HomeMy WebLinkAbout389 Green Mountain Dr - 210904202003INDIVIDUAL 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. 981
Please call for final inspection before covering any portion of installed system.
OWNER: GMAC Financing- Martha Wolfe PHONE. 328-1085
MAILING ADDRESS: Eagle
AGENT: PHONE:
SYSTEM LOCATION: 0`3�8�9Green Mountain Drive, Lot 43, Filing #2 Kaibab Subdivision
LICENSED INSTALLER: LICENSE NO.
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
12SO -. GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED 780 SQUARE FEET OF TRENCH BOTTOM. or 260' of 10" S132
SPECIAL REQUIREMENTS:
ENVIRONMENTAL HEALTH OFFICER: - e^f DATE: / C/
CONDITIONS:
1. ALL INSTALL4 S MUST COMPLY WITH ALL REQUIRE ENTS 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. p
INSTALLED ABSORPTION OR DISPERSAL AREA: 72S O SQUARE FEET. 62(0
J �s
INSTALLED SEPTIC TANK: or Q GALe)1LONS DEGREES FEET - 54
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALS AND ASSEMBLY X YES NO
COMPLIANCE WITH COUNTYISTATE REGULATION REQUIREMENTS: X YES NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS COMPLETED.
COMMENTS:
C+- A
ENVIRONMENTAL HEALTH OFFICER: DATE: /
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
1010,14: it
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
_APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 9 f
y ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY Number:
P. 0. BOX 179
EAGLE, COLORADO 81631
949-5257 Vail 328-7311 Eagle 927-3823 Basalt
P nr�?Cnj_ATTnni TEST FEE a , �� , nr_0 PERMIT APPLICATION FEE $150.00 ! j
NAME OF OWNER: &174C`yi,-W7A- ,t GUM, -
MAILING ADDRESS:PHONE:
NAME OF APPLICANT (I—d4ferent from owner) : U� 5�W-4-1
ADDRESS: &- 6?! fe PHONE: 3 ;' 722v
DESIGN ENGINEER OF SYSTEM (If applicable): e_ rp;va2�,
ADDRESS: PHONE: 523-732T
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM:
LICENSED INSTALLER: ( ) YES ( ) NO
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION ( ) ALTERATION {) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Physical Address: 9 Ow M,7wv. 0/2/VY-
Parcel Number: Lot Size:
Legal Description: F�11";02 AIIAMW6
BUILDING OR SERVICE TYPE (Check applicable category):
Residential - Single Family ( ) Residential - Fourplex
( ) Residential - Duplex ( ) Commercial (Type)
( ) Residential - Triplex
NUMBER OF PERSONS: NUMBER OF BEDROOMS:
WASTE TYPES Check applicable categories):
Commercial or Institutional ( ) Dwelling
( ) Non -Domestic Wastes ( ) Transient Use
( ) Garbage Disposal ( ) Dishwasher
(X ) Automatic Washer ( ) Spa Tub
( ) Other (Specify):
TYPE OF INDIVIDUAL 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 conservation plan.
SOURCE AND TYPE OF WATER SUPPLY: ( ) Well ( ) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system: 4i A
If supplied by community water, give name of supplier: OF y 'e
;�
SIGNATURE: DATE: �T 0
,17
INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: Percent ground slope 2 0
SOIL
Depth to Bedrock (Per 8' profile hole)
Depth to Groundwater table 7X
PERCOLATION TEST RESULTS: / o 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 o `sue 4
AMOUNT PAID: IPT NUMBER
c/ CHECK NUM ER '77
NOTE: SITE PLAN MUST BE ATTACAD TO APPLIC9 ON.
