HomeMy WebLinkAbout13117 Gypsum Creek Rd - 219531200002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N® 0786
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: David Scott Telephone: 524-7557
Address: P. 0. Box 180, Gypsum, CO
System Location:_ 13117 Gypsum Creek Road
Licensed Installer: Nohhs Excavation 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:_ Inch in �___ Minutes
Absorption area per bedroom Sq. Ft.
Number of Bedrooms X 200 Sq. Ft. minimum requirement per bedroom -
equals 600 Total Sq. Ft. minimum requirement or 100 feet SB2 10"
Special Requirements: r/ U 4 IU 7 r1___1 1?� C Uld1 Yv►(�N p� ��
Date: l� Z c�� Environmental Health Officer: /L� ��-
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.
SA: GrOc-'-/G,iGoo��
INSTALLED ABSORPTION OR DISPERSAL AREA: SQ. FT.
INSTALLED SEPTIC TANK: GALLONS; _ DEGREES; j FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: L 5 PHONE
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE:
PROPER MATERIALS AND ASSEMBLY:
COMPLIANCE WITH PERMIT REQUIREMENTS:
zQ,
YESO
YES s(� NO
YES L NO
COMPLIANCE WITH COUNTY / STATE GULATION 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: David Scott Name of Owner: Same
Amount Paid: 200.00 Receipt Number: 3068 Date:/1/87 Cashier: G. Parker
Check #551
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
7 DT TI.:iT'r,.,. FOR E`.. I",, .�L Sr. .:\('=• DIC-. ..�.\L �C- 7C'....(7....
PER_•IIT APPLICATION
/-�FEE:
NAME OF O NER: �C 011
ADDRESS:
ENVIR0,MENTAL i:EALTH OFF ICE - EAGLE CCU., r:
P.O. 2,o:: 350
Eagle, Colorado 51631 No. 1 094o
S150.00 328-7311 PFRCOLITIO`I TEST F tiso.n0
�C� �VIJS�:lrrl 6)lel- PHONE: 3,zy' ��� Z
NA,ME OF APPLICANT (if different frots owner):
ADDRESS: / � //7 G-C-4Pg44HO`iE:
DESIGN ENGI::EER OF SYSTDI (if applicable)
ADDRESS: PHO: E :
Li�:aVlV L\LJL V�J1Ui.L '.•0.; INSIALLATION. OF SYSTEM: _ h7 _l 22S 6XC.s�ci�i^,
Licensed Installer (see attached list): YES- _ NO
ADDRESS: PHONE:
PER`1IT APPLICATION IS FOR: ( New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SET•?AGE DISPOSAL SYSTE-1:
Street/Rural Address:
Lot Size:6 �r�c
Legal Description:
,G.OR SERVICE TYPE (check aoolicabia cate^orv'
Residential - Single Family
Residential - Duplex
( ) Residential - Tr_olex
C NUMBER OF PERSONS:
WASTE TYPES (check applicable cate^_ories):
( ) Commercial or Institutional
( ) Non -Domestic Wastes
( ) Garbage Disposal
04) Automatic [dasher
( ) Other
TYPE OF INDTVIDUAI. SET•:AGL DISPOSAL SYS=-1 PROPOSED:
( ) Residential - Quadplex
( ) Co.--::ercial (state usage)
I`r^IEER OF BEDROOMS:
X Dwelling
( ) Transient Use
( ) Dish.,asher
Spa Tub
3
0()
Septic Tank (
)
Cor,:posting Toilet
(
)
Incineration Toilet
(
)
Vault Privy (
)
Greywater
(
)
Chemical Toilet
(
)
Pit Privy (
)
Aeration Plant
(
)
Recycling, Potable Use
(
)
Other
(
)
Recycling, Other Use
WILL
EFFLUENT BE DISCHARGED
DIRECTLY INTO T•.'ATTERS OF
THE STATE:
YES ( ) NO (Nd)
IS SYSTEM DESIGNED FOR LESS T'rTAN 2,000 GALLONS PER DAY: YES
(iv NO ( )
WASTEWATER FLOTd REDUCTION PLAN: YES
( ) NO ( )
(16 Yes, See attached tvaz.te atet Sectu .tedLI.C,t(CW methods)
NOTE: The Eiiv tojunejztaf"_ Heat' uL OS 6.i ce-"L mail ,reduce the -tequ,&L.d ab.sC,-Lpti o)t a.tea upon
apptovae OS ail adeGUat., CtiaS i C'a l et S{C'LU tedLLCtCOiI peajt.
