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HomeMy WebLinkAbout25187 Hwy 6 - 194108400055EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLEASE CALL FOR FINAL P. 0. Box 850 - 550 Broadway PERMIT MUST BE POSTED INSPECTION BEFORE COVERING Eagle, Colorado 81631 AT INSTALLATION SITE ANY PORTION OF INSTALLED SYSTEM 328-7311 or 949-5257 or 927-3823 PERMIT NO. N o 52 4 OWNER•Colorado State Highway Dept. ADDRESS: 4201 E. Arkansas, Denver, CO SYSTEM LOCATION: Wolcott Trailer Park - east end of park LICENSED INSTALLER: owner -installed k LICENSE NUMBER: **CONDITIONAL INSTALLATION APPROVAL is hereby granted for the following: MINIMUM REQUIREMENTS: gallon septic tank or aerated treatment unit. Absorption area or dispersal area computed as follows: PERCOLATION RATE: 1 inch in 10 minutes. Absorption Area per Bedroom sq. ft. No. of Bedrooms 6 X 215 sq. ft. minimum requirement per bedroom = 1300 total sq. ft. minimum requirement. / } b Isdn SPECIAL REQUIREMENTS: This is a repair permit. Will use the ;existing septic tank. Is installing a new leach field. Permit is for A3x�0&,M,M six bedrooMa for two Mobile homes, DATE: July 9, 1981 INSPECTOR: Sidney N. Fox��• **CONDITIONS: '"9"`, -0- 1. All installation must comply with all requirements of the 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 building and zoning 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: No system shall be deemed to be in compliance with the Eagle County Individual Sewage Disposal System Regulations until the installed system is approved prior to covering any part. Installed Absorption or Dispersal Area: / 41�O b sq. ft. / Installed Septic Tank: �?V gallons. PK� TPe p-) Design Engineer of System: IS�Y ,ti ar Installer of System: /"7 ,:, Phone: Septic tank cleanout to within 12" of final gr or aerated access ports above grade? Yes 10 Proper materials and assembly? Yes No Compliance with permit requirements? Yes No Compliance with County/State regulations requirements? Yes No COMMENTS: 7// , ,o,. rk2� / '.1 r, (Any item checked "No" requires correction before final approval of sy tem is made. Arrange a re -inspection when work is completed.) DATE: `%� ,/5- INSPECTOR: RE -INSPECTION DATE: INSPECTOR: RETAIN WITH RECEIPT RECORDS PERMIT NO. NO 524 CHARGES State is exempt from charges Name of Applicant: State Highway Dept. Percolation Test = $50.00 Name of Owner: same Permit Fee (includes final inspection) = Amount Paid: State Govt. is exempt - n/a ALL CHECKS OR MONEY ORDERS ARE TO BE Receipt Number: --- MADE PAYABLE TO: EAGLE COUNTY Cashier: --- White and Pink Copies - Environmental Health Department Green Copy Applicant/Owner BUILDING OR SERVICE ( ) Residential - Single Family ( ) Residential - Duplex ( ) Residential - Triplex NUMBER OF PERSONS: 3 1 ap'. Il.S(LS WASTE TYPES (check applicable categories): ( ) Commercial or Institutional ( ) Non -Domestic Wastes ( ) Garbage Disposal ( ) Automatic Washer ( ) Other APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT i EN'VIRON'IENTAL HEALTH OFFICE - EAGLE COUNTY P.O. Box 850 Eagle, Colorado 81631 No. a Z 