HomeMy WebLinkAbout999 Fender Ln - 239127202003 - 0914ISINDIVIDUAL 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. 914
Please call for final inspection before covering any portion of installed system.
OWNER: Robert Sewell PHONE: 963-338/
MAILING ADDRESS: 6333 Highway 133, Carbondale, Colorado 81623
AGENT: Self
PHONE:
SYSTEM LOCATION: Lot 3 Red Table Acres Filing 2
LICENSED INSTALLER?el f LICENSE NO.
DESIGN ENGINEEROFSYSTEM: Self
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1,000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Remember to call for final inspection before covering anything.
ENVIRONMENTAL HEALTH OFFICER: Erik W. Edeen DATE: June 8, 1989
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM
REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED /N 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 111, 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: SQUARE FEET.
INSTALLED SEPTIC TANK: GALLONS DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALSAND ASSEMBLY YES NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE ArRjE-INSPECTION WHEN WORK IS COMPLETED.
COMMENTS:
ENVIRONMENTAL HEALTH OFFICER: DATE:
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
APPLICANTIAGENT:
Robert P. Sewell
RETAIN WITH RECEIPT RECORDS
OWNER:
PERMIT
Same
AMOUNT PAID: $2/ 5.00 RECEIPT#: 1140 CHECK#: 4636 CASHIER: April Rusch
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. 0. BOX 179
EAGLE, COLORADO 81631
949-5257 Vail 328-7311 Eagle 927-3823 Basalt
PERMIT APPLICATION FEE $150.00 I PERCOLATION TEST FEE $125.00
NAME OF APPLICANT (If different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (If applicable):
ADDRESS:
PHONE:
PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
LICENSED INSTALLER: ( ) YES ( ) NO
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: ( ELJ INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address:
Parcel Number: 3 Lot Size:
Legal Description: A,!,n j P1 AWA_���g
BUILDING QR SERVICE TYPE (Check applicable category):
Residential Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential- Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS: s�
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 IN IDUAL 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 wate_rXonservation plan.
SOURCE AND TYPE OF WATER SUPPLY: (, ) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplie_dd.. by�.�comm community w ter, give name of supplier:
SIGANTURE: R� �°W _ DATE: � it
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
AMOUNT PAID: �ZI5.Do RECEIPT NUMBER 1140 C,C #41c_-3o DATE:a /
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
(Environmental Health Dept. - Rev. 4/88)
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
Name
Date Routed Application No.
Logati on
rA
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:
COMMENTS:
BUILDING: .Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
YES NO REVIEWED BY DATE
YES NO REVIEWED BY DATE
ENVIRONMENTAL HEALTH: Complies with -, YES NO REVIEWED BY DATE
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
COMMENTS: /' JV�t� ? t &%RN ! z1 d)ed gf,0 - ?111c;' alta) i , 's e.
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
FEE: $125.00
ISDS APPLICATION NO .2!5 0 l Z
OWNER:
66�
LEGAL D€5CRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING: �. �z /..�;� NUMBER OF BEDROOMS:
DATE OF PERCOLATION TEST: -S---,, S,�
TEST HOLES PRE-SOAKED: YES NO
TYPE OF SOIL:-���,��f
TIME
I WATER DEPTH 1I
INCHES OF FALL
RATE
i
2
3
1
2
3
2
3
1
2
3
t(
17
v'
��7
��'
2-0
7-
11 Z
PERCOLATION RATE: 1__>0
RECOMMENDED MINIMUM SEPTIC TANK SIZE: 1,0D
RECOMMENDED MINIMUM LEACH FIELD SIZE:
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: 2 p
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
sy
Environmental Health Officer Date /
COMMENTS: Cu /,,// �.��, %5�2cc r� 10 l4Le�—
Rev. 5/31/84
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
Kobe,N 5e ) e l l
Name
b-26-84 E►� IZZ
Date Routed DCPq Fender Application No.
Location
Lot 3, f ed Tobte, Acres
Please review the attached Individual Sewage Disposal System Permit Application and
return it with this completed form the the Environmental Health Office.
PLANNING: Complies with - YES NO REVIEWED BY DATE
Subdivision Regulations:
Zoning Regulations:
Recommend Approval:
COMMENTS:
BUILDING: Complies with -
Building Permit Applied For:
Buildina Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
ENVIRONMENTAL HEALTH: Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
COMMENTS:
YES NO REVIEWED BY SATE
YES NO REVIEWED BY DATE
irc n1n DCVTC111Cn RV nATC
EAGLE COUNTY
BUILDING DIVISION
P. O. Box 179
Phone: 328-7311
INSPECTION REQUESTSep 7 C #
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FBI `
BUIL 9b. �'��d
JOB
NAME:
AMA CALLER:
DATE:
TIME �Cy� B
RECEIVED: Li I ❑ PM
;,'`'APPROVED ❑ DISAPPROVED
q Upon the Following Corrections:
r�
DATE: TIME:
r I:
r- yam. �✓1
s� ; t r ;•
g fi_Y1$ r INSPECTOR
JOB NAME
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
PERMIT #: 914
OWNER: Robert Sewell
LOCATION: Lot 3 Red Table Acres, Filing II
INSTALLER: Self
SIZE OF TANK: 1250 gal.
DWELLING: 3 Bedrooms
PERC RATE: 20 MPI
ABSORPTION AREA: 19'X35'
FINALIZED: 09-15-89 BY: Michael Whitaker
PARCEL#: 2391-272-02-003
cD-- JOB NO. /
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
"ODDER Printed in`U.$A.