HomeMy WebLinkAbout1954 Daggett Ln - 211130200006EAGLE 'TY DEPARTMENT OF ENVIRONM. iL HEALTH
Box 811 6th & Broadway
CALL FOR FINAL INSPECTION Eagle, Colorado 81631 PERMIT MUST BE POSTED ON PROPERTY
REPAIR PERMIT ONLY
PERMIT 264 (this does not constitute
a building or use permit)
Owner MARY BOOTH — GYPSUM CREEK RANCH
System Location 1914 DAGGOT LANE
Licensed Contractor LARRY SCHULTZ
* Conditional Construction approval is hereby granted for a 1,000 gallon
xx Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate 1 inches in 20 minutes 600 sq. ft.
absorption area per bedroom 200
# of bedrooms 3 x 200 sq. ft. minimum requirement
May we suggest 600 sq. ft. of drainage field.
Date �` Inspector Xai'
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
roper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date C Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
* CONDITIONS:
1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973
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 structures not approved by the building
and Zoning office 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, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or
T n+1,
x ENVIRONMENTAL HEALTH
P O BOX 811
PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00
A CATIO FO DI DUAL SEWAGE DISPOSAL SYSTEM PERMIT
N. 502
Name of Owner:���if", Cf/� p �� I Phone:
�/l�
Address of Owner: X.nr&�lKi
Is facility within boundaries of a city/town or sanitation district?
Distance to nearest sewer sy�+^^^
Location of Proposed System:
Legal Discription:
Type of Structure: Single Family Dwelling ( ) Other:
o. Bedrooms If
Water Supply: Private Well ( ) Location: Distance From leach field:
Size of Lot: G!6 Public Water Supply: -
An appropriate plat plan must accompany site inspection for this application showing required information. (See
attached sheet.) The individual sewage disposal system will be constructed and installed in accordance with the
regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS
66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be
obtained at the Eagle County sanitarian's office.
Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone
328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final
inspection.
Name, address, and telephone of person responsible for design of system:
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit.
SIGNATURE OF APPLICANT: Date-
_eo � ��dy(This application becomes invalid 6 months from above date.)
Percolation Information:
Tank Capacity:
Absorption Area:
REMARKS:
HEALTH DEPARTMENT USE ONLY
gal. (minimum)
Sq. ft. (minimum)
APPLICATION IS: APPROVED ( JV-) DENIED
Permit No._
Fee Receipt:
File:
The above individual sewage disposal system was installed by
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THEEAGLE COUNTY HEALTH DEPT.
Date: :Z Sanitarian: R-� W,—,,
Innlic, Lion No.
0V:nEll z
Le-alDescription:-
Type of Dwelling: Ito. ofi J3edx ooris: Z^�j
Date of Test: t Z
�Z % � Dentl� of Holes: . .
Diameter: _ l� ` Tyne of Soil:
Location of Test Holes: .
Test hole Was nxeso--ked from: To:
Date Time DUte
,E
TRIE 1'
17PTER DEPTH
i 7 \?CHES .OF Fl LIB
RATE
1
2
3
�l (
l7 y
Per colatxon Rate:
:. Site Il-is been rcviellecl and .tC'StcGI fOJC rGxC01at I'
IYO !a.'I'ROVPL �UZSfl��'IiOV1�I� DITE:
�ZY
�invi.r<�I�mei�t:,,l. IIc;t:].th
I .10 Couut,y
0264-1-9L4-Pftggrt—hn Gypsum Crk Ranch L
JF
0
B NAME
F0 JOB NO.
JOB ION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
e_oi:3� L-LC
�TJ,7-1
2A
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
5;co/,)e- 'TLI) Wry),
PERMIT # 264 LLC
OWNER: 19
oo
LOCATION:
INSTALLER: Larry Schultz
SIZE OF TANK: 1,000 gallons
DWELLING: Residential - 3 bedrooms x 200 sq.ft.
PERC RATE: one inch/20 minutes (600 sq.ft.)
Suggest 600 sq.ft. of drainage field.
Z 00—
17
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
pie OF SELLING PRICE
NET PROFIT
L
finalized: /-/b
By- 7,',-en
Repair Permit
DER
Printed in U.S.A.