5! •PERMIT APPLICATION FEE: $150.00 328-7311 PERCOLATION TEST FEE: $50.00 NAME OF OWNER: ADDRESS: S i q, i.la"v .S NAME OF APPLICANT (if different from owner): ADDRESS: 9 DESIGN ENGINEER OF SYSTEM (if applicable): ADDRESS: PERSON RESPONSIBLE FOR L1VJ1riLlui11v1V yr ;�iSI "I_: Licensed Installer (see attached list): Q, PHONE: 6 PHONE: 2V 7 le Cl %if a-0 PHONE: YES NO ADDRESS: PHONE: PERMIT APPLICATION IS FOR: ( ) New Installation ( ) Alteration ( k%j Repair LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Street/Rural Address: Lot Size: Legal Description: & UT�. TW fgs f 0t`.rraC_& -/'f �5A F-9 W.� GAF ( ) Residential _ Quadplex ( ) 2omm7ciai (state usage)' NUMBER OF BEDROOMS: ( Dwelling ( ) Transient Use ( ) Dishwasher ( ) Spa Tub TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( Septic Tank ( ) Composting Toilet ( ) Incineration Toilet ( ) Vault Privy ( ) Greywater ( ) Chemical Toilet ( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use ( ) Other ( ) Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO (c/) IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES (/S NO ( ) WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO (I� yes, see attached tua6tewateA 6tow neducti.on methods) NOTE: The Envi tonmentat- Heaf th 064ice/t may teduee the AegLvked absotption area upon apptova2 a4 an adequate wa�stewatetc 6Zow neduction plan. SOURCE AND TYPE OF WATER SUPPLY: (,4 Well ( ) Spring ( ) Creek/Stream Give depth of all wells within 200 feet of system: If supplied by community water, give name of supplier: SIGNATURE: DATE: ZFZ - - - - - - INFORMATION BELOW r10BE FILLED OUT By ENVIRONMENTAL HEALTH OFFICER: GROUND CONDITIONS: PeAcent Gnound Stope Depth to Bedno ck (pen 8' Pno 4 ite Hote ) Depth to GAoundwaten Tab.2e SOIL PERCOLATION TEST RESULTS: inute/s pen inch in Hote 1 Minutes pen inch to Ho.Ee #2 Minutes pen .inch to Hote # 3 FINAL DISPOSAL BY: ( ) AbwLption Tnench, Bed on Pit ( ) Evapottampikation ( ) Above Gnound DLpeuat ( ) Sand Fitters ( ) Unde/tgtound DZspeuat ( ) Wastavaten Pond ( ) Othet Amount Paid: 6 IN Receipt Numbet Date: J - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - NOTE: Site Plan must ber=2a,trtac3h�e� to a{ppl i� IM n� 4 (Env. Health Department - Rev. 4-07-83) t FEE: $50 APPLICATION "0. OWN ER: 71 e LEGAL DESCRIPTION: RURAL ADDRESS: TYPE OF DWELLING: yyj�/ IF s # OF BEDROOMS: 62 DATE OF TEST: %= �J- �� TYPE OF SOIL: TEST HOLES PRESOAKED: YES Ll--' NO S"' � X¢0 G l a TIME WATER DEPTH INCHES OF FALL RATE 1 2 3 1 2 3 1 2 3 1 2 y3 IL PERCOLATION PATE: �D �J� / TANK SIZE• ��� - � .�' ! 1 /� LIT — SQUARE FOOTAGE PER BEDROOM: � LEACH FIELD SIZE: �OC� / �,�%o�✓ Site has been reviewed and tested for percolation rate.