HomeMy WebLinkAbout1637 Emma Spur - 246512300005 - 1033-91ISINDIVIDUAL 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. O 3 3
Please call for final inspection before covering any portion of installed system.
OWNER: Norman Wirklor PHONE: 303-927-3403
MAILING ADDRESS: P.O. BOX 6507, Snowmass Village, CO 81615
AGENT: Gary Carmichael PHONE: 303-963-1436
SYSTEM LOCATION: 1637 Emma Spur Rd. Basalt Lot 1. Blk 1 Wirklor Sub
LICENSED INSTALLER: i Y3) 1�(Yf ji ea l2 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:
SQUARE FEET OF SEEPAGE BED 850 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: 280 lineal ft 10" SB2 or 168.75 lineal ft (27 units) Place inspection
portals at end of each line.
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 /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: 1 6D 1 _,79 J �Sed'E *RFEET. I� ✓I �L��/ �� TPA^
INSTALLED S EPTIC TANK: �0 GALLONS ✓ DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALSANDASSEMBLY_ 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:
ENVIRONMENTAL HEALTH OFFICER: � DATE: 2-
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
x'
ISDS Permit #
Building Permit # �gq
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM AgEIVED
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179 MAR 15 1991
EAGLE, CO 81631
328-8730/927-3823(Basalt) EAGLE COUNTY
PERMIT APPLICATION FEE COMMUNITY DEVJ�p�p�y
$150.00 PERCOLATION TEST FEE
**************************************************************************
PROPERTY OWNER: N0P-MA-#J
�I �olS
MAILING ADDRESS: -0.9,-) 650-7 Sd31c,-•,,MA-,, ('�j �tlL,'VU�-- PHONE: gZ7-3�o
APPLICANT/CONTACT PERSON: Crgfz� CA1 V_V4-%.jC, -'r�- PHONE: ?iv ':3 ) 3�
LICENSED SYSTEMS CONTRACTOR: Ld7/k7eAj7_ /,` 061 Ht
ADDRESS:
PHONE. n ) ` ®�
PERMIT APPLICATION IS FOR: ('>C) NEW INSTALLATION ( ) ALTERATION
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: Lc T 1 VwcL,
Parcel Number: ; q �' /� - �r ; •- pay — Lot size:
Physical Address : ! 37 E:41),,4 5Pt,/ L C > _ fsA<-
( ) REPAIR
BUILDING TYPE: , (Check applicable category)
Residential / Single Family Number of Bedrooms 3
( ) Residential / Multi -Family* Number of Bedrooms
( ) Commercial / Industrial* Type
HOT TUB Yes No
WATER CONSERVATION PLAN: Yes () No ( )
TYPE OF WATER SUPPLY: Well) Spring ( ) Surface ( )
Public ) Name of Supplier:
Give depth of all wells within 200 feet of system:
*These systems require design by a Registered Professional Engineer
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTAN AY E TO: "EAGLE COUNTY TREASURER"
SIGNATURE: 42L. DATE: 3.115-A
AMOUNT PAID: RECEIPT# J (O 3 DATE: 9 -
CHECK # CASHIER:
TIME LOG
Travel Perc Final
Application # 103�?
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER: Alai, y� a,, Li/ t `� l<,l J -
LEGAL DESCRIPTION:
MAILING ADDRESS: /, "y`
TYPE OF DWELLING: (
a�� NUMBER OF BEDROOMS f��),j
TEST HOLES PRE-SOAKED: YES_ NO
TTMT? 67Tmz•n r%"nmv
6UI PROFILE
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Time to drop last inch 30 3� c4•5-1 30
PERC RATE: MINIMUM SEPTIC TANK SIZE: /Old
MINIMUM LEACH FIELD SIZE:
COMMENTS: Z 90 it 7,iw .,S B IM,
f +
PERC TEST DONE BY:
EnVironinental Health O
rev. 6/90ks
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DATE: q ✓� 5 4 /
JOB NAME'
1033-91 TxPrcl#2465-123-03-005
_ 1637 Emma Spur Rd, Basalt
Lot 1, Blk 1 Wirklor Sub
/U/ 50 ((Sp
JOB NO.
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
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
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