HomeMy WebLinkAbout689 West River Valley Rd - 211102100007INDIVIDUAL 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. 1319
Please call for final inspection before covering any portion of installed system.
OWNER: Michael Hoffman
MAILING ADDRESS: P.O. Box 5 75
APPLICANT: Richard Gilbert
SYSTEM LOCATION: Eagle Ranch Lot E
LICENSED INSTALLER: Spiegel Construct
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 563
SPECIAL REQUIREMENTS: Install 16 inf it
Install inspection portals a
Call for final inspection pr
ENVIRONMENTAL HEALTH APPROVAL: f
CONDITIONS:
1. ALL INSTALLATIONS MUST COMPLY WITH AI
TO AUTHORITY GRANTED IN 25. 10- 104. IT
2. THIS PERMIT IS VALID ONLY FOR CONNECT
TO OR USE WITH ANY DWELLING OR STRUC
REQUIREMENT OF THE PERMIT AND CAUSE
3. CHAPTER IV, SECTION 4.03.29 REQUIRES AI`
FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY IN!
NO SYSTEM SHALL BE DEEMED TO BE IN COMPLIANCE N
PRIOR TO COVERING ANY PORTION OF THE SYSTEM.
INSTALLED ABSORPTION OR DISPERSAL AREA: 5 61
INSTALLED SEPTIC TANK: 1000 GALLON 17
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY
COMPLIANCE WITH COUNTY / STATE REQUIREN
ANY ITEM CHECKED NO REQUIRES CORRECTION
COMMENTS:
ENVIRONMENTAL HEALTH APPROVAL:
ENVIRONMENTAL HEALTH APPROVAL:
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT A CHECK A
Incomplete Applications Will NOT Be Accepted
(Site Plan MUST be attached)
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.ISDS Permit # )SS1
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
* *
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
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PROPERTY OWNER: `v l t �. ( P14NJ
MAILING ADDRESS: C�, rx �7 � Lei 6 Lip 'iYCPHONE:
APPLICANT/ CONTACT PERSON: i- d ,,e-.b PHONE: '24f '2,6 4
LICENSED SYSTEMS CONTRACTOR: -1 PHONE: S �
COMPANY/DBA: (1 ADDRESS:. Lac,,;�ptii
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PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: ----
Legal Description:
Tax Parcel Number: ZII( 1 0?-1 - 00,M7 Lot Size:
Physical Address:
BUILDING TYPE: (Check applicable category)
(' Residential/Single Family Number of Bedrooms _3
( ) Residential/Multi-Family* Number of Bedrooms
( ) Commercial/Industrial* Type
TYPE OF WATER SUPPLY: (Check applicable category)
( Well ( ) Spring ( ) Surface
( ) Public Name of Supplier:
*These systems
SIGNATURE:
************ ***** ******
AMOUNT PAID:
a Registered Professional Engineer
Date: dAee f l5 : If ?4
_ RECEIPT L.o'I DATE:
CHECK #: 1 F, p- q n CASHIER: G-
ISDS PERMIT ;; ),3iq
iD
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER: (li; 7j_:7jy�Ui►�;
LEGAL DESCRIPTION: !�� (( -- (j _
MAILING ADDRESS: L_OJ ce
TYPE OF DWELLING: NUMBER NUMBER OF BEDROOMS_
TEST HOLES PRE-SOAKED: YES_ NO
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PERC TES DONE BY
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DATE:
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TRANSMISSION REPORT
THIS DOCUMENT WAS CONFIRMED
(REDUCED SAMPLE ABOVE - SEE DETAILSI BELOW)
** COUNT **
TOTAL PAGES SCANNED 2
TOTAL PAGES CONFIRMED : 2
*** SEND ***
No,
A Ft E A 1_T E F=' I—As_N
TRANSMISSION REPORT
THIS DOCUMENT WAS CONFIRMED
(REDUCED SAMPLE ABOVE - SEE DETAILSI BELOW)
** COUNT **
TOTAL PAGES SCANNED 2
TOTAL PAGES CONFIRMED : 2
*** SEND ***
No,
REMOTE STATION
START TIME
DURATION #PAGES
I MODE II RESULTS
1
— 8323517
12 - 2 - 97 8 : 52
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1 ' 30 " >
EC --- COMPLETED —
9Ei00
NOTE: TOTAL 0:01'30" 2
No.: OPERATION NUMBER 48 : 4800BPS SELECTED EC : ERROR CORRECT G2 : G2 COMMUNICATION
PD : POLLED BY REMOTE SF : STORE & FORWARD RI : RELAY INITIATE RS RELAY STATION
SIB : SEND TO MAILBOX PG : POLLING A REMOTE MP MULTI -POLLING RM : RECEIVE TO MEMORY
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NEW GRADE
SEWAGE TANK
LEACH FIELD
LOT 6
AREA SITE PLAN SCALE.,.
1319-94 .- Parcel #2111-021-00-007 y "�
JOB NAME Lot 6 Eagle Ranch HOFFMAN JOB NO.
J08 LOCATION
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
.106 FOLDER Product 278 n� a NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER Printed in U.S.A.