- - K. X O L:e reco-,mend: APPROVAL (// DISAPPROVAL r' DATE: --7 r 91— I EAGLE COUNTY f' " ,� ENVIRONTMENTAL A TH OFFICER PLEASE kn URN THIS POR-iIOiV WITH YOUR SIIL PLAN AND FEES '328-7311 949-5257 927-3823 { ENVIRONMENTAL HEALTH BOX 850 EAGLE, COLORADO 81631 PERMIT _ S75 PERCOLATION TEST FEE = 50 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NAME OF OWNER: ADDRESS: 'y 2 NAME OF APPLICANT ( I F DIFFERENT FROM OWNER) : ADDRESS: o6 o K 6 3 A Vow, Ca /e Ff 6-7 o DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): ADDRESS: NO. 8F0 PHONE: 757- 9331 PHONE: 9419- -V'/*o PERSON.RESPONSIBLE FOR INSTALLATION OF,SYSTEM: ldiedtJ7Ge ADDRESS:.,Ro Y j*(, 3. Ayy*). e /6 S I &Jo PHO IE: ?y Q+ WOO PERMIT APPLICATION IS FOR: ( ) New Installation ( ✓) Alteration Repair LOCATION OF PROPOSED FACILITY: County Lot Size City or Town, if within City or Town Limits LEGAL DESCRIPTION: Ja i- �Lj4> , JW Flu .Sec K STREET (RURAL) ADDRESS: ��,vg 6twtt•� !,(fS. G %�e F�a� �'�yr✓ IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? Yes ( ) No BUILDING OR SERVICE TYPE: (Check applicable category) ( a Residential - Single-family dwelling ( ✓) Residential - Duplex -_T�vo '%W§ ( ) Commercial - State usage # Persons f J # Bedrooms 3 WASTE TYPES: (Check all applicable) ( ) Commercial or Institutional ( ) Non -domestic wastes ( ) Other -- - - Residential - Triplex Residential - Quadplex Dwelling ( ) Transient Use ( ) Garbage Grinder ( ) Dishwasher (� Automatic Masher SOURCE AND TYPE OF WATER SUPPLY: ( ✓) Well ( ) Spring ( ) Creek or Stream Give depth of all wells within 200 feet of the system: 1 If supplied by community water, give name of supplier: TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( ✓� Septic Tank ( ) Aeration Plant ( ) Chemical Toilet ( ) Vault Privy.. ( ) :Composting Toilet ( ) Recycling, Potable Use ( ) Pit Privy ( ) Incineration Toilet ( ) Recycling, Other Use ( ) Greywater ( ) Other WILL EFFLUENT BE DISCHARGED DIRECTLY INTO 14ATERS OF THE STATE? Si gnatur 0, 2(2 ;Xk ( ) Yes ( ✓ ) No Date ;7— /— Pl * * * * * * * q * * * * * * * * * * * * * * * * * * * * * * * INFORMATION 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: SOIL PERCOLATION TEST RESULTS: Minutes per inch in Hole No. 1 Minutes per inch in Hole No. 2 Minutes per inch in Hole No. 3 FINAL DISPOSAL BY: ( ) Absorption Trench, Bed or Pit ( ) Evapotranspiration ( ) Above Ground Dispersal ( ) Sand Filter ( ) Underground Dispersal ( ). 'Wastewater Pond ( ) Other . -1 a Zt _%ow I'FILI Wia"s No ZIP, l6 - 'Pa AV/ W Appy.17 Allp Ar Yor Y-71le /W/V V S'L'P' /AT PAY IV- i'WIX..' S-M/7 Z" jp'r PA72 t' 'tf �w t 19 6171,y 00,6-99 *Iry in t4 —2, -05" 10 D, 61'9Z69 ct Aloll-wN7 4wly 4V'Af wcr 17 vly .IW 4!7 V 1-1 0*, �tz 'Ael IZ O o Z Q �r'k 4 Id 7 ter` -4 all / a,+ / 7-4! y(l j F El Pw a pq P� O 0 0 •• 4r O u O A O m p aS O m O ri yl m 1 X ' 43 U 0 0 COPELAND CONCRETE, INC. 28803 us Hwy 6 Rifle, Co 81650 Phone: 625-1112 Some one must be on the job at time of delivery to help our driver, or we will send an extra man at M 00 Rr. Thank You. 101 Baffle and tee built in. 8► ].3" 17" 13" 20" 7K7 i 5i4`► 41 lA" Knock'outs � 40 Bottom thickness 4" 5' Top Thickness 411 Concrete baffle divides 1/3 on outlet side & 2/3 on inlet side. Model C.H. 1250 Gallon Septic Tank. Concrete bottom & side walls reinforced with " 10-10 mesh plus 4-3/8 rebar in bottom. Top reinforced with " ".1neah & 6-3/8 rebar. Digging Specs: 6t wide x 111 long. 41 10" from bottom of excavation to center of inlet. 