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HomeMy WebLinkAbout197 Williams Ct - 211120400016INDIVIDUAL 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 927-3823jP YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT. NO. 116 4 -92 Please call for final inspection before covering any portion of installed system. OWNER: .Tack Davis PHONE: 524-9751 MAILING ADDRESS: P.O. Box 155, Gypsum, CO 81637 AGENT: .Tack Davis / Tax Parcel # 2111-204-00-016 PHONE: 524-9751 SYSTEM LOCATION: 0197 Williams Ct . , Gypsum, CO LICENSED INSTALLER: _ S Davis Construction LICENSE NO. 3-7-9-27 67-95 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 930 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Install 26 infiltrator units as requested by owner. Install in serial dis bution, with inspection portals at the end of each trench. Watch set backs, and install a cleanout between the house and the septic tank Rake all trench surfaces, and call the County for final ins tion io to - illing. ENVIRONMENTAL HEALTH OFFICER: DATE: September 27, 1995 CONDITIONS: 1. ALL INSTALLATION UST COMPLY WITH ALL QUIREM TS OF THE AGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS, ADOPTED PURSUANT TO AUTH RITY GRANTED IN 0-104, C.R.S. 1973, AS AMENDED. 2. THIS PERMIT IS VALID ONLY FOR CONNECTI TO STRU S 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: 936 SQUARE FEET. INSTALLED SEPTIC TANK: 1250 GALLONS 1000 DEGREES 12'511 FEET from the house. SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR: PROPER MATERIALS AND ASSEMBLY X YES NO COMPLIANCE WITH COUNTY/STATE 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: Trenches not serially distributed. ENVIRONMENTAL HEALTH OFFICER: DATE: October 1 ENVIRONMENTAL HEALTH OFFICER: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS PERMIT APPLICANT/AGENT: OWNER: AMOUNT PAID: RECEIPT #: CHECK #: CASHIER: � - - - -- .-t,t. `-6`cx Lu"b w I I I NUT Be Accepted to Plan MUST be attached) `4 ISDS Permit # f 6 Building Permit -� is 7 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT 4Q��� ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P . 0. BOX 179 EAGLE, CO 81631 328-8755/927-3823 (Basalt) PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00 MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" � PROPERTY OWNER: JAz,:�- 0109411-i MAILING ADDRESS: Fo. /.10 lsS ,,, ��639L PHONE: APPLICANT/CONTACT PERSON: Jgz`G �f� lv---- .PHONE : -�'-?SV' LICENSED SYSTEMS CONTRACTOR: - PHONE: �. COMPANY/DBA: ADDRESS: PERMIT APPLICATION IS FOR: /)NEW INSTALLATION LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEMLTERATION ( ) REPAIR Legal Description: A,,d5 �dvuw� Tax Parcel Number: �q, 1) �� � -��i `l',� Lot Size: �, Physical Address: n/ 9-7 /_ 14/'A /I J d BUILDINc;�TYPE: (Check applicable ( )) Residential/Single Family ( ) Residential/Multi-Family* ( ) Commercial/Industrial* TYPE OF WATER SUPPLY: ( )well ( ) ( Public Name category) Number of Bedrooms --1? Number of Bedrooms Type — (Check applicable category) Spring ( ) Surface Of Supplier: Tylud 6°l�d'y�? *These systems require des1-1 SIGNATURE: AMOUNT PAID: i TIME LOG: TRAVEL: by a Registered Professional Engineer Date: **Yc �c Yc Yt Y[ac*yc �c**�t Y�****Yr it Yt YC yc yc yr Y: �k :r Yr*4r Yr M*:k Y[Yt*Yc RECEIPT CHECK Y: PERC: DATE: h 1112 � CASHIER: A _ FINAL: /7((, i