HomeMy WebLinkAbout1867 Brush Creek Rd - 210909100009INDIVIDUAL 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. PERMIT NO. 1291
Please call for final inspection before covering any portion of installed system.
OWNER: Darrell Jerman PHONE: 471-0436
MAILINGADDRESS: P.O. Box 665 city: Edwards State: CO Zip: 1420--
APPLICANT: SAA PHONE: SAA
SYSTEMLOCATION: 1867 Brush Creek Rd. , Eagle TAX PARCEL NUMBER: 2.109-091-00-009
LICENSED INSTALLER: T&T Excavation LICENSENO: Q7-93
DESIGN ENGINEER OF SYSTEM: Johnson & Kunkel- Engineering / Jim Kunkel
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
630 SQUARE FEET OF SEEPAGE BED SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Install as per Engineer's REVISED drawings.
ENVIRONMENTAL HEALTH APPROVAL: " GLJ 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. 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 13E 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: Q 0 :L SQUARE FEET.
r
INSTALLED SEPTIC TAM 100.0- GALLON DEGREEe _aT_ FEET FROM
SEPTIC TANK ACCESS TO WITHIN W OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY L__1"YES _ NO
COMPLIANCE WITH COUNTY / STATE REQUIREMENTS: iv/YES _ NO
j5�IY ITEM CHECKED NO DMI IMES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK 1S CORRECTED.
COMMENTS:
ENVIRONMENTAL HEALTH APPROVAL. DATE:
ENVIRONMENTAL HEALTH APR VAL: DATE:
(RE -INSPECTION IF NECESSARY)
APPLICANT / AGENT:
RETAIN WITH RECEIPT RECORDS
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT # CHECK #
ISDS Permit #
_�991
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
PROPERTY OWNER : j f4re_eC--z_e__ A
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MAILING ADDRESS : ` Q ' 90)( ii�6
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APPLICANT/CONTACT PERSON:
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CONTRACTOR: Q �}-tJ (~fGl G -7" qj S
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PERMIT APPLICATION IS FOR: %) NEW INSTALLATION ( ) ALTERATION ( ) REPA
LOCATION OF PROPOSED INDIVI/D�AL SEWAGE DISPOSAL SYSTEM:
Legal Description -
Parcel X/ltw® )e/Uf%� s he &,
g iption-
Parcel Number: TA-�c '* 21 02- 09 0 0002 Lot size: � Q
Physical Address: f A5wy/`✓ � k.
BUILDING(�PE: (Check applicable category)
Residential / Single Family Number of Bedrooms
( ) Residential / Multi -Family* Number of Bedrooms
( ) Commercial ./ Industrial* Type
ADDRESS:
SYSTEMS
6 0 SC
(S 1�_'
******************************
TYPE OF WATER SUPPLY: Well( Spring ( ) Surface ( )
Public (A Name of Supplier: /
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*These systems require desi n by a Reg'stered Professional Engineer
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NOTE: SITE P;�aUST'BE ;tE
ACHED TO APPLICATION
MAKE ALL REME PAYATO: "EAGLE COUNTY TREASURER"
SIGNATURE: DATE:
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AMOUNT PAID: RECEIPT# DATE: ��
CHECK # CASHIER:
Johnson, Kunkel & Associates, Inc.
CIVIL ENGINEERING • LAND PLANNING • SURVEYING • MAPPING
July 26, 1994
Ray Merry
Environmental Health
Eagle County Department of Community Development
P.O. Box 179
Eagle, Colorado 81631
RE: Septic System, Darrell Jerman Residence, 1867 Brush Creek Road
Dear Ray:
I conducted a final inspection of the above referenced individual sewage disposal system on July
26, 1994. The system has operated successfully for several months. It is my conclusion that
The leach field and dosing system has been constructed in accordance with the plans and
specifications.
Sincerely
iames S.
cc. Darrell Jei-man
23089
P.O: Box 409 • 113 East 4th Street • Eagle, Colorado 81631 • Phone: (303) 328-6368 • Fax: (303) 328-1035
P.O. Box 771196 . 200 Lincoln Ave. • Suite 210 • Steamboat Springs, CO 80477 . Phone: (303) 879-4676 • Fax: (303) 879-4870
1291-93 - Parcel #2109-091-00-009
JOB NAME 1867 Brush Creek Rd., Eagle JERMAN JOB NO.
OB LOCATION
BILL TO
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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 277 Q® NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER
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