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HomeMy WebLinkAbout24 Escalante - 239127302001 - 0941ISINDIVIDUAL 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. 941 Please call for final inspection before covering any portion of installed system. OWNER: Whitcomb R. Sterling PHONE: 927-4863 MAILING ADDRESS: Box 1218, Basalt, CO 81621 AGENT: PHONE: SYSTEM LOCATION: Lot 24, Aspen Mesa Estates LICENSED INSTALLER: Chris Preusch 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: 600 SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. AG SPECIAL REQUIREMENTS: / e'542 C��f i 7 ✓ G/f C.�� /��S %� 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 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 j�l(4d PRIOR TO COVERING ANY PORTION OF THE SYSTEM. �Q© ylof fe INSTALLED ABSORPTION OR �DIISPEERS�AL AREA: C� SQUARE FEET. INSTALLED SEPTIC It TANK: 0/'GALLONS DEGREES FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALSAND ASSEMBLY K YES NO COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: I_ YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED. COMMENTS: leff ENVIRONMENTAL HEALTH OFFICER: DATE: ®4 u 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 ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number: P. 0. BOX 179 EAGLE, COLORADO 81631 949-5257 Vail. 328-7311 Eagle 927-3823 Basalt PERMIT APPLICATION FEE $150.00 I PERCOLATION TEST FEE S125.00 NAME OF OWNER: MAILING ADDRESS: _80K I Ji S —BESAL � Ooz- 91bZ1 PHONE: NAME OF APPLICANT (If different from owner): ADDRESS: PHONE: DESIGN ENGINEER OF SYSTEM (If applicable): GWi�1S !PVE-U-54 ADDRESS: ASP-0 PHONE: g Z S- 3 R PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: C4121 S ()j2i�a_Sc14 LICENSED INSTALLER: YES ( ) NO ADDRESS: PHONE: 2 S- 3$ S 0 PERMIT APPLICATION IS FOR: (x) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: haqw, /45PEti- YVtlESEA eS'-Aj�E- "S CtrF2��(z BSc ,��� S��r2r2i+fis t Parcel Number: �,y 2Lot Size: // PL ES Legal Description: r_v T 2 4' BUILDI14G OR SERVICE TYPE (Check applicable category): Residential - Single Family ( ) Residential - Fourplex ( ) Residential - Duplex ( } Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: Is NUMBER OF BEDROOMS: WASTE TYPES Check a licable catevories : Commercial or Institutional ( ) Dwelling ( ) Non -Domestic Wastes ( ) Transient Use ( x) Garbage Disposal ()-f) Dishwasher ( 9) Automatic Washer ( ) Spa Tub ( ) Other (Specify): TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 7cSeptic 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: ( ) Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If supplied commini ty water, give name of supplier: tq5_ �) �Sr1 STtf~ S SIGNATURE: DATE: :;Z� & 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: /S Minutes per inch in Hole #1 0 Minutes per inch in Hole #2 n n 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: %5�� RECEIPT NUMBER �! gam_ DATE: NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. RECEIVED MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER". AUG 0 7 1989 (Environmental Health Dept. - Rev. 4/88) EAGLE COUNTY ow COMMUNITY DEVELOPMENT ROUTE FORM EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE % 1-7 �,Kq - Date Rou ed Application No. 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: rnmmFNTC BUILDING: Complies with - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: YES NO RFVIFWFn RY nATF (ES 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: 941 Sterling Lot 24 Aspen Mesa Estates 2391-273-02-001 JOB NAME JOB NO. JOB LOCATION 7" S F BILL TO DATE STARTED DATE COMPLETED DATE BILLED /4 LO� ? JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX PERMIT #: 941 OWNER: WHITCOMB R STERLING INSTALLER: CHRIS PREUSCH SIZE OF TANK: 1000 gal. DWELLING: 2 BEDROOMS PERC RATE: 12 ABSORPTION AREA: 600/200 LF of SB2 FINALIZED: 10-18-89 BY RPM,RS PARCEL NO.: 2391-273-02-001 S -AL JOB COST aROSS PROFIT 1s OVERHEAD COSTS u OF SELLING PRICE NET PROFIT JOB FOLDER Product 278 �® NEW ENGLAND BUSINESS SERVICE, INC., GF b I1 CdY O ( v. /c, V� / ( 1 i�e� S�GS / Printer! in U.S.A. 941 Sterling Lot 24 Aspen Mesa / 1� Estates 2391-273-02-001 JOB NAME JOB NO. inn nre-nnnr - BILL TO DATE STARTED DATE COMPLETED DATE BILLED !r/}o pl Q Ljck�m-) n JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE PERMIT #: 941 OWNER: WHITCOMB R STERLING INSTALLER: CHRIS PREUSCH SIZE OF TANK: 1000 gal. DWELLING: 2 BEDROOMS PERC RATE: 12 ABSORPTION AREA: 600/200 LF of SB2 FINALIZED: 10-18-89 BY RPM,RS PARCEL NO.: 2391-273-02-001 S , ", SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE NET PROFIT LOO/ JOB (W'tt' FOL®E R Printed in U.S.A. r--- Ay, AW Sca /e = /" a 20 ' Contour Interval- 2' t�k tip 1t� 10, ,o, / too 110 �/ PrbinO 10Z --� To fig/nf / ,� a0 fave,, Pole / f c� \� / 4 / �b �/ / Lot 24 �V) / e� TD Area 1 419 cis -� r Escalan to �5 ' Ro. w. ) rE�. - ry z r 1 � 302 � � •sue- / / l / $GQlC • /� s 5,0, f �/O `D/foh E5m I I RE Q. -7Z) q6A4-7-,q I I �� APPUCATIG'�% ti k ,74OF 1 /s L 1%, Legal Descriptinn - Lot 24, Aspen Mesa Estates - Amended First Filing, Eagle County, Colorado. I hereby certify that on may 15, 1939, a survey was performed by roc on the above described parcel of land. All eascmcnts, encroachments and righLs-of-way in evidence or known Lo use jrc shown. This survey is true and correct 'Lo the best of my knowledge and belli-J. 14'1"fi— `\\\\���;,uoo RE 4o��+,�ENT =p�N 14111 1: co. ; Partial TOpvgraP1VC 6urvey Lot 24 Aspen Mess Estates - .4mended Frsi Filing Eagle County, Colorado L INES /N SPACE SYDNEY L /NC/COME (L . S. /4//l) 80X 121 CARBONDALEL-CO_LORADO 81623 303- 963-355-9 DAT E: !8 A44U • 1989 1 S C A L F: I"= No1ed