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HomeMy WebLinkAbout133 Hawk Ln - 247106301002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION P.O. Box 175 - 500 Broadway • Eagle, Colorado 81631 Telephone: 328-8755 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1355 Please call for final inspection before covering any portion of installed system. OWNER: Charles & Irene Segal PHONE: 7ii-4757=H _777-4067—W MAILINGADDRESS: 1835 h_erman St , T) n r, City: Denver State:C_ Zip: sn21 n APPLICANT: Dave Beck PHONE: 961-0219 SYSTEM LOCATION: 105 Hawk Ln.,Rnecli Shoran TAX PARCEL NUMBER: _7471-061-01-002 LICENSED INSTALLER: ROselane Excavating LICENSE NO: 48-94 DESIGN ENGINEER OF SYSTEM: INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: 1000 GALLON SEPTIC TANK ABSORPTION AREA REQUIREMENTS: XXXXX SQUARE FEET OF SEEPAGE BED I e n 46 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Install 28 infiltrator units in trenches. Tnsi-all inspection nrt at the Pr( x each trench. Install infiltrators at 2' depth, with 1 ' of soil covera e in area of. erc test holes #1 & #3 for ��best soil conditions. / ENVIRONMENTAL HEALTH APPROVAL: ajv Uw C���- �M DATE: �/ / ` 4 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 PERM IT 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: 1022 SQUARE FEET. INSTALLED SEPTIC TANK: 1000 GALLON 84 DEGREES 12 FEET FROM SE corner of east side of house SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND PROPER MATERIAL AND ASSEMBLY X YES NO COMPLIANCE WITH COUNTY/ STATE REQUIREMENTS: X 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: ENVIRONMENTAL HEALTH APPRO L: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS APPLICANT / AGENT: OWNER: PERMIT FEE PERCOLATION TEST FEE RECEIPT # CHECK # Incomplete Applications Will NOT Be Accepted (Site Plan MUST be attached) ISDS Permit # 5`) Building Permit # -'APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P . 0. BOX 179 C, w t4-) f EAGLE, CO 81631 �k e 1 ($3 f 328-8755/927-3823 (Basalt) ************************************************************************** * PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00 * * * MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" PROPERTY OWNER: C " `�rl ej �-Z-Z-P � l5 r e Se MATLTNG ADDRFSG' /g3CT -S. "�_ sL ns�1r f r U ul Q8 OZ / D n , , i,��/� � _ � `Z � APPLICANT/CONTACT PERSON • _ 1� '� e �1� l� v Iy PHONE : Z S' 73 LICENSED SYSTEMS CONTRACTOR: 6 C d 4 t P4 l-IP AiI PHONE: COMPANY/DBA 0 e �Qt" tie ADDRESS: PERMIT APPLICATION IS FOR: q) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: /- Legal �,D�eysc'ripti�o►n: L04 2 �'t1 Z �f�i 3 d�� alk, P reel-Numbe SeI1eC m,U- 032-3fJ Lot Size: Physical Address: US Q w L%, L, tAW e BUILDING TYPE: (Check applicable category) Residential/Single Family ( ) Residential/Multi-Family* TYPE WATER SUPPLY: (Check applicable category) Well ( ) Spring ( ) S rface ( ) Public Name of Supplier: *These systems re Number of Bedrooms 3 Number of Bedrooms _ TVDP 1G-Ci --�14wel t3tAI'A design b" a Registered Professional Engineer SIGNATURE: -1 Date: AMOUNT PAID: =6 0 G ` Ic-I iiC 1 p RECEIPT #: DATE: CHECK #:\ CASHIER: COMMUNITY DEVELOPMENT DEPARTMENT (303)328-8730 EAGLE COUNTY, COLORADO December 12, 1994 500 BROADWAY P.O. BOX 179 EAGLE, COLORADO 81631 FAX: (303) 328-7185 Charles & Irene Segal 1835 S. Sherman St. Denver, CO 80210 RE: Final of ISDS Permit No. 1406-94 Parcel # 2471-063-01-002, Property located at: 105 Hawk Lane, Ruedi Shores, Basalt. Dear Mr. & Mrs. Segal, 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 building 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, Je f Fedri Environmental Health Specialist ENCL: Information Brochure Final ISDS Permit enclosures COMMUNITY DEVLOPMENT DEPARTMENT (303)328-8730 