HomeMy WebLinkAboutSE 1/4 Sec 13, T6S, R81W - 000000000000INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N2 0829
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: __ Bueno Orofina, Inc. Telephone: (303) 625-4367
Address: 687 Mesa Court, Rifl . Colorado 816.0
System Location: Eagle County, Mi nes i te, SE a 13 T6S R81 W
L4czansed Installer: Jnhn W _ Smith License Number: -
Conditional installation a proval is hereby granted for the following:
Minimum requ ements:
Absorption area of dispersal a a computed as follows:
Percolation rate: Inch in Minutes
Absorption area per be oom_
Number of Bedrooms X
equals Total Sq.
Gallon Septic Tank or
Aerated Treatment unit
Sq. Ft.
. Sq. Ft. minimum requirement per bedroom -
minimum requirement
Special Requirements: For chemical toilet. Call for inspection when installed and
to operate.
Date: 4-7-88 Fnvironmental Health Officer: Erik W. Edeen
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: GALLONS; DEGREES; FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE: -
PHONE:.
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: Bueno Orofino, Inc. Name of Owner:—Bueno Orofino, Inc.
Amount Paid: $150.00 Receipt Number: gW01 Date: 4-1-88 Cashier: Earlene
Check No. 1045
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
ENVIRO::`fE`:TAL i:EALTif OFFICE - EAGLE C0U';TY
P.O. Box 350
(r- 1 Eagle, Colorado 81631 :;o.
PERIMIT APPLICATTON FEE: S150.no 328-7311 PF.RCOLITIO`d TEST F=- ,125,00
NAME OF OV,%ER: Bueno Orofina, Inc.
ADDRESS: 678 Mesa Court Rifle, Colorado 81650 PHONE: (303)625-4367
NAME OF APPLIC,V,,T (if different from owner): same (303)625-4657
ADDRESS: same PHONE: same
DESIGN' ENGINEER OF SYSTDI.(if applicable): — N/A
ADDRESS: PHO:E :
INS1AL1;'1TION OF SYSTEM: John W. Smith
` Licensed Installer (see attached list). YES NO X
ADDRESS: 678 Mesa Court, Rifle, Colorado 81650 PFONE: (303)62'5-4367
PERMIT APPLICATION IS FOR: ( X) New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SET•?AGE DTSPOSAL SYSTr'-f:
Street/Rural Address: Eagle County
Lot Size: Minesite
Legal Description: SE413 T6S R81W
BUILDING
OR SERVICE TYPE (check aoolicabia
cate^_erv):
(
) Residential - Single Family
(
)
Residential - Quadplex
(
) Residential - Duplex
(.
)
Co.•--::ercial (state usage)
(
) Residential - Tr_-Dlex
Other
(X)
Mining Operation
NUMBER OF PERSONS: 3
Iti'T-;:fBER
-, .;
OF BED:�OO.1S., N/A
WASH: TYPcS (check applicable cate;ories):
(
)
Co«.mercial or Institutional
(
)
Dwelling
(
)
Non -Domestic Wastes
(
)
Transient Use
(
)
Garbage Disposal
(
)
Dishwasher
(
)
Automatic Washer
(
)
Spa Tub
(X)
Other Miners' Use
"`TYPE
OF
119DIVIDUAZ SET:AGE DISPOSAL SYSTE:•I PROPOSED:
( ) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( ) Greywater (X ) Chem cal Toilet
( ) Pit Privy ( ) Aeration Plant
( ) ( ) Recycling, Potable Use
Other
( ) Recycling, Other Use
WILL EFFLUENT BE DISCHA-RGED DIRECTL`i INTO ?IAT_RS OF THE STATE: YES ( ) NO (X )
IS SYSTr I DESIGNED FOR LESS 71TA:v 2,000 GALLONS P=R DAY: YES (X) NO ( )
WASTE[?ATER FLOW REDUCTION PLAN: ( X) N/A YES ( ) NO ( )
(I yes, see attached ccas.t exLte t Stc•cu .tedLt t Cn )ne thods )
NOTE: The Env.c to;vne;LtaL" Heae Ui 03'6.i,cet mat «educe the-teoui,t_d ab.sorLptton area upon
anptovaZ o5 an adequa.Lc ccas.t uca,t e t. 5Zow .tedu_-ti.oa pta;z.
SOURCE AND TYPE OF [dATER SUPPLY: N/A( ) Well
( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier:
SIG:'ATUREDATE
--------------------------- ------- - - - - --
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Peteent Gtoulzd Slope
Depth .to Bedtoeh (pet 8' P.to3'iee Note)
Depth .to Gtounciec tet Tabte
SOIL PERCOLATION TEST RESULTS:. pet .cncit in Ho,.e ? J
Atnu tcs pelt inch .to Hote # 2
u )cwi ;',S pet izLCIL to Rote, # 3
FINAL DISPOSAL By:
( ) Abso.tp-tZoA Ttelzch, Bed of Pit ( ) Evapo.ttanspiAz ti,on
( ) Above Ground D.L5pe,1,sa,L ( ) Sand FiUc-t
( ) UndetgAOU;id D.i.,spnsae ( ) Was-tcxate.t Pond
( ) OthCA
Amoumt Paid: � sy Rececpt Nw,nbe.,L � DczL,e: `/ - -
- - - - - - - - - - - - - - - - - - - - - - - - f���J - - - - - - - - - - - - - - - - -
NOTE: Site Plan must be attached to'application.
(Env. Health Department - Rev. 4-07-83)
X""
U-U-88
Date Routed
EAGLE COUNTY ENVIRONIMENTAL HEALTH OFFICE
Named - -
E Couritu - M t_no e- i A
LoLdLlon
� 3183
App i i cati on--PJi
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 ran 'DwTC,.?cn oV
BUILDING: Complies with - YES I NO I REVIEI•IED BY
I DACE
Building Permit Applied For:
Building Permit Issued: I I
Recommend Approval:
COMMENTS:-
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMEUTS :
EN11I ROi 1i4Ei1TAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
CO."MENTS :
V C4? 1
YES NO REVIEVIE-D BY DATE
YES ND REVIEWED BY
s'
Ire
DATE
829-88 TxPrcl#
JOB NAME SE 1/4 13, T6S, R81W, Minesite
Bueno Orofino, Inc.
JOB NO.
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
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.