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N® 0854
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: Louis Rimbert Telephone: 524-7407
Address: P. 0. Box 164 Gypsum, CO 81637
System Location:
Licensed Installer: Randy Hill DBA Triple H Construction License Number:- 088-20-I
Conditional installation approval is hereby granted for the fol owin :
GXISri eat 2 GP�1tiC)ri
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 X Sq. Ft. minimum requirement per bedroom -
equals Total Sq. Ft. minimum requirement
Special Requirements: New 10" SB2 system to be installed using two 80' 1 enghts
Date: July 7, 1988 Environmental Health Officer:_ Sid Fox
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.
S ®f' S 13
INSTALLED ABSORPTION OR DISPERSAL AREA: r SQ. FT- I Z
INSTALLED SEPTIC TANK: GALLONS; DEGREES; FEET
DESIGN ENGINEER OF SYSTEM:
INSTALLER OF SYSTEM: AAPOVI fl � I! PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE: 0 15'tPOC YES; NO
PROPER MATERIALS AND ASSEMBLY: YES �NO
COMPLIANCE WITH PERMIT REQUIREMENTS: YESyRTO
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES =:::n'_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) 7-6-6 ENVIRONMENTAL HEALTH OFFICER: SRO
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: Louis Rimbert Name of Owner: Louis Rimbert
Amount Paid: $150.00 Receipt Number: 50 Date: 6-30-88 Cashier: J. Brophy
Check # 7460
Cash $100.00
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. 0. BOX 179 1W. 321q
EAGLE, COLORADO 81631
949-5257 Vail
328-7311 Eagle
927-3823 Basalt
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00
NAME OF OWNER: Lnll ig ;vynAle v4
MAILING ADDRESS:
NAME OF APPLICANT (If different from owner):
ADDRESS: 19 S L-I Dam q-e -i + Lv\-
DESIGN ENGINEER OF SYSTEM (If applicable):
PHONE: a V- 7�C
PHONE:
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: ail cc 7T"I.e nsf
LICENSED INSTALLER: (,t-) YES 4t�2c ( ) NO e
ADDRESS: &K A3q(o, Cafe (e, Cold. V(ov t PHONE: SAP {--7577
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION ck) REPAIR
LOCATION OF PROPOSED -INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address:
Parcel Number: 2-111 - 302-pQ_ - Q2_ Lot Size: APeaDL i ikc.a,e_
Legal Description:
BUILDING OR SERVICE TYPE (Check applicable category):
Residential - Single Family ( ) Residential - Fourplex
( Residential - Duplex ( ) Commercial (Type)
( ) Residential- Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS:
WASTE TYPES Check applicable categories):
( ) Commercial or Institutional ) Dwelling
( ) Non -Domestic Wastes ( ) Transient Use
( ) Garbage Disposal ( ) Dishwasher
( ) Automatic Washer ( ) Spa Tub
( ) Other (Specify):
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
Septic Tank Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( ) Greywater ( ) Chemical Toilet
Pit Privy ( ) Aeration Plant ( ) Recycling, Portable Use
( ) Other ( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: ( ) YES NO
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: O YES ( ) NO
WATER CONSERVATION PLAN: ( ) YES () NO
NOTE: The Environmental Health Office may reduce the required absorption area upon
approval of an adequate water conservation plan.
SOURCE AND TYPE OF WATER SUPPLY: (,�C) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system: /I
If supplied by cqmRunity water, give name of supplier:
SIGANTURE:/4e_� DATE:
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent ground slope 1-cJe"t
SOIL PERCOLATION
Depth to Bedrock (Per 8' profile hole
Depth to Groundwater table
TEST RESULTS: Minutes per inch in Hole #1
Minutes per inch in Hole #2
Minutes per inch in Hole #3
FINAL DISPOSAL BY:
( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration
( ) Above Ground Dispersal ( ) Sand Filter
( ) Under Ground Dispersal ( 0v a tewat r Pon
y�
C � 17
$e��.
