HomeMy WebLinkAbout525 Paseo - 239127302009 - 0948ISINDIVIDUAL 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. 948
Please call for final inspection before covering any portion of installed system.
OWNER: Robert Sewell _ PHONE: 963-3387
MAILING ADDRESS: 6333 Hwy. 133, Carbondale, CO 81623
AGENT: PHONE:
SYSTEM LOCATION: Lot 12, Filing I, Aspen Mesa Estates
LICENSED INSTALLER: owner _ LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: 800 sq. ft. drain field
ENVIRONMENTAL HEALTH OFFICER: DATE: _ i
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
PRIOR TO COVERING ANY PORTION OF THE SYSTEM.
INSTALLED ABSORPTION OR DISPERSAL AREA: I� 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 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:
w DATE:
ENVIRONMENTAL HEALTH OFFICE — ?
_
ENVIRONMENTAL HEALTH OFFICER: _ DATE:
(RE -INSPECTION ECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT C-2`��
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 PERCOLATIONd TEST FEE $125.00
n
NAME OF OWNER:
MAILING ADDRESS: to 33 141vsd1 0 tbi2KtFCPeONE: & 3 -
NA14E OF APPLICANT (If different from owner):
ADDRESS: PHONE:
DESIGN ENGINEER OF SYSTEM (If applicable):
ADDRESS: PHONE:
PERSON RESPONSIBLE FOR INSTALLAT OF SYSTEM:
LICENSED XNSTALLFmV1 ( YES ( ) NO
ADDRESS: 0 1 ) W / PHONE:
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address:
Parcel Number: 7- Lot ize:
Legal Description: (I JN0nn M 4-"A w 19>A LA ®__
BUILDING 05,1�_ERVICE TYPE (Check applicable category).
Residential - Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential - Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS: 7
WASTE TYPES Check applicable categories).
Commercial or Institutional ( nwelling
( ) on -Domestic Wastes ( ) Transient Use
( arbage Disposal ( ) Dishwasher
( automatic Washer ( ) Spa Tub
( ) Other (Specify):
TYPE OF I UAL 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 water co ervation plan.
SOURCE AND TYPE OF WATER SUPPLY: ( ll ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by communit water ive name of supplier:
SIGNATURE: y4d�z-1 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
Minutes per inch in Hole #2
(6 2� d3� 1 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 q
AMOUNT PAID: 'Z7 5—, 6)C) RECEIPT NUMBER r,Z` DATE: 1 7/
/^IIr PI/ ♦11 I..n rn !'�. / i nnf`IITrn_ 11111. Q
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION.
RECEIVED
E ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER".
(Environmental Health Dept. - Rev. 4/88)
S F P 2 7 1989
FA cl E. C.10JUNTY
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
Date: April 16, 1990
Robert Sewell
6333 Hwy 133
Carbondale, CO 81623
Re: Final of ISDS Permit No. 948
This letter is to inform you that the above referenced
ISDS Permit has been inspected and finalized. Enclosed is a copy
to retain for your records. Also enclosed are informational
sheets regarding the care of your septic system.
If you have any questions regarding this permit, please
contact the Eagle County Environmental Health Officer, P.O. Box
179, Eagle Colorado 81631. Or we can be reached from Vail/Avon
949-5257; Basalt/El Jebel 927-3823; Eagle area 328-7311, indicate
extension 530 after reaching the County Operator.
Sincerely,
l� S
Raymo,P. Merry, RS
Environmental Health Of i`er
encl: Information Sheets --
ISDS Permit
xc: ISDS File No.
BP File
Chrono File
Board of County Commissioners Assessor Clerk and Recorder Sheriff Treasurer
P.O. Box 850 P.O. Box 449 P.O. Box 537 P.O. Box 359 P.O. Box 479
Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICEL'�
�-•i l 1 1 Name
.Date Routed t O� 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•
BUILDING: Complies with - YES NO REVIEWED BY
Building Permit Applied For:
Buildina Permit Issued:
Recommend Approval:
COMMENTS:
ENGINEER: Complies with -
Roads:
Grading:
Drainage:
Recommend Approval:
COMMENTS:
ENVIRONMENTAL HEALTH: Complies with -
Fl_oodplain Permit Necessary:
I.S.D.S. Regs. Compliance:
Recommend Approval:
COMMENTS:
DATE
YES NO REVIEWED BY DATE
YES NO 3EVIEWED BY DATE-
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948 Sewell Lot 12 Filing 2
JOB NAME_ Aspen Mesa Estates JOB NO.
2391-273-02-00915a5 pir5o Dkivg
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
PERMIT # 948IWO
OWNER: Robert -Sewell S�Z Hgt t�-
LOCATION: Lot 12, Filing I,Aspen Mesa Estates
INSTALLER: self
SIZE OF TANK: 1000 gal. 0TS2S%c-i--0
DWELLING: 3 bedroom
PERC RATE: 20 mpi
ABSORTION AREA: 1000 sq. ft.
FINALIZED: 4/16/90
PARCEL #:
BP# 4202
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DECEIVED
S E P 2 7 1989
EAGLE COUNTY
COIF"; MU II T Y DEVELOPMENT
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