DATE: TO: FROM: RE: 500 BROADWAY P.O. BOX 179 EAGLE. COLORADO 81631 FAX: (303) 328-7185 EAGLE COUNTY, COLORADO June 9, 1994 Rose Lane Excavating Environmental Health Division Issuance of Individual Sewage Disposal System Permit No. 1355, Tax Parcel # 2471-063-01-002 Property Located at: 105 Hawk Lane, Ruedi Shores Enclosed is your ISDS Permit No. 1355 is valid for 120 days. The enclosed copy of the permit must be posted at the installation site. Any changes in plans or specifications invalidates the permit unless otherwise approved. Please call our office well in advance for the final inspection. Systems designed by a Registered Professional Engineer must be certified by the Engineer indicating that the system was installed as specified. Eagle County does not perform final inspections on :engineer designed systems. Permit specifications are minimum requirements only, and should be brought.to the property owner's attention. This permit does not indicate conformance with other Eagle County requirements. If you have any questions, please feel free to contact Shannon Garton or Laura Fawcett at 328-8755. cc: files COMMUNITY DEVELOPMENT DEPARTMENT (303)328-8730 EAGLE COUNTY, COLORADO December 2, 1994 Charles & Irene Segal 1838 S. Sherman St. Denver, CO 80210 Dear Applicant, 500 BROADWAY P.O. BOX 179 EAGLE, COLORADO 81631 FAX: (303) 328-7185 The Environmental Health Division would like to notify you to make a formal request to extend your Individual Sewage Disposal System(ISDS) Permit #1355-94 into the 1995 construction year. The Environmental Health Division discontinued percolation tests on November 15, 1994 and final inspections on December 2, 1994 due to climatic conditions. ISDS permits are active for 120 days after the date of issue if no Building Permit has been issued for the same property. If a Building Permit has been issued for the same property the ISDS will expire at the same time as the building permit. If you still plan to apply for a Building Permit this year or in the early months of 1995 you will need to have a percolation test conducted before your Building Permit will be released. You will have to contact a Registered Professional Engineering(RPE) firm to conduct your percolation test. If you have had your permit issued and have not had your final inspection completed, but plan on constructing the system in the next few weeks, please give our office a call and we will evaluate your permit on a case by case situation. Please give the Environmental Health office a call at 328-8755, if you have any questions regarding your permit extension process. cc: ISDS Permit #1355-94 File ISDS PERMIT 35-5 PERCOLATION TEST ;Pp EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. Y' OWNER: LEGAL DESCRIPTION: Lo f 2 I / PI,1 ,�tti-SlglreS MAILING ADDRESS: TYPE OF DWELLING:diAJ late sAA NUMBER OF BEDROOMS 3 ki TEST HOLES PRE-SOAKED: YES /\ NO -� TTMF 1 2 3 1 2 3 1 2 3 1 2 3 SU1L exuylL 0' a13, ` 3. 3/L �Ido � 4(l 11126 4D 1U 20 20 31 � 4 141 5 1.12-6 , ,� ,125 U 10 40 1. .6'r J 1"12-5 ,ZS , iZs 0 2D ' ,' 025 Time to drop last inch PERC RATE: MINIMUM SEPTIC TANK SIZE: MINIMUM LEACH FIELD SIZE: COMMENTS: PERC TEST DONE BY: DATE: 5 vironmental Health Officer rev. 6/90ks ISDS PERMIT 1355 PI( C PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. OWNER: S VIZIQ rc- +e st LEGAL DESCRIPTION:-'ay-� 1- 0 6 3 _01-_O.., 105 4aw k LK MAILING ADDRESS: JU5 TYPE OF DWELLING:�s,�Pl 1 Le Ism. NUMBER OF BEDROOMS j TEST HOLES PRE-SOAKED: YES NO TIME wnrpry nrvrrw L'TT T T%r enr. 1 2' 3 1 2 3 1 2 3 . 1 2 3 0' SO 11 1 1,z s lip. �25 1 25 .5 .875 1q.0 jo 5.11 2 25 25 -0 ZO g 3, 5 h'� 0 'It . 5 .3� .5 1 13,3 10 4 20,125 175/ ' , 25 , 375 10 20 13,3 5 Iq: )0,2.5 I"r lq-5 5 .125 .5 W 40 10 6 30 20.3-7 I`� �5 zs , IZ� , 375 Z0 Lko 13,3 (, 2 .U2� �b 0.5 20,7S 19,0 I15 , 1K , 2 40, 40. ZeD 1120,11 ao.So 1C1 , ,2,( 05 ? 