j q _ J Vi2/ GtJS? �.n G tic I-ece / 9T %S / ill l �s o � - 1�1j ISDS Final Inspection' Comp eteness Form Z,l� V Tank is gal. Tank Material it Tank is located izis ft. and D0degrees from _� " (permanent landmark) Tank is located ft. and degrees from (permanent landmark) �✓ Tank set level. L Tank lids within 8" of finished grade. Size of fielft2 units lineal ft. Technology Cleanout is installed in between tank and house(+ 1/100ft). L--� There is a "T".that goes down 14 inches in the inlet and outlet of the tank. _� Inlet and outlet is sealed with tar tape, rubber gasket etc. r/ Tank has two compartments with the larger compartment closest to the house. Measure distance and relative direction to field. ►/ Depth of field ✓ , s ft. Soil interface raked. v`' Inspection portals at the end of each trench. v Proper distance to setbacks.o °/ Other _u�-_v �r Inspection meetsrequirements.Q Copy form to installer's file if recommendations for improvement were suggested. ACTION TAKEN: ��iyi � -- Ca(.c ova (V Goa' -' Setbacks Well Potable House Property LakeDry Tank Drain Water Lines line Stream Gulch Field_ 100 25 20 10 50 25 10 10 Tank 50 10 5 10 50 10 * 10 0 [tEMIESIMMEME MEE INESSI®®ME®EENES IREMEMEM®MEEeMIS IMEMEMEMMEREINININ REMEMEMEMENINININ fSEMIESIMMEME no EENIMMEMENEEN■ S,EMEMENIENONE SEENEEMEME ME MEMEMMEMMENo NoN■ ■OMIMEMEMMNoN■ ■EMIENMEMMENoosr � NONEiimmmmmmmmmmmmm ENINKIMEMENNEI.■ 11011051 IMEMEMNNo 1m1llm�IMEMNON MEE Olmommmosommoom. INSWISMeNIMMINISM. M► -NDONE MENNEN RIEREMEMINININ ■ENEMi��NIMMERNiEMEl _Em ■■ ISDS PERMIT,--',' PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER:j� ,-, Ct Lii4 Da v l 5 LEGAL DESCRIPTION: h 2 5bo u r\ A S o 1*q q r) V1.1 S � (i '-yl MAILING ADDRESS: P,().60X l5 5 (S p C) �6_1 TYPE OF DWELLING: S F des. NUMBER OF BEDROOMS ce 4eAi TEST HOLES PRE-SOAKED: YES NO rrTMr tan man ""nMTT bUIL FROFIL 0 2 3 1 2 3 1 2 3 1 2 3 04 1� 12. T 77 Ile( 1/5 21 10.0 3- 14# Z,O 51 6 �30 L3 jop T/9- 40 100 1,1514 IK7 -------------------------- Time to drop last inch PERC RATE: MINIMUM SEPTIC TANK SIZE.40tt502 -�Y 24 lXcQ Y.-VK MINIMUM LEACH FIELD SIZE: COMMENTS I =(PV7 q b-C) coj C)-4—) 0(� x 2 5-, 8 3 _q2CL PERC TEST DONE BY: 15 P510 n-y\- DATE: 11! 2,' "i rt En,Vironmental Health officer rev. 6/90ks 0 J 0 <[A:z C -- e Ff- 0 W EST 0 t�AcN IF-c= DR wAy .7 y� Ngr" AC R ass c� IN i r RECEIVED Y, COMN'ibi yO Y DEVELOPMENT 1164-92 - Parcel #2111-204-00-016 %ClC Jack Davis JOB LOCATION IL -, JOB NO. W ,55r' BILL TO DATE STARTED DATE COMPLETED DATE BILLED zy-'�- C—m _ c)f Lk JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL a✓ , ^ �,IqVv�i ` i��. TOTAL LABOR ' r1 / SSU�Q' C lce� s" GAS c rule, S iti cG �C %J _ r� o / Ca S INSURANCE y 2 o?S-°c C rre� of u'� /li�S cep, 7�uC'fvyJ /ire /C) i SALES TAX �c•�Ti Ft o3 �U 9r �„��:� �4 trc y! a e 3 30 MISC. COSTS TOTAL JOB COST -.111,'l(d lU /�I j _ )�� f- e P/I LIAI GROSS PROFIT TS LESS OF SELLING PR % ICE NET PROFIT JOB FOLDER Pralucl 2�78 �® �EW EN` G�BUSINESS SERVICE, INC.,-G{ji�0,T0�� 71 ]�s, , i���O6... FOLDERA ��. G�cp�z,u�� �tit� "e (��1yi%�'�Cd( 1 tl hG(Xn�ilr 1 V �G(V Y✓L 7 k�, i 114L4 --1 z 10(it C�,vta ©( eY i w rib air C( da,cjc-- v� S ��it4 g 40 kaz C)/Ia a g-4 jol I 11 &q rq a t7fq'�tt�,`Jli'Ctr►ts �- /— J held ec.)Aazvx il021-42- lo)lfj1S aiq z c�; ��►ins c� T rz�� �a� ja t,,re- ►aa v,