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HomeMy WebLinkAbout147 Grange Ln - 239115101006 - 0875ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
Eagle County Department of Environmental Health PERMIT N2 0875
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: Herbert and Janet Weisbard Telephone: 963-2410
Address:__-0147 Grande Lane Carbondale, CO 81623
System Location: 0147 Grange Lane Carbondale, CO 81623
xTs"HwInstaller: Owner License Number: - N/A
Conditional installation approval is hereby granted for the following:
Minimum requirements: 1000 Gallon Septic Tank or 780saftAerated Treatment unit
Absorption area of dispersal area computed as follows:
Percolation rate:_ Inch in —15 Minutes
Absorption area per bedroom 260 Sq. Ft.
Number of Bedrooms X 260 Sq. Ft. minimum requirement per bedroom -
equals 780 Total Sq. Ft. minimum requirement
Special Requirements: Maintain the following setbacks - At least 10 feet between the leach field
and property lines and at least 100 feet between the well and leach field. You must provide
an as -built site plan prior to final approval.
Date: q-2EL8 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.
INSTALLED ABSORPTION OR DISPERSAL AREA: 600 SQ. FT.
INSTALLED SEPTIC TANK: G-50 GA LL ONS;_ __�
/n� DEGREES; a5 FEET
DESIGN ENGINEER OF SYSTEM: N 1 14
INSTALLER OF SYSTEM: DWOZP, PHONE:
SEPTIC TANK CLEANOUT TO WITHIN 12"OF FINAL GRADE OR
AERATED ACCESS PORTS ABOVE GRADE:
PROPER MATERIALS AND ASSEMBLY:
COMPLIANCE WITH PERMIT REQUIREMENTS:
YES- O
YES - NO
YES NO
COMPLIANCE WITH COUNTY / STATE REGULATION REQUIREMENTS: YES
COMMENTS:
NO
(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:D
DATE (Re -Inspection) ENVIRONMENTAL HEALTH OFFICER:
RETAIN WITH RECEIPT RECORDS PERMIT
Name of Applicant: Herbert Wei sbard Name of Owner: Same
Amount Paid: 1 275,00 Receipt Number: 419 Date9-12-88 Cashier: E. Huenink
Check # 2908
White and Pink Copies - Environmental Health Department Yellow Copy - Applicant / Owner
PER:•iIT AP:'i.IC:.TION FEE:
NAME OF OUNER:
'HALTii OFFICE - EAGLZ COL•,::•`."
P.O. 2,0:: -14:-To) W
Es�,-le, Colorado 81631 No. �I
S150.00 328-7;1' PFRCOLATIO': T?;ST , FF: $125-.0(
ADDRESS: C> C� I\ [., A IV PHO::E:
NkME OF APPLIC,VNT (if different From owner):
ADDRESS:
DESIGN ENGI::EER OF SYSTDI. (if applicable) :
ADDRESS:
C t.hJ V1V L\LJ1 VitJ1LuL, ili i� INSiALI--MON Or SYSTEM:
PHONE:
PHONE:
Licensed Installer (see attached list): YES NO
ADDRESS:
• PHONE:
PERMIT APPLICATION' IS FOR: () New Installation ( ) alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUALSE?•?AGE DISPOSAL SYST.E.I:
Street/Rural Address: Q ,e4947iy o LPG C®
Lot Size: 4,C
Legal Description: Al W_ A l iff v <-ih%- A t 1, S Ve `.f- r v7 Ali fA P
BUT
OR SERVICE TYPE (check applicable cate^_orv)•
(A) Residential - Single Family
( ) Residential - Duplex
( ) Residential - Tr_olex
NUMBER OF PERSONS:
WASTE TYPES (check applicable cate^_ories):
( ) Co«,.;:ercial or Institutional
( ) Non -Domestic Wastes
( ) Garbage Disposal
( ) Automatic Washer
( ) Other
r + tvi.