O
AMOUNT PAID: SD. RECEIPT NUMBER � DATE:
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
Se_e_ 1010r n-1 , -L � 9 l L'xr 5�h %16e., : t— CO ltQ�
j
(Environmental Health Dept. - Rev. 4/88) r�r Sao
AkW repO -r permit A= '
� � s Al
J 'SyS+e.n �a 6
EAGLV,'Q11�NTY DEPARTMENT OF ENVIROtIMFAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT N9 91 (this does not constitute
a building or use permit)
Owner Louis Rimbert
System Location 4 miless south of Gypsum, CO
Licensed Contractor Purley Bertroch
* Conditional Construction approval is hereby granted for a 1250 gallon
x Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate I inches in 27 minutes 800 sq. ft.
absorption area per bedroom 400
# of bedrooms 2 x 400 sq. ft. minimum requirement
May we suggest
Date June 15, 1976 Inspector
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approvvd prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date l / � f
I to Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
* CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973
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 structures not approved by the building
and Zoning office 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, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class -I, Petty Offense ($500.00 fine - 6 months in jail or
both.
CHARGES
Percolation Test $50.00
(includes final inspection)
Permit Processing Fee $25.00
Check (no cash) x
Money Order
Permit N? 91
Name of Applicant Louis F. Rimbert
Amount Paid $75.00
Date Paid June 4, 1976
Cashier Erik W . Edeen by HV
ALL CHECKS ARE TO BE MADE PAYABLE TO EAGLE COUNTY
Eagle Cty. — White Copy Applicant — Green Copy Dept. — Pinic Copy
PERMIT NO.
Name of Owner:
Address of Owner:
Is facility within bou
ENVIRONMENTAL HEALTH
P.O. BOX 811
EAGLE, COLORADO 81631 PERMIT FEE $25.00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT I
282
✓`'��`�'�---r���'��I�"��'� Phone: S �
of a city/town or sanitation district??•
Distance to nearest sewer system:
Location of Propi
Legal Discription
type of structure: Single Family Dwelling ( ) Other: No. Bedrooms
-
Water Supply: Private Well ( ) Location: Distance From leach field.,—6 'el
Size of Lot: �• z ��'�'0 Public Water Supply:
An appropriate plat plan must accompany site inspection for this application showing required information. (See
attached sheet.) The individual sewage disposal system will be constructed and installed in accordance with the
regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS
66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be
obtained at the Eagle County sanitarian's office.
Appointment far final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone
328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final
inspection.
Name, address, and telephone of erson responsible for design of system:
The undersigned acknowledges that the above information is,true and that false information will invalidate the
application or subsequent permit.
-�eSIGNATURE OF APPLICANT: . 4=2c — Date:
(This application becomes invalid 6 months from above date.)
Percolation Information:
Tank Capacity!
Absorption Area: i
REMARKS:
HEALTH DEPARTMENT USE ONLY
gal. (minimum)
Sq. ft. (minimum)
Permit No.
Fee Receipt:
File:.
APPLICATION IS: APPROVED ( ) DENIED
The above individual sewage disposal system was installed by
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT.
Date: Sanitarian:
I;AGLI: COIJI'ITY IiE,t%LTI[
INDIVIDUAI, SLWi;.GE DISPOISAL SYSTEM PILRMIT
ROUTE; Sall'
1),-ILC 1,e:lCrrc0
Location,
Please revJ.ew that-I:achCJ a-PI'lication and return it: and this completed forra to the
Environmental cjff:fict� worje4I-I-,- 010 c, y
Planning:
Comments.
File NwIlbc--f-
C; 0 1,;Ip 1 i e s W i f.-. h:
:sCz-ling Regul<,Lions
Recontuend Approval
Yes No Reviewed By Date
15-179
County Engineer: Roads
Grading:
Drainage
Recommend Approval
Comments:
Building Department: Set Backs
S I, t (I
Access
Other
Recoaxiond Approval
IVA
Co n,:ri (-, i s ,.- s :
IVA
Co n,:ri (-, i s ,.- s :
COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
A C T I V I T Y R E P O R T
Section
FILE REFERENCE: .� f
Code
County
INDIVIDUAL OR
ESTABLISHMENT:.
NARRATIVE: j
411
r /
.. v
v `'7— -7�07
-20
I "
:.Q
ly
Ito
R4,r
LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:�f!
6C�
{,;. eft, 71X
DATE: 19
REPRESENTATIVE:
ES: 7 (Rev. 6-70-.100`•
REPAIR PERMIT APPLICTAION
FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
A permit fee of $150.00 shall be charged for alteration, enlargement or any repair
involving alteration of an existing sewage disposal system. This fee is authorized
by Eagle County Individual Sewage disposal System. Regulations adopted and effective
March 27, 1980.