SOURCE AND TYPE OF [;TATER SUPPLY: ( ) well Spring
( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied n'tt water, give name of supplier:
�o<<
SIGNATURE: /� DATE:
- - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
INFOZIATION BELOW TO BE FILLED OUT BY ENVIRONVJFTAL HEALTH OFFICER:
- --�/ - - - - - -
GROUND CONDITIONS: Peneent G.toujid Slope '0—
r Dept;z to Bedto eh (pen 8' P.to �tiee Ho ee )
Depth .to Gnauj1dXa tct Tabte �
SOIL PERCOLATION TEST RESULTS:. S Mc.jtutcs pen .cjLejL i;z
Hoi-e 51
AValt-tcs peA inch to
Hate #2
I L(;Ll� C,S 13 eel. .(,I L(JJiL "t 0
Ho.ee
FINAL DISPOSAL BY' -
(>9 Ab�so.tptc ojj Tnejtck, Bed o,t Pit ( ) Evapo.t=;LsPiAation
( Above Gncwtd DZspenae ( ) Saad Fietet
( ) LbLdetg.towtd Dispeua_e ( ) Wastccra.tct Pond
( ) O.th e,t
Amou;tt Paid: Rece�; t NLunbe.t ��14� Dczt,�
- - - - - - - - - - - - - - - - - - - - - - - - - - - -6&#</- - - - - - - - - - - - - - - -
NOTE: Site Plan must be attached to•application.
(Env. Health Department - Rev. 4-07-33)
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
May 11, 1987
David Scott
P.O. Box 180
Gypsum, CO 81637
RE: Individual Sewage Disposal System Permit
Dear Mr. Scott,
I have reviewed your application for an Individual Sewage
Disposal Permit. The application is incomplete and the
following information is required before we can issue a permit.
1. Street/Rural address of the installation site.
2. Scaled site plan showing the following:
Appropriate location of the existing ISDS systems on
the site.
Show the 50 foot setback from the stream.
Upper pond.
See the site plan requirements on the instruction
sheet for more information.
In addition, we need to make arrangements to inspect an 8 foot
soil profile hole and a percolation test.
If you have any questions, please call or stop by.
Sincerely,
Sid Fox
Asst. Environmental Health Officer
EAGLE COUNTY
SF/gp
cc: Building File
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
DAVID JAMES SCOTT
TRUST - SUSAN DIANE
SCOTT TRUST
908 LAKECREST DR
SENECA, SC 29672-7096
Property Record Card
Eagle County
Account: R025010
Tax Area: SC071 - GYPSUM
(AREA) - SC071
Acres: 53.300
Parcel: 2195-312-00-002
Situs Address:
013117 GYPSUM CREEK RD
GYPSUM AREA, 0
Value Summary
Legal Description
Value B y.
