HomeMy WebLinkAbout71 Deer Trail Ave - 239127102002 - 0915ISINDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
c� P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631
Tele
phone: 328-7311 or 949-5257 or 927-3823 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 915
Please call for final inspection before covering any portion of installed system.
OWNER: Robert P. Sewell PHONE: 963-3387
MAILING ADDRESS: 6333 Highway 133, Carbondale, Colorado 81623
AGENT: Splf PHONE:
SYSTEM LOCATION: Lot 23 Red Table Acres 0071 Deer Trail Avenue
LICENSED INSTALLER: Robert Sewell LICENSE NO. 011-89-I
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Leach field must not be installed within the 15' easement. 1000 gallon
minimum septic tank, 600� minimum leach field
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 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: (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: / ;� � (L GALLONS _ DEGREES Z-0 FEET
SEPTIC TANK CLEANOUT TO WITH_ IN 8" OF FINAL GRADE, OR:
PROPER MATERIALS AND ASSEMBLY Y NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: t ::::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: �l16'. -�/ DATE:
ENVIRONMENTAL HEALTH OFFICER: ATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT/AGENT: Robert P. Sewell
AMOUNT PAID: $ 275.00 RECEIPT #: 1167
PERMIT
OWNER: Same
CHECK#: 4682 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 1 PERCOLATION TEST FEE $125.00
NAME OF OWNER:
MAILING ADDRESS:
NAME OF APPLICANT (If different from owner):
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTEM (If applicable):
ADDRESS:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
LICENSED INSTALLER: ( ) YES ( ) NO
ADDRESS:
PHONE:
PHONE:
PERMIT APPLICATION IS FOR: ( f),,NE-VrINSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAE SEWAGE DISPOSAL SYSTEM:
Physical Address:
Parcel Number: Le ,3 Lot Size:
Legal Description: O'njo R ig4f) (` „ t yY.I IQe le'-A04_
BUILDING OR ERVICE TYPE (Check applicable category):
Residential - Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential- Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS: 3
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 IN9X(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 (,�PJO
WATER CONSERVATION PLAN: ( ) YES ( ) NO
NOTE: The Environmental Health Office may reduce the required absorption area upon
approval of an adequate water nservation plan.
SOURCE AND TYPE OF WATER SUPPLY: (Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied nby�community wat/ ive name of supplier:
SIGANTURE: Y� DATE: % . RV
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: lt,2,15 RECEIPT NUMBER (% 07
DATE:
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
(Environmental Health Dept. - Rev. 4/88)
COLORADO DEPARTfIENT OF HEALTH
ACCOMMODATIONS INSPECTION REPORT
la�re Co. Eagle County Acct. No. Category No.
.ocation 71 Deer Trail, Red Table Acres Zip
Iwner Address Zip
Iperator Address Zip
Inits Capacity Male Female Juv.
later, Source -Type Red Table Acres Sewage, Type -Method Septic Food Source
iwimming Pool
1n inspect'.on of the above noted facility on this date reveals the violations and deficiencies
Listed below which you are hereby ordered to correct:
Inspection at septic system on May 19, 1989, 11:15 a.m., excavation
for drain field, tank and field not ready for final inspection.
Please call when ready.
Erik Edeen 927-3823, extension 530
5-19-89
Datr3 Rocoiv@d By
ES:M D:E! (5--75-10)
Erik Edeen
-.,ted By
5vO 0
COLORADO DEPARTMENT OF HEALTH
ACCOMMODATIONS INSPECTION REPORT
dame
_
Co.Acct. No.
Category No.
_ocation
7l /jde�
�P 7 �G`'�-�
Zip
]wner
Address
Zip
3perator
Address
Zip
Jnits
Capacity
Male Female
Juv.
dater, Source-Typeet-Olta4e
AcrL5 Sewage Type -Method
Food Source
Swimming
Pool
Rn inspection of the above noted facility on this date reveals the violations and deficiencies
listed below which you are hereby ordered to correct:
er,--4 S3 b
Date
CPS:57
(5-75-10)
Received By
Inspected By
core
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County^
FEE: $125.00 ISDS APPLICATION NO. 2 3
OWNER: en.� t;2
LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING: /-., �_ NUMBER OF BEDROOMS:
DATE OF PERCOLATION TEST: `7- ZLr— % q TYPE OF SOIL
TEST HOLES PRE-SOAKED: YES k_ NO
TIME
I WATER DEPTH
,I INCHES OF FALL
RATE
11
2
3
1
2
3
1
2
3
1
2
3
It ,'3S
G
v
r
Z
l
PERCOLATION
RATE: / _s-
RECOMMENDED
MINIMUM SEPTIC TANK SIZE:
ri 61�1611
U
RECOMMENDED
MINIMUM LEACH FIELD SIZE:
RECOMMENDED
MINIMUM SQUARE FOOTAGE PER
BEDROOM:
0c
SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE.
Environmental Health Officer
COMMENTS:
Rev. 5/31/84
z s"- E �
Date
EAGLE COUNTY
BUILDING DIVISION
P. O. Box 179
Phone: 328-7311
INSPECTION. REQUESTsJs'"
BUILDING PERMIT NO.
DATE: JOB
NAME:
TIME ❑ AMt CALLER:
RECEIVED: ❑ PM
❑ OTHER: LOCATION:
❑ PARTIAL
r .
Ave -
Ready for Inspection: ❑ MONDAY ❑ TUESDAY ❑ WEDNESDAY ❑ THURSDAY N�IFRIDAY ❑ AM ❑ PM
COMMENTS:
a
0� APPROVED
DISAPPROVED
REINSPECT
fivupon the Following Corrections:
j�
moo,.
DATE: TIME iZ s hm
✓' f� �,i
€a 1? f INSPECTOR
x i
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
Name
Date Routed 1 1, Application No.
(Location) ins— -f-r,-, L Aj-c-- ,
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: iC_ iC3
COMMENTS:
BUILDING: Complies with -
Building Permit Applied For:
Building Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainaae:
Recommend Approval:
COMMENTS:
ENVIRONMENTAL HEALTH: Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Apy roval:
COMMENTS:
YES NO REVIEWED BY DATE
YES NO REVIEWED BY DATE
YES
NO
REVIEWED BY
DATE
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
ame
Date Routed
6j-123
Application No.
kLOca p on)
0071 Deer 7r t 1 40L
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: OE
Recommend Annroval: -5 fa G
COMMENTS:
BUILDING: Complies with -
Building Permit Applied For:
Buildina Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
YFS Nn RFVTFbJFn RY nATF
G--
( 11k
YES NO REVIEWED BY DATE
ENVIRONMENTAL HEALTH: Complies with - YES NO REVIEWED BY DATE
Floodplain Permit Necessary: X
I.S.D.S. Regs. Compliance:
Recommend Approval: x
COMMENTS:
JOB NAME
Lo-F -;,3 Af,,e� -00r�t
im��tJOB NO. q15
;JOB LOCATIQN
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
PERMIT # 915 INSURANCE
OWNER: Robert P Sewell SALES TAX
LOCATION: Lot 23, Red Table Acres MISC.COSTS
0071 Deer Trail Ave.
INSTALLER: SELF
SIZE OF TANK: 1000 gal.
DWELLING: 3 BEDROOMS
PERC RATE: 15 MPI
ABSORPTION AREA: 600 sq. ft. TOTAL JOB COST
FINALIZED: 8-18-89 BY: Mike Whitaker GROSS PROFIT
parcel #: 002-02-271-2391 LESS OVERHEAD COSTS
OF SELLING PRICE
NET PROFIT
✓LQGR Printed in U.S.A.
R.