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HomeMy WebLinkAbout1394 Eby Creek Rd - 193929201007INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Eagle County Department of Environmental Health PERMIT N® 0765 P.O. Box 850 - 550 Broadway *** R E P A I R P E R M I T *E&gl(?Colorado 81631 ** R E P A I R P E R M I T 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: Margaret Bumgardner Telephone: 3 2 8 - 6 6 2 7 Address: P.O. Box 142 Eagle, CO 81631 System Location: 1385 Eby Creek Road - F a_g l e, CO Licensed Installer: W.Y. Construction License Number: - 011-86- I Conditional installation approval is hereby granted for the following: Minimum requirements: N f A 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 215 Sq. Ft. Number of Bedrooms 2 X 215 Sq. Ft. minimum requirement per bedroom - equals 645 Total Sq. Ft. minimum requirement Special Requirements: The existing septic tank must be uncovered for inspection. The leach field must be located at least 100 feet from the well and at least 10' from the property line gnd road rigf�t of, way. The installer must provide an Date: nvironmenta Heat Officer: CONDITIONS: (Con't) as -built, dimensioned site plan. The leach field area should beh lfenced off from the hrose corral area. 1. All installations must comply wit a l 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: � '700 1 SQ. FT. INSTALLED SEPTIC TANK: GALLONS; DEGREES; FEET DESIGN ENGINEER OF SYSTEM INSTALLER OF SYSTEM:iluL'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:_T�2 `� '�" � oQ Wc-g t'WAPttkQ0 4�3 (Z�CP t)PC 0 - �� fxulC kJ As '7P — P, PZf_rtii r Ut1 �c,ZO (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 Name of Applicant: Margar e t R u m g a r d n e r Name of Owner: Sam P PERMIT Amount Paid: $ 2 0 0- 0 0 Receipt Number: 2 2 7 7 Date: 8 2 2 8 6 Cashier: Earl e n e H u e n i n k White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner APar IC:;,T IOR DiS� �S:;L p7":1 7 EN"IIRONIENTAL EEALT11 OFFICE - EAGLE COU',TY .1 P.U. Lu:: n50 c�0� fr Eagle, Colorado 81631 `;o. PERMIT APPLICATION FEE: S150.O0 328-7317 PF.RCOLATIO`: TEST FF- .: SSO.00 NAME OF 0?J\ER: ADDRESS: NAME OF APPLICANT (if dif/ferent/ from owner): ADDRESS: / (/UD /L = .- Q.L DESIGN ENGINEER OF SYSTDI (if applicable) ADDRESS: PErn iIV INS ALI_kTION OF SYSTE•1: :E:1 SZ- PHONE: --6g5V/ PHO:: E : Licensed Installer (see attac ed list): YES _- NO ADDRESS: '2 (_ I lC PHONE: oe;rl- PERMIT APPLICATIONIS FOR: ( ) New Installation ( ) Alteration; Repair LOCATION OF PROPOSED INDIVIDUAL SE?•?AGE DISPOSAL SYS E_•1: Street/Rural Address: Lot Size: L/ Legal Description: <;D S.X/ n , BUILDING OR SERVICE TYPE (check apolicablevcateaorv)- Residential - Single Family Residential - Duplex ( ) Residential - Tr_ole:c NUMBER OF PERSONS: WASTE TYPES (check applicable cate^ories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes Garbage Disposal (� Automatic Washer Other TYPE OF Z*;DIVIDUAL SE?.AGE_.'DISPOSAZ SYSTE_•1 PRO�cOSED: ( ) Residential Quadplev ( ) Co.•--::ercial (state usage) N17' :iBER OF BEDROOMS: Dwelling ( ) Transient Use Dishwasher ( ) Spa Tub yam, peptic tanx k ) Cor,.posting Toilet ( ) Incineration Toilet ( ) Vault Privy ( ) Greywater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Other ( ) Recycling, Potable Use ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO 1-7ATERS OF THE STATE: YES ( ) NO (� IS SYSTE`1 DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO n WASTEidATER FLOW REDUCTION PLAN: YES ( ) NO (j<:r (16 yes, see attached tUastetUate Stccv .tedu�Ctian me Beds) NOTE: The Envtito;uiefLtaL" Hea'L ut 03'�.icct matt educe .the .'Leou.i.,ted ab.so,-Lption atea upon apptovae o' an adequate tva,s.t e;Cate "L 6Z= ,teduc,tCon p' Za;a. SOURCE AND TYPE OF ?dATER SUPPLY: Well ( ) Spring, ( ) Creek/Stream Give depth of all wells within 200 feet of system: 7j If supplied by community war4r, give name of supplier: SIGNATURE------ -/I—-----------------DATE------ ------ INFOZ[ATION BELOW TO E FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Peneent G.touiad S.Zope 2-��� r Depth ,to Bedto eh ( pest 8' P,to 6ZZe Hote) 79 Depth to Gnoun&a te,t Tab.Ze 7 e, � SOIL PERCOLATION TEST RESULTS: tu,tEs pelt .cnch in Ho.Ze K 1 A1.i,nu tcs pelt finch .to Hote # 2 1 LZiLU t e s Pe%L irLC'a to Hote # 3 FINAL DISPOSAL BY: Abso.tptioii Trench, Bed o.t Pit ( ) Evapotta►asPiAation ( ) Above Gncund D.tspe usaZ ( ) Salad F.i Uc.t ( ) Unde;tg.tound D.Zspe-tsa.Z ( ) Was.tewatc.t Pond AmoulLt Paid: �0� 4' Receipt NtunbuL Date: NOTE: Site Plan must be attached to -application. (Env. Health Department - Rev. 4-07-83) FEE: $50.00 OWNER: LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DWELLING: &9 DATE OF PERCOLATION TEST: TEST HOLES PRE-SOAKED: YES PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County NO ISDS APPLICATION NO. NUMBER OF BEDROOMS: 13 TYPE OF SOIL: TIME WATER DEPTH INCHES OF FALL RATE 1 2 3. 