Market
Override Section: 31 Township: 6 Range: 84 PCLIN LOTS 10,11,14
BK-0329 PG-0801 WD 09-30-81
Land (1)
$15,160
N/A BK-0637 PG-0702 WD 04-12-94
Land (2)
$210
BK-0637 PG-0703 WD 04-12-94
N/A R785543 QCD 12-31-01
Single Family
$215,920
N/A
Residence (1)
Single Family,
$53,170 +:_"y
N/A
Residence (2)
Single Family
$88,850
N/A
Residence (3)
Extra Feature (1)
$1,520
N/A'
Extra Feature (2)
$5,780
N/A
Extra Feature (3)
$2,890
N/A
Extra Feature (4)
$3,240
N/A
Extra Feature (5)
$3,040
N/A
Extra Feature (6)
$2,140
N/A
Extra Feature (7)
$270
N/A
Extra Feature (8)
$12,360
N/A
Extra Feature (9)
$29,770
N/A
Extra Feature (10)
$11,500
N/A
Land (3)
$11,700
N/A
Total
$457,520
$457,520
A#: R025010 P#: 219531200002 As of: 12/31 /2014 Page 1 of 11
EAGLE COUNTY E`1VIRONMENTAL HEALTH OFFICE
J
Name) _
Date Routed
Application 10o
Location
Please revie,:i the attached Individual Seviage 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:
COIMPIENTS : '
BUILDING: Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
C04 MENTS:
EN'/ I RONi tENTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Reco,,.mend Approval:
CO."MENTS:
YES Nn RFvr71.1cn Rv
- - - ----
uft I C
i f
YES I NO
I REVIE'-IED BY
DATE
I
YES NO REVIE!"IED BY DATE
YES NO REVIE14ED BY I DATE
k
Nxz
Ice
t -7.7
EAGLE COUNTY INVOICE NO.
N2 3068
DATE: I Q_/ i / i / ?,�S%
TO:
Make Check Payable to: Send Payment to:
EAGLE COUNTY TREASURER
P.O. Box
Eagle, CO 81631
CASH(4)
CHECK NO.
ACCT.
ITEM
AMOUNT
71 �11
7S/ZS
TOTAL
- r--+nmar 1—i f'—, - I 1rn i-nnv - racniari 1 raaUlrar
I
N
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $50.00 ISDS APPLICATION NO.
OWNER:
LEGAL DESCRIPTION:
S— 3 / Z ._dQ -Go 2
.RURAL_ ADDRESS: /�S 1/
TYPE OF DWELLING: r— NUMBER OF BEDROOMS:_
Gzy�` y G
DATE
OF PERCOLATION TEST:
6 -- � _�1 —7 TYPE OF SOIL:
�� (
TEST
HOLES PRE-SOAKED:
YES_ NO
1
TIME
2[
C /j3r`)
1
WATER DEPTH
2
3
II INCHES
1 1
OF FALL
RATE
2
3
'-`--�-�
Z�-
Z_
S
PERCOLATION RATE: `5—
RECOMMENDED MINIMUM SEPTIC TANK S-IZE: or)
RECOMMENDED MINIMUM LEACH FIELD SIZE:62/
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: (%
SITE HAS BEEN REVIE!,JED AND TESTED FOR PERCOLATION RATE.
c
Environmental Hea th Officer
COMMENTS:
Rev. 5/31/84
- zo
Date
0786 Scott 13117 Gypsum Creek 1/+
JOB .NAME Road �Qfyw- I it-) T: ,eTcxy 1-� IC'.�
JOB Na
,00 JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
2-0 , ems'
v( Ja s
bus y
C��T
i
/ lJ
v• \ Ge�
Vwj
r32 V 5`J
2AS—M—W-002—
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
►oerixx; ','k
PERMIT #786
-16
'A 3� ,1�
OWNER: Susan Scott A �UI
LOCATION: Gypsum Creek Road
INSTALLER: Hobbs Excavation �ac'&
SIZE OF TANK: 1000 gal
DWELLING: Res. Single Fam. 3 bedroom
PERC RATE: 1 inch in 5 minutes r ��
ABSORPTION: 100s. f. B 13 I� Gyps ^, A 1.?,
FINALIZED: 6/19/,87 BYl:Erik Edeen
a i��
p�� I
`W�/`
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
_DER Printed in U.SAA,