HomeMy WebLinkAbout34900 Colorado River Rd - 168701401002INDIVIDUAL 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. 930
Please call for final inspection before covering any portion of installed system.
OWNER: Donald L Slater PHONE: 303-653-4493
PO Box 219, Gypsum, CO
MAILING ADDRESS:
AGENT: Self 1 PHONE:
SYSTEM LOCATION: 341-65 Colorado RIyer Rid
LICENSED INSTALLER: LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. D (®
SPECIAL REQUIREMENTS: (�00
® 6 _ � 8
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 /11, 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 MATERIALS AND ASSEMBLY YES NO
COMPLIANCE WITH COUNTYISTATE 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
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT R: CHECK N: CASHIER:
APDT TCATZIC' FOR-•.••i.�.,AL SF'.�AGF DICP'ISAL 'C- Fr.T.-(T...
PER`•fIT A.PPI.IC<'.TION FEE:
NAME OF 01.'\ER:
ADDRESS:
ENVIRO.NNENTAL HEALTii OFF ICE - EAGLE COUNT`:'
P.O. 20M ,S30
Eagle, Colorado 51631 `:o.
S150.00 328-7311 PFRCOL%TIO`. TEST FEE: $125,00
NkME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTE21. (if applicable) :
ADDRESS:
P'Lr ,;LJ 1:,:;, V�'- 1jj Al. IivS ALL.-MON OF SYSTEM:
. Licensed Installer (see attached list).
• S4Cre, F,1 64fip7- � 4,-I
- PHONE: . 3 3 Y T9 3
m
PHONE:
11
14
p / PHONE:
YES v0
ADDRESS:
PHONE:
PERMIT APPLICATION IS FOR: New Installation
( )
Alteration ( ) Repair
LOCATIO`' OF PROPOSED INDIVIDUAL SET•TaGE DISPOSAL SYSTE:-I:
Street/Rural Address: 37/7-T C0109-Ar O
Lot Size: 33
Legal Description:
BUILDI`;G OR SERVICE TYPE (check apolicable cate^orv)•
Residential - Sir. -le Family
( )
Residential - QuadDlex
( ) Residential - Duolex
( Residential
( )
Co.--::ercial (state usage)
) - Tr:-?lex
NUi1BER OF PERSONS: 3
NUMBER OF BEDROO.1S: �..
WASTE TYPES (check applicable (
( ) Co«:..:ercial or Institut
(
Dwell(
) Non -Domestic Wastes
( ) Garbage
( )
Transing
Transient Use
Disposal
( )
Dishwasher
( ) Automatic Washer
( )
Spa Tub
( ) Other
`TYPE OF INDTVIDUAL SET -.AGE DISPO! _ --
( ) Septic Tank ( ) Corposting ToiletL.
( )
Incineration Toilet
( ) Vault Privy ( ) Greywater
OO
Chemical Toilet (-M" P02AQ,/)
( ) Pit Privy ( ) Aeration Plant
( )
Rec}•c_ing, Potable Use
( ) Other
( )
Recycling, Other Use
WILL EFFLUENT BE DISC:i.A-RGED DIRECTL`i INTO ?!=RS OF THE STATE: YES ( ) NO (�
IS SYSTc I DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES (:) NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO (-\4 )
(16 Yes, see atLa.ched tc�Ls.L ex Ltet S.Zelo Aeductc:on ,ne;dtcds )
NOTE: The EnvZio;vne;Ltatr-_' Hea't,U;t O H.i CCA� mat reduce the •teou,�,.ed abs e%LptLon a.tea upon
QpptUVQr? U6 an adequate CcaS tr'yi'at e 5CLt1 .teduCtCOiI pZaii.
SOURCE AND TYPE OF WATER SUPPLY: 49') Well
( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system: zoo �
If suppli—ad by community water, give name of supplier:
-
SIGNATURE_-Z-(-
-L�
DATE_
INFOR�fATICN
BELOW TO
- - - -
BE FILLED CUT BY ENVIROWIENTAL
-%/
- - - - - - - - - - - - - - -
HEALTH OFFICER:
GROUND CONDITIONS: Pe,,ceent G.tou;id Slope
r Depth to Bedto ch ( pen 8' P•to S �ee Hole)
Depth to Grtoundtca.tet TabZe
SOIL PERCOLATION TEST RESULTS:_ A{.ututcs peA .c.n6t in Ho,.e n 1
Minutes peJr inch to Haee # 2
%i (itu,tc s pe% iiLck tiu Ho-Ce 03
FINAL DISPOSAL BY: -
( ) Abs o•rptLoi'! T,tench, Bed o.t Pit
( ) Above Gneund DZs pe ma t
( ) Undetg•tound Dispvusae
( ) Fvapott'trutsp•vtati.on
( ) Sand Erect
Pond
Amau;it Pacd: Reee�pt Nu1:;be.t �� DcLt2: — 9—O
NOTE: Site Plan must be attached to -application.
(Env. Health Department - Rev. 4-07-83)
EAGLE COUNTY ENVIRONI.MENTAL HEALTH OFFICE
Name j -
Ll-
Date Routed
3�►g
Location
App 1Gti�onVo
Please rev.ie:-i the attached Individual Se.•iage Disposal System Permit Application and return
1+ ...-:4-L, t1-2- _
he Environmental Health Office.
YES -NO .REVIE 417D BY
DATE
BUILDING: Complies with - YES I NO I REVIE!!ED 6Y DATE I
Building Permit Applied For:
Building Permit Issued: I I
- -- _Recommend Approval: I -
/02
_
I -
�vn �
A10,1� Roads
- ---- -- rading:
Drainage:
Recommend Approval:
COMMENTS:
ENVIROIT iENTAL HEALTH:
Complies with -
Floodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
C0: 1ENTS:
YES
YES
Kel
NO
REVIE FED BY
REV I E14ED BY
DATE
DATE
November 15, 1989
To: ISDS File NO. 930
From: Raymond P. Merry, RSX
RE: Status of ISDS Permit 11 0 7sued to Dan Slater in 8/89
A telephone conversation with Jackie Slater on November 15, 1989
revealed that the septic system was installed and covered by
Herman Hogue, son-in-law of Ken Schultz. When they called for a
final inspection, Erik asked if the installer could photograph
the installation when completed and gave the approval to cover.
No photographs were found in the file so I asked if Mr. Slater
could track down the photos and send them to me. This file
should be placed in the "completed" file for future reference.
FEE: $125.00
OWNER: jL
LEGAL DESCRIPTION:
RURAL ADDRESS:
TYPE OF DWELLING:
PERCOLATION TEST
ENVIRONMENTAL HEALTH DEPARTMENT
Eagle County
ISDS APPLICATION NO.
NUMBER OF BEDROOMS:
DATE OF PERCOLATION TEST: — �� % TYPE OF SOIL:
TEST HOLES PRE-SOAKED: YES NO
TIME II
WATER DEPTH - 1)
INCHES OF FALL
RATE
1
2
3 it
1
2
1 3 ►i
1
. 2
3
1
2
3
I
PERCOLATION RATE: 6— /,-/ r".
RECOMMENDED MINIMUM SEPTIC TANK SIZE: l v 7— — & vt
RECOMMENDED MINIMUM LEACH FIELD SIZE: d�
RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: / f��'� S ��
SITE HAS BEEN REVIEINED AND TESTED FOR PERCOLATION RATE.
gu�lq
Environmental Health Of icer Date
COMMENTS:
Rev. 5/31/84
930 Slater 34185 Co River
I
JOB NAMI Road
JOB NO.
JOB FOLDER Product 278 iW@ NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER