HomeMy WebLinkAboutPiney Valley Ranch Main House - 185306200002INDIVIDUAL 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. 1116
Please call for final inspection before covering any portion of installed system.
OWNER: Piney Valley Trust Ranch —MAIN HOUSE 949-5380
PHONE:
MAILING ADDRESS: Box 3149, Vail, CO 81658
AGENT: PHONE:
SYSTEM LOCATION: 11 miles N & 2 miles W of Wolcott
LICENSED INSTALLER: Ewing Trucking LICENSE NO. 17-92
DESIGN ENGINEER OF SYSTEM:
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 700 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: 23 Infiltrators in trenches Place inspection portals at the
end of each trench.
ENVIRONMENTAL HEALTH OFFICER: DATE: 10130191
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.
/�/% n /
INSTALLED ABSORPTION OR DISPERSAL AREA: 700 SQUARE FEET. ill'a a� 3
INSTALLED SEPTIC TANK: GALLONS DEGREES 3-7 FEET Y jWn 4 W COr/Jer j Am,
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALS AND ASSEMBLY YES NO
COMPLIANCE WITH COUNTYISTATE REGULATION REQUIREMENTSYES 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:
Ar
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS PERMIT
APPLICANT/AGENT:
OWNER:
AMOUNT PAID: RECEIPT #: CHECK #: CASHIER:
ISDS Permit # /
Building Permit # S_O %
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: ?IV# I UMtt7 GweW1 -Ttzt>S i
MAILING ADDRESS: PV 40Y 31,19 , VI-4,-, Op, PHONE: r/v�{9- 53d'y
APPLICANT/CONTACT PERSON: Leo ,Si-r�►EFFf Cbasr(�v
PHONE:
LICENSED SYSTEMS CONTRACTOR: C'u/�cse d4vinc,`%2veKiN6 �C i3OuS7-��
ADDRESS: (J. ay 9V/ /�yva, �v • �/� 2 U PHONE: 9V9- SSfr9
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PERMIT APPLICATION IS FOR: NEW INSTALLATION ( )•ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVI UAL SEWAGE DISPOSAL SYSTEM:
Legal Description: Nr- %y SW Za Sec ¢ - T3,5 R 8a W 6 TN P/1
Parcel Number: Lot size:
Physical Address: #A,,fs ,jtrH i Of WPL@s'fr,('p,
BUILDING PE: - �- (Check applicable category) (3-!-
( Residential / Single Family Number of Bedrooms
( ) Residential / Multi -Family* Number of Bedrooms
{ ) Commercial / Industrial* Type
HOT TUB Yes. No
WATER CONSERVATION PLAN: Yes ( 1 No (X)
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 REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
S /o
IGNATURE: , (- V DATE: 45
AMOUNTPAID: , RECEIPT# DATE:
CHECK # CASHIER:
TIME LOG
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JOB NAME, ,,,_, 11 mi N & 2 mi W of Wolcott
Piney Valley Trust Ranch
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