HomeMy WebLinkAbout10 Mesa Dr - 193929407001INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631
Telephone: 328-8755
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE.
Please call for final inspection before covering any portion of installed system.
PERMIT NO. 1 2 0 4 —92
OWNER: Eby Creek Mesa, Ltd. PHONE: 949-4141
MAILING ADDRESS: P.O. Box 2065 city: Avon State: CO Zip: 81620
APPLICANT: Eby Creek Mesa, Ltd. PHONE: 949-4141
SYSTEMLOCATION: 0010 Mesa Drive TAX PARCEL NUMBER:
LICENSED INSTALLER: Don Lilly, Water Systems LICENSE NO: 57-92
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
l j rlUld/4
f ®® CO GALLON�9EPfile"ANK
ABSORPTION AREA REQUIREMENTS: Na
SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
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SPECIAL REQUIREMENTS: / I 1tb1 t�t'tlLC jfJ G i (? r>7 /2/[�
ENVIRONMENTAL HEALTH APPROVAL: DATE: AD
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. 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. CHAPTER IV, SECTION 4.03.29 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM TO BE LICENSED.
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMPLIANCE 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: y/ SQUARE FEET.
INSTALLED SEPTIC TANK: a4Q6 GALLON bt�6GREES FEET FROM
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY YES _NO
COMPLIANCE WITH COUNTY / STATE REQUIREMENTS: YES _NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED.
COMMENTS:
ENVIRONMENTAL HEALTH APPROVAL: DATE: %�2
ENVIRONMENTAL HEALTH APPROVAL: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
PERMIT
PERCOLATION TEST FEE
OWNER:
RECEIPT #
CHECK #
ISDS Permit # % 0 7 C�
Building Permit #_
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8755/927-3823(Basalt)
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
PROPERTY OWNER: C1
MAILING ADDRESS: ✓6o x 20A Vo.d PHONE •
i
APPLICANT/CONTACT PERSON: PHONE: t� 2
LICENSED SYSTEMS CONTRACTOR: i c1 T� s y S 'i'p ,,� S' jJo N ; �• %' / `\
ADDRESS: 0 o x G ,�l /
PHONE •
***************************************************************************
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION (I() ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: Oo f0 !yl e sA Z:?r
Parcel Number:
of size:
Physical Address: C)C�) I r) \ C,�t �_ � \ \ 0 0
BUILDING TYPE: (Check applicable category)
( ) Residential / Single Family Number of Bedrooms
( ) Residential / Multi -Family* Number of Bed ooms
Commercial / Industrial* Type ., ./r- ,ate %',^Q3
TYPE OF WATER SUPPLY: Well( ) Spring ( ) Surface ( )
Public (�<) Name of Supplier:
*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: Y /,y�i; DATE:-Cc-7%z-
**********************'***************************************'***********
AMOUNT PAID: �, �.( RECEIPT# 9 Jao
CHECK #
1`
DATE:
CASHIER:
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328-8730
EAGLE COUNTY, COLORADO
December 11, 1992
S00 BROADWAY
P.O. BOX 179
EAGLE. COLORADO 81631
FAX (303) 328-7207
Eby Creek Mesa, Ltd.
P.O. Box 2065
Avon, CO 81620
RE: Final of ISDS Permit No. 1204-92, 0010 Mesa Drive
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. This permit does not indicate
compliance with any other Eagle County requirements. Also
enclosed is a brochure regarding the care of your septic system.
Be aware that later changes to your dwelling may require
appropriate alterations of your septic system.
If you have any questions regarding this permit, please
contact the Eagle County Environmental Health Division at
328-8755.
Sincerely,
Brenda Henderson
Office Assistant
Environmental Health
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ENCL: Information Brochure
Final ISDS Permit
cc: Files BP#5420
120%-92 - 0010 Mesa Drive, Eby Creek Mesa Ltd',
JOB NO.
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
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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 &�9@ NEW ENGLAND BUSINESS SERVICE, INC„ GROTON, MASS, 01471 JOB FOLDER
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