41 7" from bottom to the outlet. Drawing Page 33 Z-- 1 1 L- PAi e �d �—d q) A,) <n a r, 0 /M0h, /4Al? '-/ dtl vJ79 777-rAit- Y t REPAIR PERMIT APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS A permit fee of $150.00 shall be charged for alteration, enlargement or any repair involving alteration of an existing sewage disposal system. This fee is authorized by Eagle County Individual Sewage Disposal System Regulations adopted and effective March 27, 1980. For minor repairs of less than $100.00 for maintenance of the individual sewage disposal system, no fee shall be required. A percolation test fee of $50.00 shall be charged for all new leach fields on repair permits. Percolation testing may be waived at the discretion of the Environmental Health Officer on certain repair cases where prompt action must be taken to prevent a health hazard. IF PRESENT SYSTEM IS PRE--EXISTING,.NON-CONFORt-LING, ANEW SYSTEM SHALL- BE INSTALLED, COMPLYING WITH ALL CURRENT REGULATIONS._ IF A NEW SYSTEM IS REQUIRED, ALL FEES ARE APPLICABLE. -DESCRIPTION OF PROBLEM/MALFUNCTION:, JA,M ISY ® i Sd k CPi�t� TYPE AND SIZE OF SYSTEM PRESENTLY IN USE: DATE PRESENT SYSTEM WAS INSTALLED: PERMIT NUMBER FOR ORIGINAL SYSTEM, IF A PERMIT WAS ISSUED BY THIS DEPARTMENT: # SITE PLAN BELOW SHOWING PRESENT SYSTEM COMPONENTS: Y, OWNER APPLI ADD DATE: JOB NAME _ 0524 Wolcott Trailer Park East en Hsi G JOB 'NO. BILL TO DATE STARTED DATE COMPLETED DATE BILLED IW6'�� YA � �'.& � QC - 141 �L� � 9 _ MOTE D,v V40LCUt\ 1 5r7`S RieAV2- £2r+-T Adel ss 661/0-J u� o ----- -- -- T07 Sby,n- a(u1u wI� WCCiPd 1�a5e� TOTAL N PERMIT #524 TOTAL �!o OWNER: Colorado State Highway Department INS -- _--�•- -� �-- I. LOCATION: Wolcott Trailer Park (east end of park) SA MISc. COSTS INSTALLER: Owner SIZE OF TANK: REPAIR PERMIT FOR NEW LEACH FIELD ONLY 215 sq.ft. DWELLING: Two trailers - total of 6 bedrooms x (1,300 sq.ft.) PERC RATE: One inch/10 minutes TOTAL JOB COST GROSS PROFIT Finalized: 7-15-81 By: Erik Edeen LESS OVERHEAD COSTS % OF SELLING PRICE JOB FOLDER Product 278 Qp NEW ENGLAND BUSINESS SERVICE, U a �a a L7 H z H 3 H W o c w w a w H w H A z w \ H Z rx w � 0 w >q z 3 0 z 0 `� W H x oo R 10 W 1`- Ga a H aVi IA 6 1 6 g � v INDIVIDUAL 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. 10 3 Please call for final inspection before covering any portion of installed system. OWNER: Department of Highways c/o Leonard Oeltjenbruns PHONE: 945-7441 MAILING ADDRESS: BOX 1430, Glenwood Springs, CO AGENT: PHONE: SYSTEM LOCATION: Wolcott Trailer Park (West End) LICENSED INSTALLER: Leonard Oeltj enbruns (Hiway Mtco Supervisor) LICENSE NO. DESIGN ENGINEER OF SYSTEM, INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING: (2) 1000 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT. DISPERSAL AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 854 square feet trench/280 square feet 10" SB2/29 infiltrator chambers REPAIR PERMIT FOR NON CONFORMING SYSTEM. Place portals at end of each trench. Z. lor 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 SYSTTEE���M�. ,, /{, INSTALLED