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
(Environmental Health Dept. - Rev. 4/88)
ROUTE FORM
EAGLE COUNTY ENVIRONMENTAL HEALTH OFFICE
Names��// �� �VI
Ro ted ! r-08 ( W-&,. V8). 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 -
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 NO REVIEWED BY DATE
Floodplain Permit Necessary:-44
r
I.S.D.S. Regs. Compliance:
RecommendApproval:
COMMENTS:
Ao Cl"'�— 790s4'�,�07
r
COMMUNITY DEVELOPMENT
DEPARTMENT
(3031) i28-$'10
EAGLE COUNTY, COLORADO
January 14, 1992
Martha Wolfe
P. O. Box 554
Eagle, CO 81631
500 BROADWAY
P.O. ROX I _19
EAGLE. �:OLORADO 3163 I
FAX(,O:i)S-7'07
Re: Water supply and sewage disposal (information/inspection)
for property located at:
0389 Green Mountain Drive
Lot 43 Filing #2 - Upper Kaibab Subdivision
Eagle, CO 81631
Dear Ms. Wolfe:
All loan inspections are completed under the authority of the
Eagle County Building Resolution, Section 3.09.03, A(7),
adopted by the Eagle County Commissioners on October 8, 1985.
On January 6, 1992, this department conducted a site
inspection of the above referenced property. -The inspection
was requested by you for the purpose of evaluating the
existing condition of the on -site wastewater disposal and
water supply systems.
A review of the County records indicates that:
On J 5;- 19"JO;W t e -se a disposal system was permitted
un r Permit Number 981, i pected and approved in accordance
with Coun ewage Disposal Regulations. The
system consists of a 1250 gallon septic tank and 780 square
feet of absorption area (through utilizing 260 lineal feet of
10" SB2 piping). A visual inspection of the ground surface
indicated that the system is apparently functioning
satisfactorily at this time. Obviously, this does not
guarantee the continued satisfactory performance of the
system.
The water supply to this residence is from the Town of Eagle,
a community water system. The community water system is
inspected on a regular -basis by the Colorado Department of
„1
m
Martha Wolfe
January 14, 1992
Page Two
Health and to the best of our knowledge complies with current
drinking water standards.
If you have any further questions concerning this inspection,
please feel free to call me at 328-8730 or write.
Respectfully Submitted,
� toy /�iaY /i/%Grrc/
Zyymrond Merry, R.E.H.S /
Environmental Health Officer
Department of Community Development
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EAGLE COUNTY
,JJl Uluauway
Eagle, Colorado 81631
May 22, 1990 (303) 328 7311
Mart a Wolfe
Box 1221
Eagle, CO 81631
Re: Water supply and sewage disposal inpsection-for property
ocated at: 0389 Green Mountain Drive
Lot 43-Filing )#2-Upper Kaibab Subdivision
Eagle, CO 81631
Dear Ms. Wolfe:
All loan inspections are completed under the authority of the
Eagle County Building Resolution, Section 3.09.03, A(7),
adopted by the Eagle County Commissioners on October 8, 1985.
On May 22, 1990, this department conducted a site inspection
of the above referenced property. The inspection was
'requested by you for the purpose of evaluating the existing
condition of the on -site wastewater disposal and water supply
systems.
A review of the County records indicates that on September
21, 1976, the sewage disposal system was permitted under
Permit Number 125, inspected and approved in accordance with
County Individual Sewage Disposal Regulations. The system
consists of a 1250 gallon septic tank and 1000 square feet of
aj..)0rPL_LulJ area. H visual inspection of the ground surface
indicated that the system is apparently functioning
satisfactorily -at this time. -obviously, this inspection does
not guarantee the system's continuous satisfactory
performance.
The water supply to this residence is from the town of Eagle,
a community water system. The community water system is
inspected on a regular basis by the Colorado Department,of
Health and to the best of our knowledge complies with current
drinking standards.
If you have any further questions concerning this
please feel free to call me at 328-7311, Ext. 530,
Respectfully Submitted,
Ra nd P. Merry,
Environmental Heal Officer
Board of Co &9nKjsj8jerPF C%WJWITY DEVF&Q1?9WVeoorder
P.O. Box 850 P.O. Box 449 P.O. Box 537
Eagle, Colorado 81631 Eagle, Colorado 81631 Eagle, Colorado 81631
inspection,
or write.