For minor repairs of less than $100.00 for maintenance of the individual sewage
disposal system, no fee shall be required.
A percolation test fee of $125 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 health hazard.
IF PRESENT SYSTEM IS PRE-EXISTING, NON -CONFORMING, A NEW SYSTEM SHALL BE INSTALLED
COMPLYING WITH ALL CURRENT REGULATIONS. IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE
APPLICABLE.
DESCRIPTION OF PROBLEM/MALFUNCTION: LsA"ki' ckd R(Uq! red -
TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: (0 GA I CM S£ [ J� j �Aut�-
DATE PRESENT SYSTEM WAS INSTALLED: 11; -7 L
PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT : #
SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS:
OWNER OF SYSTEM: ( 6(jC2
ADDRESS:
APPLICANT:
ADDRESS:
DATE:
PHONE:
PHONE:
854 Rimbert 1954 Dagget Lane/
JOB NAME 2111-302-00-025 JOB NO. q
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
GROTON, MA 01471 JOB FOLDER Printed in W5.A.
EAGLF, " 'NTY DEPARTMENT OF ENVIRONME"TAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT NO 91 (this does not constitute
• a building or use permit)
Owner Louis Rimbert
System Location 4 miless south of Gypsum, CO
Licensed Contractor Purley Bertroch
* Conditional Construction approval is hereby granted fora 1250 gallon
x Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Perc rate I inches in 27 minutes 800 sq. ft.
absorption area per bedroom 400
# of bedrooms 2 x 400 sq. ft. minimum requirement
May we suggest
Date June 15 , 1976 Inspector
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approvid prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
r materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date Inspector 1(�
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
* CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973
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 structures not approved by the building
and Zoning office 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, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or
both.
ENVIRONMENTAL HEALTH
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Name of Owner: — 1 1--
Phone:
Address of Owner: �f �A,14647.4 ,1
Is facility within boundaries of a city/town or sanitation district? ' 2lf-
Distance to nearest sewer system:
Location of Prop
Legal Discription
Type of Structure: Single Family Dwelling ( ) Other: No. Bedrooms
Water Supply: .Private Well ( X ) Location: Distance From leach field: 6,
Size of Lot: Aw"bev�`i�-� P/ Public Water Supply:
An appropriate plat plan must accompany site inspection for this application showing required information. (See
attached sheet.) The individual sewage disposal system will be constructed and installed in accordance with the
regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS
66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be
obtained at the Eagle County sanitarian's office.
Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone
328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final
inspection.
Name, address, and telephone of person responsible for design of system: p- 44/! ri
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit.
SIGNATURE OF APPLICANT: ���; Date: Cf
(This application becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information: —11 A
Tank Capacity: / 2—S-0 gal. (minimum)
Absorption Area: CV00 �-0 Sq. ft. (minimum)
REMARKS:
APPLICATION IS: APPROVED ( ) DENIED
Permit No._
Fee Receipt:
File:
The above individual sewage disposal system was installed by
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT.
Date: Sanitarian:
COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
ACT I V I T Y RE PORT Code
Section County
FILE REFERENCE:
INDIVIDUAL OR-�-
ESTABLISHMENT:-
f .
ADDRESS:
NARRATIVE:
414 In
A4 /r .
LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:
A=14-c
DATE: 19
ES: 7 Rev. 6-70-100
LIP
S 6
REPRESENTATIVE:
C
cv—
ap
ZU 3
174-O
:24
7* , i,
F-
r-r
af
LLI
4_
LL
F-
(n
V:
a
L/
C
a
C
�L
L
a_
LL
Q
C
C
z
H
r.i
WE
O
O
U
W
J
U
d
W .--1
M
LD
rl
U QILo
H
O
LLo x M
O d
= m =
O
•
O J O
W ()
J W
d J
F- CD
L d
W W
O
W
c
C
L)
N
ri
4-)
(Z W
Ln W
ro LL.
m
F--
Ln
co W
N F-
OJ
I O
I� H
N F-
rs CT-
C)
W
a.
(1)
W
W
LL.
