Legal Description:
BUILDING OR SERVICE TYPE (check applicable cate;orv_):
(V5 Residential - Single Family ( ) Residential Quadples
( ) Residential - Duplex Commercial (state usage)
( ) Residential - Tr_olex
NTTAIRFR nF PFRgn\TS
WASTE TYPES (check apolicable cateories):
( ) Corunercial or Institutional
( ) Non -Domestic Ldastes
( ) Garbage Disposal
( ) Automatic Washer
( ) Other
TYPE OF INDIVIDUAL SE?.AGE DISPOSAL SYSTE•1 PROPOSED:
NUMBER OF BEDROOMS: ;-
(
+jj
Septic Tank
(
)
Composting Toilet
( )
(
)
Vault Privy
(
)
Greywater
( )
(
)
Pit Privy
(
)
Aeration Plant
( )
(
)
Other
( )
WILL
EFFLUENT BE DISCHARGED
DIRECTLY
INTO WATERS OF
THE STATE
Dwell'. �(
Transit,
Dish,a r
Spa Tu JUN 161986
ENVIRONMENTAL HEALT_N
Incineration Toilet
Chemical Toilet
Recycling, Potable Use
Recycling, Other Use
YES ( ) NO
IS SYSTEM DESIGNED FOR LESS T'dAN 2,000 GALLONS PER DAY: YES NO ( )
WASTE'sdATER FLOW REDUCTION PLAN: YES ( ) NO ( )
(I6 Yes, see attached tvaStewat,_e-t S_tctu .teducti.on Methods)
NOTE: The EnvZtojzmentat' Heae-fL 0��.%e�� mat educe the•tequi.ted ab.soAptcon atea upon
appno vae o 5 an adequate Leas te<ca ten 5 oLu ned uctio r1 p fan . -
SOURCE AND TYPE OF WATER SUPPLY: ( ) [Nell ( Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier:
1
SIGNATURE- � yJ-- /-%1-�✓-% - - - - - - - - - - - - DATE_ - G// 'f6
- -` - - - -
INFORMAT1ON BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Peneent Gnouizd Stope
Dep-t.'z to Bed -Lock eh (pen 8' Pno '� �e Ho 2e )
Depth .to Gnoundzcate,t TabZe
SOIL PERCOLATION TEST RESULTS: i;tutc/s pelt -6LCh in Hoe.e n 1
ALuiu-tcs pen inch .to Hof-e # 2
I�Vi..%Li.L(.e/s pc,,. it Lck to Hoze # J
FINAL DISPOSAL BY:
( J Abso.tptioil Tnejtch, Bed on Pit ( ) EvapottanspiAation
Above Gnoujtd- Ji p�,sa2 (,..) Sand Fi is t
( ) Unde,tg.tound Dis pvusae ( ) Was.tcxat t Pond
( ) OthCft
Amoumt Paid:
C%C7 g/g �'D-- RCCCC�?t iVLU;1bC•t)03 DCLte:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTE: Site Plan must be attached to"application.
(Env. Health Department - Rev. 4-07-83)
A parcel of land situated in H.E.S. No. 275,"Township 7 South, Range
86 West, County of Eagle, State of`Colorado;'said parcel being more
particularly described as follows:
Commencing at Corner No. l.of.said H.E.S.'275,,(also being Corner No. 5
of H.E..S. No. 335), a lava stone in place, the True Point of Beginning;
thence N.50°11'04"E. along the northwesterly line of said H.E.S. No.
275, (also being the southeasterly line.of said H.E.S. No. 335), 1531.99
feet to Corner No. 2'of said H.E.S.. No., 275; thence S.37°39'05"E. along
the northeasterly line of said H.E.S. No. 275, 1814.96 feet; thence
N.81044'18"W.-2202.63 feet to a point :on the.southwesterly line of said
SI_F_Q_ Mn 975• h},nnnn M Q70o7l5a"T.T. .1..... j.3 _ ..at___- ---i-- :--
0760 McGehee �J
.JOB NAME JOB NOS C� r
,106 LOCATION
BILL TO _
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
^TA' MATERIAL
S i J
AV
•�, i � 7;. '7 j, �
Via.
_ v • �` "
\ � y !���i�Vlr��t `
GROTON, MA i in USA
04=6062,a1 04C3os3E i '��i_A�01DOS O4�06Cc= P0LAP01D3IS