Sheriff
P.O. Box 359
Eagle, Colorado 81631
Treasurer
P.O. Box 479
Eagle, Colorado 81631
EAGLE COUNTY
551 Broadway
Eagle, Colorado 81631
(303) 328 7311
Date: June 15, 1990
GMAC Financing -Martha Wolfe
0389 Green Mountain Drive.
Eagle, CO 81631
Re: Final of ISDS Permit No. 981
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,
Raymo P. Merry, RS
Environmental Health Of i'er
encl: Information Sheets
ISDS Permit --
xc: ISDS File No.
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
TELEPHONE
303/328-7311
Vtxtwzt t'- 17.7
EAGLE COUNTY
Board of County
Eagle, Colorado 81631
Commissioners
Ext 241
Assessor
February 7, 1984
Ext 202
Clerk and
Recorder
Ext 217
Sheriff
Eagle: Ext 211
Basalt: 927-3244
Thomas Rau
Gilman: 827-5751
389 Green Mountain Drive
Eagle,Colorado 81631
Treasurer
Ext 201
Administration
RE: LOT 45 K I ABAB SUBDIVISION
Ext 241
Animal Shelter
949-4292
Dear Mr. Rau,
Building
Inspection
ISDS was inspected by Sid Fox of Eagle County
Ext 226 or 229
Environmental Health Office on February 1, 1984.
Community
Inspection revealed that property is serviced by
'n
Developmen
exs' system and with no apparent problems with
Ext226or22
-eXS1si ng system. System operating properly on
e ruary 1, 1984.
County Attorney
Ext263
If you have any questions reference the above —!
please contact the Environmental Health Office.
Engineer
(328-7311 ext 238 )
Ext 236
Environmental
Health
Ext 238
Sincerely,
Extension Agent
Ext 247
Library
�
Ext 255
Erik Edeen
Public Health
Environmental Health Officer
Eagle: Ext 252
Vail: 476-5844
Personnel
EE/gV
Ext241
Purchasing
Ext 245
Road and Bridge
Ext 257
Social Services
328-6328
1
BUILDING PERMIT APPLICATION
om.
Jurisdiction of-1C��'U _ g
O
Annlirant to comolete numbered spaces only.
JOB ADDR ESS
lb -I
LEGAL
1 DESCR.
LOT NO.
�
BLK
TRACT I
([:]SEE ATTACHED SHEET)
OWNER.r.w ,�.+- - MAIL ADDRESS j' (-� ZIP /jj// PPHOO'NE
CONTRACTOR MAIL ADDRESS PHONE
3 Ccxj V\ -e V "Z --'-
LICENSE NO.
ARCHITECT OR DESIGNER - MAIIL ADDRESS PHONE
�s4 �� hevti—
LICENSE NO.
-
ENGINEER MAIL ADDRESS - - PHONE
5 _
_ LICENSE NO.
LENDER \ (f j((} �r !( MAIL{,AD DRESS
BRANCH
USE OF BUILDING �'`
7 �- ► �[^ l� l llLLL`° iF +its ,�!✓ �i ii G r (` t; t! GJ
��tr7 j j" i 1 `� 7_ �7 t{%hr
t�
8 Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
'
9 Describe work: G 1 L1 r _ -' i C /' �'v10 c '
10 Change of use from
Change of use to
11 Valuation of work: $
PLAN CHECK FEE
7 ,)
PERMIT FEE
SPECIAL CONDITIONS:
'Type of
Const.
Occu}Sancy
Group
Division
Size of Bldg.
(Total) Sq. Ft.
No. of
Stories
Max.
Occ. Load
Fire
Zone
Use
Zone -
Fire Sprinklers
Required ❑Yes -]No
APPLICATION ACCEPTED BY.
PLANS CHECKED BY
APPROVED FOR ISSUANCE BY.
