Loading...
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.