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HomeMy WebLinkAbout755 Valley Rd - 211105324001INDIVIDUAL 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. 1050 ` Please call for final inspection before covering any portion of installed system. OWNER: Mary B. ColliNyt(s Trust PHONE: 303-524-7555 MAILING ADDRESS: P.O. BOX 400, gypusm, CO 81637 AGENT: PHONE: SYSTEM LOCATION: 755 Valley rd. Parcel "A" Rachel Subdivision LICENSED INSTALLER: Shaw Escavating LICENSE NO. 20-91 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 302 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 10 infiltrator units (62.5 lineal ft.) must be in two lines. 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 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. yn y / INSTALLED ABSORPTION OR DISPERSAL AREA: I V INSTALLEDS EPTIC TANK: I 71 v GALLONS_. if 0 DEGREES_f 0 FEET SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS AND ASSEMBLY /V YES NO COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: 0 YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE { -.INSPECTION WHEN WORK IS COMPLETED. COMMENTS: S �r__I )1 5 fa& /AI`G� 7 C� �J� no -f- 'ff- / /�✓C�i� �(I S /'�//� 1 ENVIRONMENTAL HEALTH OFFICER: / ( �` DATE: S ® ENVIRONMENTAL HEALTH OFFICER:' DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANTIAG ENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: COMMUNITY DEVELOPMENT DEPARTMENT (303) 328-8730 EAGLE COUNTY, COLORADO May 2, 1991 Mary B. Collins Trust P.O. Box 400 Gypsum, CO 81637 725 CHAMBERS AVE. P.O. BOX 179 EAGLE, COLORADO 81631 FAX (303) 328-7207 RE: Issuance of Individual Sewage Disposal System Permit No. 1050 Enclosed -is your ISDS Permit No. 1050. The enclosed copy of the permit must be posted at the installation site. You must call our office for final inspection before covering any portion of the installed system; the deadline for final inspections is December 1. If you have any questions, please feel free to contact us at the following numbers for your calling area: Basalt/El Jebel 927-3823 ext. 730; Eagle Valley 328-8730. Sincerely, Roger Hosea Asst. Environmental Health Officer Community Development cc: ISDS file encl. RH/alm e ISDS Permit Building Permit # AZ.I± APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY P.O. BOX 179 EAGLE, CO 81631 328-8730/927-3823(Basalt) PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00 PROPERTY OWNER: /�12"1 11 MAILING ADDRESS: f D /� CEO Q PHONE; Z 5l -7J 1 �J APPLICANT/CONTACT PERSON: L CC PHONE: LICENSED SYSTEMS CONTRACTOR: -� - �c��J.� c C�.�O rn ADDRESS: /3'd S7i PHONE. PERMIT APPLICATION IS FOR: (X)NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Legal Description: / /9RC e— r7,, /'f �y� L SG� ©�,, �S�o �✓ Parcel Number: �SC _ / /?O Lot size: 5,9 cry E� Physical Address : T z//,s` — -2 y -a-cp BUILDING TYPE: �-- (Check applicable category) ("`44) Residential / Single Family Number of Bedrooms ) 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:�s�, Give depth of all wells within 200 feet of system: 0/VL *These systems require design by a Registered Professional Engineer NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" SIGNATURE: DATE: G� ✓� -- %/ AMOUNT PAID: ©f�� - RECEIPT# �� DATE: ���� CHECK #k y CASHIER: TIME LOG Travel Perc Final t Application r p,�'g9 G G PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER: —Ca/ LEGAL DESCRIPTION:_L�GIY% ,4 %�Gc� sy✓j' ��, MAILING ADDRESS: TYPE OF DWELLING:, S�,n /���{i NUMBER OF BEDROOMS TEST HOLES PRE-SOAKED: YES NO TTMF. 1 2 3 1 ----- --- 2 --- 3 1 vi 2 inLtr 3 [tt'►1G 1 �-• 2 /y ►7UlL YKUrILt 0' 1.3 13 i� ZZ �L� IJ lL I 3� %, Gr 1-7 41 -7 A�5' 6' 617 z o ,17 z z 7' 8 44_ ✓✓� JG 5 7 � _ Z � Ll /�L ii I / �/v .., o� Viz/ ly 2 ;� /� � 1 �' j �7 (" 7 1� -,-L ,17- . Time to drop las inch L /61? 1/,Y %4 ?j PERC RATE: /Gt V, MINIMUM SEPTIC TANK SIZE: ld�C MINIMUM LEACH FIELD SIZE: 3 0 � ,, COMMENTS: jG !`h�rj k,­ef SLp,— 61 12 !`)44 PERC TEST DONE BY: ironmental He rev. 6/90ks Officer 1U5U-yT w ,JOB NAl SE 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 Qp NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 Printed in U.S.A JOB FOLDER In [a 7s-s-" vull-ey gel (w, ns y � l 1 001 b101879-Q