No. of
Dwelling Units
OFFSTREET PARKING SPACES:
Covered Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR
IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS
COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT. THE GRANTING OF A' PERMIT DOES NOT
PRESUME TO GIVE _AUTHORITY TO VIOLATE OR CANCEL THE
PROVI510 S OF ANY OTHER STATE OR LOCAL LAW REGULATING
C ION OR THE PERFORM N E OF CONSTRUCTION.
l
Special Approvals
Required
Received
Not Required
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
SIGNATURE OF CONTRACTOR OR A THORIZED AGENT (DATE)
�° 71 u~
SIGNATURE OF OWNER IF OWNER BUILDER) (DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT fir': "7
r
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Formm 100.1. 1-77 - - -
J
EAGLE COUNTY ENVII;ONMENTAL HEALTH
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ROUTE SLIP
Name
Na- —te .e -er.re Perini L lumbr
Location
?lease review the attached application and return it and this completed form to the
nvironmental Health office within 6 working days.
?lanning: File Number Yes No Reviewed By Date
Complies with:
Subdivision Regulations
Zoning Regulations
Recommend Approval-
�-
Jormnents
t
'ounty Engineer: Roads
Grading:
:Drainage
Recommend Approval
U ��✓v "l
% �- 7�
'omments:
3uilding Department: Set Backs
Site
Access
Other
Recommend Approval
r
'omments:
ENVIRONMENTAL HEALTH'J
P.O. BOX 811
PERMIT NO. EAGLE, COLORADO 81631 PERMIT FEE $25.00
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NQ 3 ♦ r,
Name of Owner: G C. t_kC'0L-4k4rr Phone: 3 Z8-77z(►
Address of Owner: V PPe-e Q # 4 3 ax -13( CA G L E
Is facility within boundaries of a city/town or sanitation district? 00
Distance to nearest sewer system: ( h I L-E
Location of Prop4
Legal Discription
Type of Structure: Single Family Dwelling ( C---YUther: No. Bedrooms b
Water Supply: Private Well ( ) Location: Distance From leach field: -7�
Size of Lot: Z 101 Public Water Supply:CCat...�
An appropriate plat plan must accompany site inspection for this application showing required information. (See
attached sheet.) The individual sewage disposal system will be constructed and installed in accordance with the
regulations governing individual sewage systems within Eagle County, and shall comply with House Bill 1553 CRS
66-14, 1973. Payment shall be made to the Eagle County Treasurer. Permit, upon approval of this application, may be
obtained at the Eagle County sanitarian's office.
Appointment for final inspection must be made prior to construction by contacting the inspecting sanitarian. [Phone
328-7718 between 8:30 and 9:00 AM.] Refer to permit number. No approval will be given on any system without final
inspection.
Name, address, and telephone of person responsible .for design of system:
The undersigned acknowledges that the above information is true and that false information will invalidate the
application or subsequent permit.
SIGNATURE OF APPLICANT: Date:
(This application becomes invalid 6 months from above date.)
HEALTH DEPARTMENT USE ONLY
Percolation Information: /1 Permit No.
Tank Capacity: / DOO gal. (minimum) Fee Receipt:
Absorption Area: /. DOD Sq. ft. (minimum) File:
REMARKS:
APPLICATION IS: APPROVED (X) DENIED ( )
The above individual sewage disposal system was installed by
AND HAS BEEN INSPECTED AND APPROVED BY A REPRESENTATIVE OF THE EAGLE COUNTY HEALTH DEPT.
Date: Sanitarian:%
4��
H'D L E
PE1120LPTION TEST
Feu: $ -r- 0. 0 0
1PI-)licPtion No. 17"ermit .No.
Ovvner:
Legal Description:. 74-
Tyne of Dwelling: No. of Bedrooms:
Date of Test: Denth of Holes:
Diameter: — / 2 f7 Tyne of Soil:
Location of TeS't Holes:
Test hole Nvas Dresoaked from:
Time Dot -
To:
Time Date
TIME
WATER DEPTH
j INCHES OF FALL
�RATB
2
3
1
2
2
3'
Z4 7(
f2s
<3
6-
343�
Percol . aLion Rate:• 4�2... J*,rpi l000 �7�1 �/
Site h P. s been reviev,--ed, aid t�es- (I for peTco VIC ion rate.--
7�
We recommend: I 11-PR-0 W L DISIPPROV/4- IL MOTE:
ov
f Ke-
Erik Ili. I,, d e c a, R, _P . S.