ABSORPTION OR DISPERSAL AREA: f/� SQUARE FEET. P/Gt l '/� ^��r%5 INSTALLED SEPTICTANK� DOD GALLONS ar DEGREES 35 FEET N.W. cc/ner pf/� SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: \ PROPER MATERIALS ANDASSEMBLY V 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: - 9/ ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: ISDS Permit # 1�03 Building Permit # 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: Ca .G b v F T, 4/,j s /Do L• �R� f i a �,, MAILING ADDRESS: A 0, /3 D30 , lr� one W 0 0J Jpl2rn,y� PHONE • `=i' �� � - 94gl APPLICANT/CONTACT PERSON: 5 PHONE: 9 - % 4141 LICENSED SYSTEMS CONTRACTOR: L ebti p,e U AIs (//L,, fc p v .1 ADDRESS: P 13 S j . 0 , a /y 3 6 , o o %=2 /A' 5, (0 PHONE: -7 At' � 1-/ 41 77 PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION () ALTEP.ATION LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: { ) REPAIR Legal Description: Parcel Number: Lot size: Physical Address: BUILDING TYPE: - -- (Check applicable category) { Residential / Single Family Number of Bedrooms���„ es�� ( ) Residential / Multi -Family* Number o Bedr oms ( ) Commercial / Industrial* Type i1/1IT; , anQ S HOT TUB .._ Yes ( ). No WATER CONSERVATION PLAN: Yes ( ) No TYPE OF WATER SUPPLY: Well( Spring,( ) Surf ce Give depth of all wells within 200 feet of system: wo Co Lc, O *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" s _ SIGNATURE: DATE : _s *��x��*xrrrrrxraxrrrycxyr*s****�rr�r 7rxr*r*�r*xxs**�"',r AMOUNT' PAID : CDOH N/o Fee- RECEIPT# DATE: CHECK # CASHIER: TIME LOG Travel Perc Final I COMMUNITY DEVELOPMENT DEPARTMENT (303) 328.8730 EAGLE COUNTY, COLORADO November 25, 1991 Department of Highways c/o Leonard Oeltjenbruns Box 1430 Clenwood Springs, CO 81601 RE: Final of ISDS Permit No. 1103 Dear Mr. Oeltjenbruns: 725 CHAMBERS AVE. P.O. BOX 179 EAGLE, COLORADO 81631 FAX (303) 328.7207 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 Division, P.O. Box 179, Eagle, Colorado 81631. We can also be reached, depending on your calling area, at the following numbers: Eagle Valley 328-8730; Basalt/El Jebel 927-3823. Sincerely, Y C. Kelley Carhart Office Assistant ckc Encl: Information Sheets Final ISDS Permit cc: Chrono File ISDS File Building Permit Filey I r, I ISDS PERMIT 7 1163 PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER: De p q `ul �lTlP.hbruns �l LEGAL DESCRIPTION: V MAILING ADDRESS : PQ 'Boy 1436 Glenujaa .5 rin NO, TYPE OF DWELLING: 5F R // ��b,�Je /aWx°-s NUMBER OF BEDROOM, 3+3 i TEST HOLES PRE-SOAKED: YES NO TTMP. 'rT. .TT"^ ter. r.wt. 1 2 3 1 2 3 1 2 3 1 2 3 ®' RveY Cobb �� MI5 47 �Z 43 43'� 1 59 5/ �z `lg 5 � 1 3.375 I, ia5 105 / 5 4q l.2 21 55 56 57 {0 �5g II �.►�5 .75 2 �.� 6.7 �2.5 3 00 01 O L Ili 3 7' 13 1, 5 .75 z 3, 3 (� 7' ,� 5 4 05 06 07 13� 7q l�}Z 175 .5 1.5 10 n iZ i�$ �Z I( t,lz5 G�5 /.5 3,/ <g 3,3 6 71 ZU Z� ZZ 17g 9y _I 7 g 1.125 .375 875 �f %3 3; �,; 8 2 1$ 10 1w 3, 5 ), ) A15 Time to drop last inch #-/0-/-5 PERC RATE: l/SE /D - MINIMUM SEPTIC TANK SIZE: MINIMUM LEACH FIELD SIZE: ?54 %2 �r&"A 980 R oT 10"5$l/�q fh-Fi14,Jor vb"Le,, COMMENTS : �512C_lr pelrt3111 Fz*- nd)i ctm Ermihq 5y5&VIII, PERC TEST DONE BY: EnvirogmentalV Hea rev. 6/90ks cer DATE: 9, '2 - 9/ 10 x 135o / CPJv 0�3 ,70 "I e, v 14Lu I LA)e5T 5 IDF I i 1- max-' ed -4a 7- a--L d 14 9 3 7,2 1/1 A R L-r /S Tr a �^'�ccir o a ijOdl - �dYllo� 1�IJ�►g sL/ �/ �� �/ !