( ) Residential - QuadDle:i:
( ) Co.--::ercial (state usacre)
P.'L:iBER OF BEDR00_`,S:
� ) Dwelling
( ) Transient Use
(, `} Dishwasher
( ) Spa Tub
-TYPE OF
INrDIVIDUAL =.-,AGE
DISPOSAL SYS=i PROPOSED:
( )
( )
( )
( )
Incineration Toilet
Chemical Toilet
Recycling, Potable Use
Recycling, Other Use
00
( )
( )
( )
Septic Tank
Vault Privy
Pit Privy
Other
( ) Cor-posting Toilet
( ) Greywater
( ) Aeration Pant
WILL EFFLUENT BE DISCHARGED
DIRECTLY INTO ? AT='RS OF THE
STATE: YES
YES (*) NO ( )
IS SYSTcEH DESIGNED FOR LESS
TH..N 2.000 GALLONS PER DAY:
WASTE:•?ATER FLOW REDUCTION PLAN: YES ( ) NO (�}
(IS yes, See atttachea was-texa,'Le-t S.QC(v Leduction me.v'LCd5)
NOTE: The EnvZto u?7ejLLaZ HeaetlL OS .�Cca,t );fall teduce -tiLe -teoU.(.ted ab.So,LptitCjt
Qtea UpUj1
apptovaE OS an adeGua,iC tea.s.tz:eat'vt StCcV .Ledu—ctio;t pi-a;t,
SOURCE AND TYPE OF WATER SUPPLY: ( X Dell ( ) Spr;no
( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community water, give name of supplier:
SIGNATURE: DATE:
• - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - -
INFORt{ATION BELOW TO BE FILLED OUT BY ENVIRON'VJFTAL HEALTH OFFICER:
- -
GROUND CONDITIONS: Pence;tit G.towid S-eope -3- 5-17Q
Dept'L .to Bedtoch (pen 8' P,toS'Zee Hotel L
Dep.Vt to Gnoujidi atet Tabte v
SOIL PERCOLATION TEST RESULTS: A cjtutcS pet inc;L in Ho.ee
K1
fYL Mutt tc-5 pet inch to HO.ee
# Z
'ri"L-6tult e,S per iiLG'L -t 0 HOZe
03
FI,VAL DISPOS l[ RV:
( ) Abso.tpti.ojl T Lejtcli, Bed of Pit ( ) Evapo.ttanspiAatZon
( ) Above Gnowid DZspetsa.e ( ) Sajtd F,i.,e,tc,t
( ) Undetg.towid Dispetsae ( ) Was tetca.tct Pend
( J O-Me t
Amou;t,t Pac d:
176 — Recec;pt Nwnbe-t te:
-------------------- y29PS------------- - - - -
NOTE: Site Plan must be attached to•application.
(Env. Health Department - Rev. 4-07-33)
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $125.00 ISDS APPLICATION NO. 3/6'6
OWNER:
LEGAL DESCRIPTION:
RURAL ADDRESS: o I q 7
TYPE OF DWELLING:
0 @/ , NUMBER OF BEDROOMS:
DATE OF PERCOLATION TEST: zz- 8� TYPE OF SOIL: 5
TEST HOLES PRE-SOAKED: YES f- " NO
WATER DEPTH
____TTIME
INCHES OF FALL
RATE
1w
2
3
1
' 2/
3 11
2
3
1
2
3
b
2--
,20 Yv
a '/
P
p rw ►'('
y.©
PERCOLATION RATE: /r 6 m e �z
RECOMMENDED MINIMUM SEPTIC TANK SIZE: / bO V pt tk G4
RECOMMENDED MINIMUM LEACH FIELD SIZE: -)So-
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: � 6
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
b e7
Environmental) Health Officer Date
/
COMMENTS: E ' 4*P7AW 4110(xU1j1 '� 1' a Ca - /l4 �eAsY ld - ,4- Cj� —
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JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
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MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
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JOB FOLDER Product 278 NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 ^p FOLDER Primes! in P.S.A.