O
F-
r Q
•r U
� J
a_
t\ d
LO
N F-
Lf) H
I
rn �
Irt w
m a_
W
Z
3
O
U-
CD
W
d
Z
644
O I= I O 'I O
l
N
Ln
w
tY
Ct
p
d
U
•r
a
LZ
rL3
4-
W
F--
V)
tn
LL-
CD
W
W
Z
C�
Z
W
2--
V)
W
p
(n
(n
w
p
p
d
O
W
f-
N �
V) Q
O
(n
Z W
O >-
H
d
F-
(/) ..
Z �
H W
J
_)
O d ��
Lf)
W Z
J H
m p ]�
Ln W
Z V)
O Z
a. LJ
(n U
W H
J ••
Ln
z Ln
O w
Ln af
LY p
LLJ CD
a. d
a) OOO
L o Z Z Z C
p O
4-) (ll Ln E
(1) r C CO
H
J•
Q'
•r f0 di
~r O+->
Card O
X
O O
F-O- W
O
r
J) iT a-•> S_
Q
rCS r C C L/) (n (n 0- U
(�
S_
S- rO •r •r W W W S-
:3 -�
(DU r r >- >- >- O
I
O
O O
C •r U U Ln ��
LL_ a.
.r E >, >,--- -0
C
>>
U a U U I ro
H
I v
Ln
a)
C -C (1) (1) -
F-
s
U)H
U
`..�`.-0
Q
r
O
(3)
W
cl:�
ro r
O
S_
S
F-
W
•r (0
!Z'
4-3 N
—i --
LLJ
J
C U
W
C (1) to •0
d CT r
a)
N L-
��
•r E
LL-
C)
a) «3 Ln rd
W • • (3) m (1) M-
(1) O
3 S •r lZ
S >- L r
W
I >
U
cr:
M I- p V)
Q)
F- d +-) iZ^ (n N
p
(n
J
L ��
m
— — —
r- 4-)
LL U C ((nn 4-
>-
O
p 0 C
O tY U O O
O
(3)
Ln
r-
Ln a. -0 +> O 41
H J
+-)
O
0) a.
rY (1) r6 E
F- d
rC3
a_
C S.
W (n S- > 4-) rO
d to
U
O
•r N C
F- Z S_ r (1) C
JO
Cr-
4-3 4-) O
dO >>a)r (1)
J Cl-
(1)
CL
In r[) •r
3 J r0 Ln (L) 4- a)
d v)
3
--1 E C 3 >
F- H
-0
LZ >•> ro
O d O O .-
V) LC
co >>
U) r
W
E (L) S-
F- C7 (1) U O (T
Z
U r
(1)
co
F-
O S- (3)
Z U N
H W
•r •r
•r
C
(n
U C3 d
H O •r .--
co
r E
S-
O
>-
O 4- CD C S-
3 d
C ro
O
•r
Ln
>- O 4- 4--> r (L)
L) 3
p LL.
C7
i->
J CDf 4->
Z W
ro X
a)
�
-)
F- N 3 +3 ro
cn
a) x a
+)
-P
d
4-> 3
� C r (1) r
r6
•r In
(/7
w a:+a) .. 3
J
U 0) r LL
U
N a)
O
a' d r- +> >- >>
`i ::D
= •r 7 S-
Q)
C V) r- S- • • Ln
m F- a) Z3 d
r •r
T
p
U Ln p F-
r
H (z ro Q) ^ H
S Cam- a_
r- C
H
.O
3 Ln •C >, m
m Ln (v z
a)
•
I I I
ro
S- O N 4-
W L/) r -6 (n
a' H
U
O U (Z (0 •r W
CO W co ro
O
M
• •
C
W
r- r r
•r Ln 3 U C.'3
-�C >>
= J • • +.) a'
r-
U�
LL.
Z
H
Ln O
Ln •r
d.
>-
ra ro rtS
•r •r •r
r
CL
r- i•-> •r Q) d
ro Ln M U I? 3
C>
its •r >
d Z C C W
S = d a) CO F-
r
(0
N
a) • • •I'
F-
4-3 4--) -P•r
a) •r Ln W
F- S-
U (D _) E d
>>
H
CD
S- � Q
C C C
rC1
U � Q) 4-) � V)
a. •r
Ln Li- a_ C 4- 3
4- .Q
W
-0 W •r
W
a) Q) Q)
S- O c) r0
U S-
H O O
O
2-1(n
-ap S-
U
-aU••
Y
(U p roS J
•r V a- Z
p in Z S--LL
-0OOd
E U
H•r•r•rLn
U
E 1 -0 O a)d+->r
O
W O•rr-O=
Q)
�•-�
L1
n (n
to Ln 0
Z
WE
C S- -P � C
0- O 4-> .0
W Z H > CO
4-)•r
F-
O
r- Z (D
d
(L a) a
(_D
_C-O
O ro O -P M
a) ro •r -P
m CD F- C > W
0-r
dlf
ro m
W
C: t YLn
u
C-) 21- LD dOHLn:�-a..0
HdW Oa_
a) L?