Enviroi.-mientol
Eagle County
Y
dal
5u
TELEPHONE
303/328-7311
Board of County
Commissioners
Ext 241
Assessor
Ext 202
Clerk and
Recorder
Ext 217
Sheriff
Eagle: Ext 211
Basalt: 927-3244
Gilman: 827-5751
Treasurer
Ext 201
Administration
Ext 241
Animal Shelter
949-4292
Building
Inspection
Ext 226 or 229
Community
Development
Ext 226 or 229
County Attorney
Ext 263
Engineer
Ext 236
Environmental
Health
Ext 238
Extension Agent
Ext 247
Library
Ext 255
Public Health
Eagle: Ext 252
Vail: 476-5844
Personnel
Ext 241
Purchasing
Ext 245
Road and Bridge
Ext 257
Social Services
328-6328
EAGLE COUNTY
Eagle, Colorado 81631
February 1, 1984
SUBJECT: Sewer System Inspection for Property located
at 0389 Green Mountain Drive - Eagle, Colorado
TO WHOM IT MAY CONCERN:
All water and sewage disposal system loan inspections are done
under the authority of the Eagle County Building Regulations,
Section 10, sub -paragraph 3-A, adopted by the Eagle County
Commissioners, September 20, 1982.
An on -site inspection on Monday, February 1, 1984 of the above
referenced property revealed that the septic system appears to
be functioning properly with no apparent problems. The original
individual sewage disposal system permit #125 was approved in
Septemberlof 1976 in accordance with applicable County and State
regulations concerning such installations.
This department recommends that the septic tank be pumped every
three or four years.
Potable water is supplied by the community water supply (Town of
Eagle). This water supply is inspected annually and tested by
the Colorado Department of Health on a routine basis.
If you have any further questions concerning this matter, please
contact our office.
Sincerely,
Sidney N.
Assistant Environmental Health Officer
EAGLE COUNTY
SNF/lf
EAGLE,4'"�.UNTY DEPARTMENT OF ENVIRONN�TAL HEALTH
Box 811 6th & Broadway
Eagle, Colorado 81631
PERMIT NO 125 (this does not constitute
a building or use permit)
Owner G• Clint Brookhart
System Location Upper Kaibab - Lot # 43 - Filing # 2
Licensed Contractor
* Conditional Construction approval is hereby granted for a 1, 000 gallon
XX Septic Tank or Aerated treatment unit. Yv
S \r 5 yr. u
Absorption area (or dispersal area) computed as follows:
Perc rate 1 inches in 10 minutes 11000 sq. ft.
absorption area per bedroom
# of bedrooms x sq. ft. minimum requirement
May we suggest 1, 000 sq. ft, of drainage field
Date
Inspector
FINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements.
Date 9- a/- 7 Inspector �� �i Yam. o�� )
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973
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 structures not approved by the building
and Zoning office 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, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or
both.
o.........• ••....•.....•..........•..•.........................•....•..............•..•••.•........................•...._
CHARGES
Percolation Test $50.00
(includes final inspection)
Permit Processing Fee $25.00
Check (no cash) XXXX
IVloney Order
Permit N? 125
Name of Applicant Brookhart, G. Clint
Amount Paid $75.00
Date Paid 9-1-76 Receipt # 253
Cashier Sharon Miller
ALL CHECKS ARE TO BE MADE PAYABLE TO EAGLE COUNTY
Eagle Cty. — White Copy Applicant — Green Copy Dept. — Pinic Copy
4000 J4
Fah., 9-2/-76
Zoe
ul�]Bf' /)ati b a�j
106 (_7 6A Y 4ve,
T.l A i
981 Martha Wolf Lot 43 Green I
JOB NAME Mnt. Drive 0389 Green Mountain l J�
Dr. JOB NO.
JnR I nCAT1nN
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
'TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
LESS OVERHEAD COSTS
% OF SELLING PRICE
NET PROFIT
JOB FOLDER Product 278 �® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER'
Printed in U.$.A.
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