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Home My WebLink About42 Salt Creek Ct - 210719300034INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631 Telephone: 328-7311 or 949-5257 or 927-3823 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 912 Please call for final insaection before covering anv Dortion of installeri svctam OWNER: Glen R. Miller PHONE: 328-6650 MAILING ADDRESS: Post Office Box 1109 Eagle, CO 81631 AGENT: Owner - Self PHONE: 328-6650 SYSTEM LOCATION: 0042 Salt Creek Road LICENSED INSTALLER: Owner installed LICENSE NO. DESIGN ENGINEER OF SYSTEM: INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: 1250 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 480 square ft. minimum size leach field, 601 of 101' SB 2 per bedroom ENVIRONMENTAL HEALTH OFFICER: Erik Edeen DATE: June 7, 1989 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 Ill, 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: (TO BE COMPLETED BY INSPECTOR): NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE 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: �% 90 SQUARE FEET. INSTALLED SEPTIC TANK: ArP GALLONS DEGREES FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: j� PROPER MATERIALS AND ASSEMBLY /y�' YES NO COMPLIANCE WITH COUNTYISTATE REGULATION REQUIREMENTS: n YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED. COMMENTS: ENVIRONMENTAL HEALTH OFFICER: � "� � DATE: — ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS APPLICANTIAGENT: Glen R. Miller PERMIT OWNER: Glen R. Miller AMOUNT PAID: $2/ 5. 00 RECEIPT #: 1687 CHECK #: 1007 CASHIER: Jo APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE EAGLE COUNTY No. 7 P. 0. BOX 179 EAGLE, COLORADO 81631 949-5257 Vail 328-7311 Eagle -3823 Basalt ° T APPLICATION FEE 5150.00CATION TEST FEE ,125.00 NAME OF OWNER: MAILING ADDRESS: )jog 1 PHONE: 62 NAME OF APPLICANT (If different from own ): ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: LICENSED INSTALLER: ( ) YES (-K) NO ADDRESS: '2 ;'r > / D 9' . Z2 .r tr 67' / 1,,*? f PHONE: v PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: 04 -7- Parcel Number: Lot Size: p .ter 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 (X) Dwelling ( ) Non -Domestic Wastes ( ) Transient Use ( ) Garbage Disposal ( x) Dishwasher O Automatic Washer ( js) 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: 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: (X) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: a 1 n If supplied by commun'ty-water, give name of supplier: SIGANTURE: DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope Depth to Bedrock (Per 8' profile hole) Depth to Groundwater table SOIL PERCOLATION 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 ( ) Wastewater Pond ( ) Other CL_-a lob-7 AMOUNT PAID: c RECEIPT NUMBER , (QDATE: SQa -0GJ NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. (Environmental Health Dept. - Rev. 4/88) lei 5 CQP4 fir , 9P-7 ale PERCOLATION TEST�� %L ENVIRONMENTAL HEALTH DEPARTMENT Eagle Count FEE: $125.00 Paid v��eC�-�� ,3a147 OWNER:_ (�Ien �i. CYO; ! IeY - �CGS C61 1 LEGAL DESCRIPTION: �� RURAL ADDRESS: o0t]�2 Batt reeK 'Road �l 2 TYPE OF DWELLING: dam« Y� DATE OF PERCOLATION TEST: .�-�3'-� TYPE OF SOIL: r� ....� TEST HOLES PRE-SOAKED: YES NO TIME II WATER DEPTH it INCHES OF FALL RATE \ 1 2 1 3 k 1 2 2 3 11 1 2 3 c I II PERCOLATION RATE: Zr% /-17,4 e� RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: t7` C) i— RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: Zd />�•- �� .�� SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Environmental TiWth Officer COMMENTS: Rev. 5/31/84 19-- Z_�, —g% Date If PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125.00 Paid OWNER: LEGAL DESCRIPTION: ISDS APPLICATION NO. RURAL ADDRESS: 00t�2 �att CreeK/Road TYPE OF DWELLING: �� ds� NUMBER OF BEDROOMS: L_ DATE OF PERCOLATION TEST: TEST HOLES PRE-SOAKED: YES _TYPE OF SOIL: NO TIME I WATER DEPTH 1! INCHES OF FALL RATE 1 2 3 1/y2 ti 1 1 2 3 11 1 2 3 D p [-- i 40,94s Ste! �z - 2 / / 1IC2 16> i- PERCOLATION RATE: Ir� 1-2, RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: d ,j- RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: a SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Ok_ 0 Environmental e lth Officer COMMENTS: Rev. 5/31/84 2_�, — - Date EAGLE COUNTY BUILDING DIVISION P. O. Box 179 INSPECTION REQUEST Phone: 328-7311 BUILDING PERMIT NO. eVAPPROVED ❑ DISAPPROVED REINSPECT O Up<n the*-ollowing Corrections: r y�r DATE: TIME: NSPECTOR ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE - Name Date Routed o Application No. Location Please review the attached Individual Sewage Disposal System Permit Application and return it with this completed form the the Environmental Health Office. PLANNING: Complies with - YES NO REVIEWED BY DATE Subdivision Regulations: Zoning Regulations: ✓ Recommend Approval: f COMMENTS: BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: COMMENTS: YES NO REVIEWED BY DATE YES NO REVIEWED BY DATE /t:Q N(1 D171tTE71.1M RV nATG 1 LJ I.V 1\L Y 1L�\LV V I V111 L _5 $ APpm 3 a �►1 A S; tc, CK Cy* 912 Miller UU42 5aiz ureex Road JOB NAME- JOB NO._l �001-013 LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED AMARY losq T �. v i �O� Sw T Al"!(wD.! % OF SELLING PRICE o ) � j-, # / /ohl/: 7 NET PROFIT JOB FOWER Product 278 �e NEW .ENGLAt JOB FOLDER Printed in U.S.A.