U
a.
U r
cn
a'
F- N :::- S- >-
-0 a
H
• r a) r
W
H
Z W a' Q) M- F-
C
J
LL-
Ln U of
^ d_
(n
^^^^ p
^^
L) M W ..0 Q
a) N
a.
O
>y S. O>
O
W
Z
J (n F- ro p
>
a.
-C ru a)
LL.
a•
H
J Z Z
•r 4-
W
d
Z
a. Cl. .J
CD
O
>-
`....,--
— — — L- W O d
(D H
�
O
Z
F-
LL
LL- F- U • •
C
CD
W>-
v
z
�F-
p
W
W
=FW-
d
J
m
F-
W
J (n W O
(Y
d
ca�
U
H
2::
Ln
a_
J F- Z
O
C.D
W
O
cnd
O
H
o.•
J
m
z
3
F-
3 — 3 Ln
Ln
lY
W
U
H
W
L
S
F-
J
d
W
S
J
d
F-
Z
W
Z
O
Z
W
m
F-
z
O
p
W
J
J
LL
W
m
O
F-
3
O
__j
W
M
Z
_O
F-
d
O
L.L.
Z
H
ail
C C C
Ln N Ln
� 4--) 4-->
C � �
100
C C C
iZ QJ
ro
v v s_r
Lz a. a)
O — +)
Ln -,.,e 3
U -0
O
� "O O
� m(�..
� z
U d-) •i, W
a M p F-
Ln
w
F-
N
Z Z
O O
H H
H Q
p J
z o
o U
U �
W
p 4.
Z
O H
O
cD (n
a)
W
1V
W
C � F-
•O Q
S_ O
Ln Q) S- .
C -P (
rt3 r •i-�
S_ •r rii
Ca_0 CD
-0-U
rO C
> t0
WN3�
W
co
+-)
•r �
S- F-
O a_
H
O r r W
N rO to U
m LO V) LLJ
a) a)
L LZ Q
U Ln Ln
C •r •-
a) p p
S-
• F- -0 -0
> C C
m C O =
J O O O
d+->(OC^
C:)O a1 S. S J
a_o>va)
cn Ln O 'C7
H p p C
M d d 0 0
H d
LL
f•-
z
O
d
WIC
r
�
V
r �Y5 m
Z
_o
F-
d
U
a.
a_
CO
cod �
O
C`
�
p
w
S
>
N
�
U
d
F-
41
I
+;
W
Q) m
F
(/)
p
>
r
ro
E
Z
d
J
Q)
= �
-ro
a
W
~
H
1 O)
V 1
�
C
E
4�
to
O
L
�
O
>
C
Z
-0 (3)
S- (3) >
(M w
•r N •r
W Cy
tt3 •r a--)
J Q
a S_ U
QJ
J
S_ -= 4-
(i3
C 4-3
F- W
+-) 4-
3
O rn
Ln W
>, = a)
v
a) :3
z LL.
C RS
fn
rn -C
N C
r
r
W J
S• •r rt3
ro
(3) 4- O
m Q
O
O
Q) •O
'O
4- +3
J
} > (1) Q)
r
C U
.J C]
4- -P
>
C O r0
Qw
E cn o
_0
rts +-)
N
v •r C3
C
(v v a
0)..0 rC)
•r
r S- E
2: Cr
S F-
U O
w w
ro to
(1)
3 N S_
F-
N
r- C
�
Q) •r C1
C/')
C O
+-)
C Zi
>- Ln
F--
Q) +
4-
r (2) S-
N
^ +-) (o
O
r= Q)
3 E
>-
C In r
r0 4-- ...0
W w
V)
O >,
Q)
3
Z F-
Z
•r to U)
U
S_ 4-3
N
O J
-P Q)
C
o r0 (A
Q >-
t--� ¢
ro r- =
r0
4- Q)
c/)
Q Ln
S- ro
C
7:5 rn
F- O
N N E
Q1
O m
C� 3
U a-
i o a)
+)
Q) > U
Z LLL)
J �-+
ro (n N
S- ro S-
2::
o
ro
(03
rL
s_ -v <n
E
ro
C)
Q W
O
U a) 0-
LL. LL-
C7
4- Q) r-
S-
-0 Q)
Z)
F- Q
0)(0
o •O
a) S
O
�-+ 3
-0 ro V)
4- aJ
-0 >,
U
ME w
(1) 3 O
S_
ro C
)
= Cn
>T Q) 0.
