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Home My WebLink About258 Escalante - 239127206002 - 0949ISINDIVIDUAL 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. 949 Please call for final inspection before covering any portion of installed system. Robert Sewell 963-3387 OWNER: PHONE: MAILINGADDRESs:6333 Hwy. 133, Carbondale, CO 81623 AGENT: PHONE: SYSTEM LOCATION: Lot 16, Aspen Mesa Estates LICENSED INSTALLER: owner LICENSE NO. 011-89-1 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. SPECIAL REQUIREMENTS: 600 sq. ft. leach field minimum. ENVIRONMENTAL HEALTH OFFICE DATE: OQ �� Of CONDITIONS: 1. ALL INSTALLLAT ONS MUST COMPLY WIT ALL RE NTS OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS, ADOPTED PURSUANT TO ORITY 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: v 00 SQUARE FEET. INSTALLED SEPTIC TANK: 1660 GALLONS DEGREES FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: ah,I PROPER MATERIALS AND ASSEMBLY e YES NO COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: 1-1( 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: d� ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: T 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 $125.00 NAME OF OWNER: MAILING ADDRESS: 3 3 3., �� ) 3 �U� �H0NE .3 - 3 W2 NA11E OF APPLICANT (If different from owner): ADDRESS: PHONE: DESIGN ENGINEER..OF,SYST-EM (If applicable): ADDRESS•` PHONE: PERSON RESPONSIBLE FOR INSTALLAT O YSTEM: LICENSED INSTALLER: ( YES ( ) NO ADDRESS: PHONE: PERMIT APPLICATION IS FOR: (6) NEW INSTALLATION ( ) ALTERATION' ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: n -� Physical Address: C..o i Parcel Number: l_or l!o Legal Description. BUILDING OR_,Q.ERVICE TYPE (Check applicable Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: t Size: category): ( ) Residential - Fourplex ( ) Commercial (Type) 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 INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: Septic Tank' Composting Toilet ( ) Incineration Toilet ( ) Vault Prifvy`( ) Greywater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Portable Use ( ) Other %( ) Recycl i ng, Other Use WILL EFFLUENT BE DISCHARGED'DIRECTLY INTO WATERS OF THE STATE: ( ) YES ( 4-M 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 Giv,ee depth of all wells within 200 feet of system: If supplied by comm ity w ter, giv name of supplier: SIGNATug i s�Q,,� DATE: 8� �I-NFORMATION 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 ?� J 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: 142 RECEIPT NUMBER y DATE: `------ rurry hmmoCD !-Zl < rOCNTFR• 77 MAKEALL NOTE TE:PLAN MUST BE PAYABLE~TO: "EAGLE COUNTY TREASURER". TO APPLICATION. RECEIVED 000 S E P 12 1989 (Environmental Health Dept. - Rev. 4/88) c6- / ERA; LE COUNTYG 00 5� CO�v��l�NITY DEVELOPMENT D011TC Cl1W EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE Na h Date Ro to d Applicatia, N-locatign)- 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 - Building Permit Applied For: Building Permit Issued: Recommend Approval: COMMENTS: ENGINEER: Complies with - Roads: Grading: Drainage: Recommend Approval: COMMENTS: ENVIRONMENTAL HEALTH: Complies with - Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: COMMENTS: YES NO REVIEWED BY DATE YES NO REVIEWED BY DATE YES J NO ; REVIEWED BY TE FEE: $125.00 OWNER: 18n 4 LEGAL DESCRIPTION: RURAL ADDRESS: PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County L0 X 16 x ISDS APPLICATION NO. TYPE OF DWELLING: NUMBER OF BEDROOMS:_ -�9 t - 7 r s _ - 6 DATE OF PERCOLATION TEST: // ✓ -TYPE OF SOIL: E V . TEST HOLES PRE-SOAKED: YES NO �� Cry .lG, TIME WATER DEPTH aI INCHES OF FALL RATE 1 2 3 I 1 2 3 II 1 2 3 11 1 2 3 3S ; 3 "L/ 341-f II 3 t� I i II I I .. PERCOLATION RATE: ];—, ) �= &L RECOMMENDED MINIMUM SEPTIC TANK SIZE: RECOMMENDED MINIMUM LEACH FIELD SIZE: RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: SITE HAS BEEN REVIEWED AND TESTED FOR PERCOLATION RATE. Environmental Health Officer Date COMMENTS: Rev. 5/31/84 EAGLE COUNTY BUILDINGSIGN P. O. Boxx179 INSPECTION REQUEST 179 Phone: 328a311 BUILDING PERMIT NO. COMMENTS: 949 Sewell Lot 16 Aspen Mesa JOB NAME Estates %(��3 j (- 027' d�' UUa JOB NO. G�2 JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX PERMIT #: 949 S"ATO r �ilZ OWNER: ROBERT�,SEWELL M,t\T: LOCATION: Lot 16, Aspen Mesa Estates INSTALLER: OWNER -- '" B COST SIZE OF TANK: 1000 gallon woZS DWELLING: 3 Bedroom PROFIT PERC RATE: 20 MPI ABSORPTION AREA: 600 sq. ft. EAD COSTS FINALIZED: 11-09-89 BY: RM LING PRICE PARCEL NO. 2391-272-06-002 PROFIT JOB FOLDER Product 278 �® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 014 Printed in U.S.A. -7 99 K Ve L Ivp A r L LCT ao p I-- li ct t- ..-,5'r AT P -S L e sT' T- P, 1/0$ P P tihv 6 1,4 uk) I do C, 71L RECEIVED S E P 12 1989 EAGLE COUNTY' COMMUNITY DEVELOPMENT