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HomeMy WebLinkAbout19717 Hwy 131 - 168905300004INDIVIDUAL 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. 9.29 Please call for final inspection before covering any portion of installed system. OWNER: John Comer PHONE: 303-756-8202 MAILING ADDRESS: 3527 S Hudtnn, r)PnvPr, CO 80237 AGENT: (1 McCoy, SYSTEM LOCATION: 1971q Hi Way 131, McCoy, CO 80463 LICENSED INSTALLER: Owner LICENSE NO. DESIGN ENGINEER OF SYSTEM* INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: 1 nnn GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BEDS cSQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: c CX C ENVIRONMENTAL HEALTH OFFICER: DATE: 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: 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 A RE -INSPECTION WHEN WORK IS COMPLETED. COMMENTS: ENVIRONMENTAL HEALTH OFFICER: DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANTIAGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Number: 3303 ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P. 0. BOX 179 EAGLE, COLORADO 81631 evf 949-5257 Vail 328-7311 Eagle 927-3823 Basalt C. `PERMIT APPLICATION FEE $150.00 I PERCOLATION TEST FEE $125.00 NAME OF OWNER: MAILING ADDRESS: NAME OF APPLICANT (If different from owner): ADDRESS: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PHONE: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: ®W m (yx LICENSED INSTALLER: ( ) YES ( NO ADDRESS: PHONE: PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: Parcel Number: Lot Size: 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,i 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: () YES ( ) NO WATER CONSERVATION PLAN: ( ) YES ( ) NO NOTE: The Environmental Health Office may reduce the required absorption area upon approval of an adequate wat r conservation plan. SOURCE AND TYPE OF WATER SUPPLY: (l Well ( ) Spring ( Creek/Stream Give depth of all wells within 200 feet of system: N If suppii b om unity water, give name of supplier: SIGNATURE: `� � , �''� 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 FINAL DISPOSAL BY: Absorption Trench, Bed or Pit ( ) Above Ground Dispersal ( ) Under Ground Dispersal ( ) Other AMOUNT PAID: 1 6D RECEIPT NUMBER Minutes per inch in Hole #2 Minutes per inch in Hole #3 ( ) Evapotranspiration ( ) Sand "Fi 1 ter ( ) Wastewater Pond NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER". (Environmental Health Dept. - Rev. 4/88) DATE: RECEIVED J U N 2 9 1989 EAGLE COUNTY COMMUNITY DEVELOPMENT I APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number: 3291 P. 0. BOX 179 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: ���� C����tt2 MAILING ADDRESS: /,/I w 0 V l3 1 ��11 ��• PHONE: 6 S 3 — `f `I a S NAME OF APPLICANT (If different from owner): IKOW15 ADDRESS: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: LICENSED INSTALLER: ( ) YES (x ) NO ADDRESS: ow ,J 6 ,Z PHONE: PHONE: PHONE: PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: l'17/5 N."14 Is/ M'-(, 1) Parcel Number: Lot Size: Legal Description: BUILDING OR SERVICE TYPE (Check applicable category): '51—Residential - Single Family ( ) Residential - Fourplex ( Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: NUMBER OF BEDROOMS: WASTE TYPES Check applicable cateoories : Commercial or Institutional Dwelling ( ) Non -Domestic Wastes ( ) Transient Use (X) Garbage Disposal ( 5.�) 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 C�4 NO IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: (X) YES ( ) NO WATER CONSERVATION PLAN: (-)4) 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: ('() Well ( ) Spring ( } Creek/St r am Give depth of al wells within 200 feet of system: f z c7ci,, �ceC If supplied y o.,m *tyj1water, give name of supplier: SIGNATURE: DATE: INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope Depth to Bedrock (Per Depth to Groundwater SOIL PERCOLATION TEST RESULTS: 8' profile hole tahla 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: RECEIPT NUMBER DATE: CHECK NUMBER CAgHTFR- NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY.TREASURER". (Environmental Health Dept. - Rev. 4/88) JOHN D. COMER COUNSELOR AND ATTORNEY AT LAW 11039 EAST LANSING CIRCLE ENGLEWOOD, COLORADO 80112 TELEPHONE 799-8430 June 20, 1989 Mr. Eric Edeen County Sanitarian Eagle County Department of Community Development Eagle, CO 81631 Re: Waterwheel Ranch, McCoy Dear Mr. Edeen: Please accept the enclosed check in payment for my septic system permit. I intend to install a 1,000 gallon septic tank with 100 or more feet of leach line at 300 feet distance from the Colorado River. It is my understanding that these specifications equal or exceed the county requirements for a two -bedroom dwelling, with respect to treatment capacity and water quality. Your years of experience in Eagle County certainly qualify you to assess the absorption characteristics of the alluvial soils lying adjacent to the county's major water courses. This, and the fact that my building permit fees now approach one -thousand dollars, cause me to ask you to exercise your option to waive the percolation test together with the $125.00 charge for same.. Si cere y, John D. Comer JDC/par Enclosure RECEIVE® J U.4 2 3 1989 Ic_�o f©-23-89 AR EAGLE COUNTY c& 3054 RCpt• Pol COMMUNITY DEVELOPMENT DPP- 3Zq cum 33C�3 COMMUNITY DEVELOPMENT DEPARTMENT (303) 329-8-730 EAGLE COUNTY, COLORADO October 4, 1990 Dear Applicant: 725 CHAMBERS AVE. P.O. BOX 179 EAGLE. COLORADO 81631 FAX (303) 328-7207 Please be advised that this office will not be conducting percolation tests between November 15, 1990 and March 15,. 1991. Additionally, all final inspections on installed systems must be completed prior to December 1. If you have any questions, please call me at 328-8730 or 927-3823 ext. 730 in the Basalt/El Jebel area. Sincerely, Roger Hosea L Asst. Environmental Health Officer RH/alm ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE John Comer Name 6-30-89 3303 Date Routed 19719 Highway 131 McCoy, CO 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: COMMENTS• map!@ BUILDING: Complies with - YES NO REVIEWED BY Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: DATE (ES NO REVIEWED BY DATE ENVIRONMENTAL HEALTH: Complies with - VrQ pin DMITENJEM Rv nnTD Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: COMMENTS: /V &,A- � �.....i i.v n� Y 1 L'.'Y LLI L! 1 ✓� � L ,p,� ■ PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125.00 ISDS APPLICATION NO. OWNER: cS n L , LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DWELLING: e J NUMBER OF BEDRObA : Z DATE OF PERCOLATION TEST:' �'—�� TYPE OF SOIL: TEST HOLES PRE-SOAKED: YES X_ NO TIME I WATER DEPTH it INCHES OF FALL RATE 1 2 3 II 1 2 3 ►I 1 r 2 3 1 2 3 °Z L ;tl t 1 Z l /0 1 2 0 is II 1 3�p PERCOLATION RATE: RECOMMENDED MINIMUM SEPTIC TANK SIZE: (�(� RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: SITE HAS BEEN REVIE!•!ED AND TESTED FOR PERCOLATION RATE. �9�. Environmental Heal h Officer Date COMMENTS: Rev. 5/31/84 0929-89 TxPrcl# J0 3 NAME, 19719 Hiway 131, McCoy J013 NO. John Comer 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 lo TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT JOB FOLDER Product 278 NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 Printed in U.S,A JOB FOLDER R. i I