O •r
r E •r
Z fn
W
i_ V) rn
O :3
r- «5
O Z
Z CD
Q
Cr C>
CD Q)
-C S_ -p
w =
U C
O S-
o •r Q) S-
^ F-
�--r Cl
•r Q)
—4
4-) U (0
CD Q
Q �-+
(1) a--) CY)
kq a)
V) N
Z J
CL
-0 N tL)
-0
Ln (3) C r0
+ J
W
4-) O
F- c.D
M
r X a)
co r-
r 1
N w
-
«S
4-) r0
O U 4--3
>X
U r-
W F-
(n r0 r0
to (n
4- •r r0
I Z
Ln
o
O
C:) 4-- _0
a) a)
r- 4- -C
= =
0 0• r
r (L)
(L) 0 0
o-
• >
4-
Q) U rt5
O
O C •r
4-
4- S-
(n U
LO O b
O O
a) -P 4-)
r+
r1 •r C
C
+� CL r C
J
4fq +) t +
Ln
rn (0 QJ
i J
E
a--) S QJ
F-
O
i-) C 00
C1 4--1
C -P r 0-
>- F-
(1) r0 O .-i
S_ >,
.r E -P O
3
4- U
to
+-) S- C +-)
F- W
r0 N QJ
Z L3 J
4-) C a) I-
O r
r C L E C
W Z CO
•r •r r N
C 00
O C a)
In f-+ Q
E> 0)
•r In
U S O-�Ie
W >- U
S r ro
E O
S •r S_ ro
= -j t r
O O W U
C1
a) ro •r -P
CL Ci _1
C >, r0
O •r
Q) C a)
LL O CL
Q•r-02:
LL-0
¢ S_ W -0
i--+UQ
Is
O_
U
Z
S
LL-
J
Q
W
J
m
O
CL.
LL
O
z
O_
F-
L)
(/)
W
Him
O
J
w 9
N W
W
CL
W
cn --
>- Cr-
V)
LL-
CD
O
W
IJ
N Y
r
h
LLJ
J
J
Q
Ln
_z
V)
Q
F
W
F-
Ln
N
Z
W
N
LL1
C1.
W
Q
0
W
Q
CL.
W
m
N
S
CY]
w
O
Ln
Ln
Ln
y
w
a.
Q
LL-
)-r
w
F-
N
V)
J
Q
Z
CD
nf
O
CL'
O
LL-
W
m
O
Z
F
CL'
w
O_.
F-
Z
W
z
0
w
O
U
s
Ld
F-
N
r
t/)
F-
Z
W
U)
LLI
d
C'3
_Z
3
O
V)
O
_j
w
cn
Z
Q
J
CL
W
F-
LN
W
Z
O
S
a
63
W
Z
O
N
V)
U-
Z
O
Cn
<
N
N
U
N
W
)
W
W
J
d'
W
11
z
o
0-
O
F-
3
o
n_
o
¢
O
4
Q
Q
m
co r� 7
JOB NAME
JOB NO.
AW Ir1n 1 AP-ATVIN
t
( &J� r
BI L TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
cTOTAL
y0—Y-Y)
PERMIT # 91
4
OWNER: I ntui c Rimbert
LOCATION: 4 miles south of Gypsum - a tract in track 97 -
township 4 - R85 W (one acre)
INSTALLER: Purley Bertroch
SIZE OF TANK: 1,250 gallons
DWELLING: single family - 2 bedrooms x 400 sq. ft.
PERC RATE: one inch/27 minutes (800 sq. ft.)
LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 =— Finalized: / - I Z - / 6
By: Erik Edeen
Printed in US.A