��'�'c //w l 2r - (N�s7 eo-4- D Gf , �GfJO L / OW,- ���GI %! CGo� �i^e� �l Zvi /1 iiG�le a /ODO 74 X7, -7�L FEE: $50 APPLICATION '30. MINER: LEGAL DESCRIPTION: RURAL: ADDRESS. TYPE OF MJTELLING : /�%ZQ� # OF BEDROOMS: DATE OF TEST: TYPE OF SOIL: TEST HOLES PRESOAKED: YES NO TIM'�IE 11 WATER DEPTH II INCHES OF FALL 11 RATE PERCOLATION PATE: 1 SQUUE FOOTAGE PER BEDROOML: OD TANK SIZE: LEACH FIELD SIZE: Q Site has baen reviewed and tested Cor percolation race.- Ve reco=—,end: APPROVU �� DISAPPROVAL DATE:< EAGLE C UN;TY )ATE REFERRED h ROUTE FORM CeAo - SAcNe 9c wot N i _E Coit t4w', . �P-_fhA?. LOCATION APPLICATION NO. .'lease review the attached application and return it and this completed form =o the Environmental Health Office.. I A TTTT T ITt� ,omments Complies with: Yes No Reviewed By Subdivision Regulations Z �( I Xnc, Regulations CU %3 Recommend Approval 3UILDING Set Backs Site L As - Other Recommend Approval � 'omments: i, GTNEER 1 7 /i 3 /,i I (not always necessary) Roads Grading Drainage i Recommend Approval PLEASE RE I UkIV '[HIS POR"i UN 11iI i H YOUR -SITE PLAN AND FEES 3?8=7311 koy-l", - - PERMIT FEE = $75 949-5257 927-3323 ENVIRONMENTAL HEALTH BOX 850 lw� EAGLE, COLORADO 81631 PERCOLATION TEST FEE = $50 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NAME OF OWNER: Co Ia �'ia le- A.44 A so ati tDepl. ADDRESS: 'y?o / E',Is/ 141?ll, A,,-VIts PHONE: 7S 7 NAME OF APPLICANT (IF DIFFERENT FROM OWNER)- 104ce,, jDR,'c -7- ADDRESS: 0y %4 .14 3 /q 00 _ (10 /0 S(l6 2 a PHONE: � y q� y,/1►o DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): ADDRESS: PHONE: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: ,Cp��ea �.Q.•eTN ADDRESS: 63 Vo.yt�pfd S fb.2e PHONE: 7#9- 4//6d PERMIT APPLICATION IS FOR: ( ) New Installation Alteration ( Repair LOCATION OF PROPOSED FACILITY: County ;",a s /!c. City or Town, if within City or Town Limits LEGAL DESCRIPTION: STREET ( RURAL) ADDRESS: he Lc S (a 4- Lot Size ' #e c, oa0- IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY? (--� Yes ( ) No BUILDING OR SERVICE TYPE: (Check applicable category) /Z -/ -Z. :31Va SSI2 GaV INVOIlddV / 0 Cf : SS3daaV :W31SAS JO 2INMO 0 LS p a ,�»��.� :p.--ter yi^� r.0.r•HI ��lZ• ^'D mot'/6•YO /O/ 94' J/�yS /dcs 1%4i /o �o ate,' IfP, o zlrl 9F chid' p0- g - 9 k ZrZ y -- s/ova. iip ai- /6 • Yp ya/'C !//"/ >9 •_�F pbaV I O.f Sv o I I n Oh X Ch J 1 O Yj a �•' � tee. Vicc h•3°��� ! •1 /JD^/nJ 4517/d 2 /iooJp9D` SYv /!09 P.Ai!!' �16 DOOZ,999/JAo*ZZ P bn' ; »ys drdZ.atd t 4�'O P�a',%FYi :rs� ry ot� � rn�•u o� • 1 F-- V-1 ?gas ; i'i vd �+a r. � 1 � Wh;�1 ` ray/f l a t zt n a t- kjri LoU ILI �.► 4 < • .Z p Q 1103-91 JOB NAME, T JOB, NO. 7 .40'J­OEI LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE - - - t' - -- 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 JOB FOLDER Printed in U.S.A