1 2 3 1 2 3 1 2 3 I /?N M 0--/%- PERCOLATION RATE: ( V RECOMMENDED MINIMUM SEPTIC TANK SIZE: 1:�.TI U OT t2 i t� RECOMMENDED MINIMUM LEACH FIELD SIZE: G �� RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:/5 SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Environme-n-M Health 0 ficer Date COMMENTS: -The— �"yiS?iugA SCP c 1c rrvA� _ I A 1 A e A A I 1 w A A i A ll --T I.ea-c-A 9d c am, �C � ke y A Rev. 5/31/84 dAPo EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 August 28, 1986 Margaret Bumgardner P.O. Box 142 Eagle, CO 81631 RE: ISDS Permit #765 Dear Ms. Bumgardner: Enclosed is your ISDS Permit 765 for property located at 1385 Eby Creek Road, 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 repairs on your septic system. This yellow copy of the ISDS Permit must be posted on the installation site. Please note the special requirements and conditions for issuance of this permit. You must call our office for final inspection before covering any portion of the installed system. We can be reached at 328-7311, Ext. 227. If you have any questions, please contact our office. Respectfully, Gail Parker, Secretary Environmental Health Office EAGLE COUNTY /gp CC: W.Y. Construction Board of County Commissioners Assessor Clerk and Recorder P.O. Box 850 P.O. Box 449 P.O. Box 537 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Sheriff Treasurer P.O. Box 359 P.O. Box 479 Eagle, Colorado 81631 Eagle, Colorado 81631 EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 August 26, 1986 Margaret Bumgardner P'. 0. Box 142 Eagle, CO 81631 RE: 1385 Eby Creek Road Dear Ms. Bumgardner: The purpose of this letter is to notify you that the individual sewage disposal system serving the above referenced residence is mal- functioning and must be repaired. A site inspection on August 223% 1986 revealed that sewage effluent had collected in an open pit. It appears that the sewage effluent is being discharged from a properly functioning septic tank into a plugged leach field. The repairs for the septic system must be "permitted" by this office „ installed by an Eagle County licensed installer and prior to covering,.a final inspection by this office. If you have any questions concerning the repair or permitting process, please give me a calla Sincerely, c Sid Fox, Assistant Environmental Health Officer SF: pm cc: Files 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 EAGLE COUNTY 551 Broadway Eagle, Colorado 81631 (303) 328 7311 Date: November 7, 1986 Margaret Bumgardner P.O. Box 142 Eagle, CO 81631 RE: Final of ISDS Permit # 76S 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 /gP 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 �,4, Date Routed EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE gr Name � - App i i cati on 14o cation Please rev.ie:v 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: Complie Building Permit Building Pe Recomme COMMENTS: . . YES ran . . 'DPAITM.Mn RV ... r- s with - Applied For: rmi t Issued:;k� id Approval: YES I NO REVIE!•!ED BY DATE I ENGINEER: Complies with - YES NO I REVIE1111ED BY DATE Roads: Grading: Drainage: Recommend Approval: COMMENTS: -Tk Jeetc u 4) b . ENVIROIT IE71TAL HEALTH: Complies with - YES NO Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recom-mend Approval: COiIIMENTS : 17CX:? AT— gg< f_ REVIE14ED BY dot t, - s DATE i i •P ,.ril l .. FOR INr.,1:1 .=' cE.;,,GE DIS^OS,.',L SYSTE"S .f A permit fee of S150.00 shall be char:,ed for alteration, enlar ec;ent or ar.y reoair� involving alteration': of an existinc,, se,, -lace disposal syste�l. This feeis au`:ori:ed by Eagle `Gounty`Indi•vidual Se,;/ane Disposal System Regulations adoated and =_ffec=ive March 27, 1930. For minor repairs of less than $100.00 for maintenance of the individual se -,race disNos.:1 system, no fee shall be required. A percolation test fee of $50.00 shall be charged for all new leach fields on repair permits. Percolation testing may be waived at the discretion of the Environmental Health Officer on certain repair cases where prompt action must be taken to prevent a hey, ""ti 6"ra IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEU SYSTEM SHALL RE I?ISTALLED., COMPLYTIIG IvIITH ALL CURRENT REGULATI-ONS.. .IF A NE! -I SYSTEM IS REQUIRED, ALL FEES ARE APPLICABLE. .TYPE AND SIZE OF SYSTEH PRESENTLY ICI USE: o GL h i}ArE PRESENT SY57EIi IdAS INSTALLED: A(Bw -1a PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: SITE PLAN BELO4 SHOOING PRESENT SYSTEM COMPONENTS: — V 0!•JNER OF SY AN APPLICANT: ADDRESS: DATE: 4, 0765 Bumgardner 1385 Eby JOB W Creek Rd -� (�q4{ I; JV CE!F-99- -M_ inn i nreTinr.i BILL TO DATE STARItED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL PERMIT #765 ****REPAIR PERMIT**** OWNER: Margaret Bumgardner lv9f LOCATION: r38k Eby Creek Rd., Eagle , CO INSTALLER: WY Construction SIZE OF TANK: Existing DWELLING: Res. Single Fam. - 3 bedroom PERC RATE: 1 inch in 10 minutes ABSORPTION AREA: 700 s.f. FINALIZED: 10/86 BY: Sid Fox m JII - :OST OFIT COSTS PRICE !OFIT a;l&hy /4 Printed in USA,