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HomeMy WebLinkAbout332 Escalante - 239127206010 - 0963ISINDIVIDUAL 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. 9.63 Please call for final inspection before covering any portion of installed system. OWNER: Bob s€w€11 PHONE: Q63=32R7 MAILING ADDRESS: 6333 Hwy. 133, Carbondale, CO 81623 AGENT: PHONE: SYSTEMLOCATION: 0332 Escalante. Lot 18, Filing I, Aspen Mesa Estates LICENSED INSTALLER: owner LICENSE NO. DESIGN ENGINEER OF SYSTEM, INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: 1 OQO GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: 975 SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS:T_Led. ENVIRONMENTAL HEALTH OFFICER: DATE: CONDITIONS: 1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED /N 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: —IP SQUARE FEET. jj INSTALLED SEPTIC TANK: �,) GALLONS ZO DEGREES -2) FEET <—' SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS AND 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: oe ENVIRONMENTAL HEALTH OFFICER: /\ DATE: ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF ESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number: EAGLE, COLORAD01781631 �•� ( !� 949-5257 Vail 328-7311 Eagle 927-3823 Basalt PERMIT APPLICATION FEE $150.00 PERCOLATION) TEST FEE $125.00 NAME OF OWNER: IJp s Q wV_ L` MAILING ADDRESS: —NAME OF APPLICANT (If different from owner): ADDRESS: DESIGN ENGINEER OF SYSTEM (If applicable): ADDRESS: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: LICENSED INSTALLER: ( ) YES ( ) NO ADDRESS: ONE: ?(6 ,3 -.3.� erg% PHONE: PHONE: PHONE: PERMIT APPLICATION IS FOR: ( L,)NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Physical Address: Parcel Number: Lot Size: #?Oat I Legal Description: BUILDING OR VICE TYPE (Check app icable category): Residential - Single Family ( ) Residential - Fourplex ( ) Residential - Duplex ( ) Commercial (Type) ( ) Residential - Triplex NUMBER OF PERSONS: NUMBER OF BEDR0OMS: WASTE TYPES Check applicable categories): Commercial or Institutional ( ) Dwelling Non -Domestic Wastes ( ) Transient Use ( Garbage Disposal (L--�'"Dishwasher ( -1 -Automatic Washer ( ) Spa Tub ( ) Other (Specify): TYPE OF INDI DUAL 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 "-"N0 IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: (; YES j� �fd WATER CONSERVATION PLAN: ( ) YES ( CAO NOTE: The Environmental Health Office may reduce the required absorption area upon approval of an adequate water copervation plan. SOURCE AND TYPE OF WATER SUPPLY: ( Well ( ) Spring ( } Creek/Stream Give depth of all wells within 200 feet of system: 41RP If supp led by comm u ity wate , give name of supplier: SIGNATURE: DATE:_ INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: Percent ground slope 10 b Depth to Bedrock (Per 8F profile hole) 7 8 Depth to Groundwater table >g SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole #1 3o Minutes per inch in Hole #2 ga Minutes per inch in Hole #3 FI AL DISPOSAL BY: Absorption Trench, Bed or Pit ( ) Evapotranspiration Above Ground Dispersal ( ) Sand Filter ( ) Under Ground Dispersal ( ) Wastewater Pond ( ) Other AMOUNT PAID: r9 RECEIPT NUMBER DATE: 1 � CHECK NUMBER .21 CASHTr NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION. MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" (Environmental Health Dept. - Rev. 4/88) PERCOLATION TEST ENVIRONMENTAL HEALTH DEPARTMENT Eagle County FEE: $125.00 ISDS APPLICATION NO. OWNER: LEGAL DESCRIPTION: L-a lff�1.�s� ems% RURAL ADDRESS: S S E::� J"c c, /r r s TYPE OF DWELLING: NUMBER OF BEDROOMS: 3 DATE OF PERCOLATION TEST: il lqo TYPE OF SOIL: TEST HOLES PRE-SOAKED: YES NO 3 % ✓)" TIME �I WATER DEPTH Ii INCHES OF FALL RATE 1 2 3 II 1 2 3 111I —1 2 3 1 2 3 v aor"p} 362 3 f ��� y a , S `a -� 3 I 3 - -10/w ff 3 ` Ss" ,�_• s � a� _ems".� D :0 oil PERCOLATION RATE: 3O /1/0 RECOMMENDED MINIMUM SEPTIC TANK SIZE: 0 0 0 RECOMMENDED MINIMUM LEACH FIELD SIZE: 9 7.�s Pc�`)"7 "f RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM: 02 s < SITE HAS BEEN REVIEIHED AND TESTED FOR PERCOLATION RATE. /Ar.) Environmental He h ider Date COMMENTS: Rev. 5/31/84 ROUTE FORM -� EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE ©�j Name A-X 0 � J� ate poutedLlr - a33a=s�et��qe Application No. Locati n A S, Please review the attached Indi{ridual 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: // �/y 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: YES NO REVIEWED BY,/ DATE YES NO REVIEWED BY DATE ENVIRONMENTAL HEALTH: Complies with - YES Floodplain Permit Necessary: I.S.D.S. Regs. Compliance: Recommend Approval: COMMENTS /7�� ��®S . � l4._- ,I'l ,4�11, NO REVIEWED BY , as .l 75 II e p o Sri 44; CIS 1 8 336. r I NOTE: Contour interval = 2 feet. Legal Description: Lot 18, Aspen Mesa Estates Amended, First Filing, Eagle County, Colorado. /o / 336. r, � I NOTE: Contour interval = 2 feet. Legal Description: Lot 18, Aspen Mesa Estates Amended, First Filing, Eagle County, Colorado. R EG/ yr 1.. O°•eaee 1� rt� 14111 m, . Vep°emeo°ems L I L P'a1v`���,, Cyr . cc, cA. "A I cc, It) BY' LIMES /N S ACE SYDNEY L/NC/COME (L.514111) BOX 121 CARBONDALE COLO. 303-963-3852 29 c2_'Yt 0 1 SCALE:I"= (=,O' 'Sepr)(c, Lor mAl'u'll 0 1 1990 EAGLE COUNTY COMMUNITY DEVELOPMENT 963 Sewell loot 1S Filing I JOB NAME_ Aspen Mesa Estates 033 Escalante 5ql -a?a "0& -O, JOB NO. G'0 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 I t 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 JOB. FOLDER Printed 10 U.S.A.