20 19v zo Time to drop last inch PERC RATE: D MINIMUM SEPTIC TANK SIZE: 100O Ck 1 t6n_5 MINIMUM LEACH FIELD SIZE: , o4 6 Qj COMMENTS: G� U ` F( ;( 1,75 XV7541 --55— _ 0`�� � Z n _ �ye��cTi� s. �� �a[ dt t► Id 1,X ,5 = a� 1-Irafions 5 t �,-7S d.Shal oW 'h 12 rc feSf nr- r kole5 # I d 3 4n nlaxdmrze f Sall lac dim, PERC TEST DONE BY: claimer-4Q.(,JZ DATE: 5 Environmental Health Officer rev. 6/90ks I ce V:13:61 � 1355-94 - Parcel #2471-063-01-002 JOI 105 k_,Lane StGAL -- Ruedi Shores Sub. Lot 2 Filing 2 JOB NO. JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED r� 'C � raao-si S t� 3 q i C cvf, 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 276 Qp NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER Printed in U.S.A. _1 VLOOIG OVEN ' - Nv T . 00 _. - _o t Q \ Q2'-Ole - - - _ - - � 1 � vet• `` - _ - - —� r INDIVIDUAL 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. 1355 Please call for final inspection before covering any portion of installed system. OWNER: Charles & Irene Segal PHONE: 722-4757-14,777— 67—W MAILING ADDRESS: 1835 S Sherman St . , Denver, City: DPniTpr state: C0 zip:80210 APPLICANT: Dave Beck PHONE: 96i-()2,'19 SYSTEMLOCATION: 105 Hawk Ln. ,Rued! Shores TAX PARCEL NUMBER: 2471-061-01-002 LICENSED INSTALLER: Roselane Excavating LICENSE NO: 48-94 DESIGN ENGINEER OF SYSTEM: INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: 1000 GALLON SEPTIC TANK ABSORPTION AREA REQUIREMENTS: X_XXXX SQUARE FEET OF SEEPAGE BED 1,046 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Install 28 infiltrator unit-4 in trpnchpq. Tnst-a11 inGpPr HQn p ortal G at tha e each trench. Install infiltrators at 2' depth, with 1 ' of soil coverage, in area of Pere test holes #1 & #3 for best soil � conditions. Z JGJ1� ENVIRONMENTAL HEALTH APPROVAL: `% U.� tx- t.(iLv cx�t.f DATE: 61� ! L ` / CONDITIONS: t. 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: 1022 SQUARE FEET. INSTALLED SEPTIC TANK: 1000 GALLON 84 DEGREES 12 FEET FROM SE corner Of east side of house. SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND PROPER MATERIAL AND ASSEMBLY X YES NO COMPLIANCE WITH COUNTY/ STATE REQUIREMENTS: X 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: 7 ENVIRONMENTAL HEALTH APPRO L: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS APPLICANT / AGENT: OWNER: PERMIT FEE PERCOLATION TEST FEE RECEIPT # CHECK # incomplete Applications Will NOT Be Accepted (Site Plan MUST be attached) ISDS Permit # Building Permit # i APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT / ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY P. O. BOX 179 G 0 'B" ti q 4 "$4-) / EAGLE, CO 81631 C -t� Lk 3 328-8755/927-3823 (Basalt) * PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00 * * * MAKE ALIs REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" PROPERTY OtiVNER. / � Y� � J e MATTJNr AnT1RFCS � _ �^ APPLICANT/ CONTACT PERSON: ,4,LQ� e I c `�' U I S� PHONE LICENSED SYSTEMS CONTRACTOR: (:{ /7F PHONE: COMPANY / DBA : d P�om lie ADDRESS : *************************************************************************** PERMIT APPLICATION IS FOR: 4) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Legal De�slcription: �L4f-41 S 0 0L PrNA: seCJMA � 0323 Lot Size: Physical Address: ! �� At AN-Q BUILDING TYPE: (Check applicable category) ()0 Residential/Single Family ( ) Residential/Multi-Family* 4'.CmTi?P,r[�i_al_/Trld'1�t7'7�1* Number Number Tvne of Bedrooms of Bedrooms TYPE OF WATER SUPPLY: (Check applicable category) Well ( ) Spring ( ) S rface c /I ( ) Public Name of Supplier: 1w -P CA- J"`G'Ci �a� e Gw�� *These systems re tc�y.re design byla Registered Professional Engineer SIGNATURE: ���-�`�� Date: AMOUNT PAID: RECEIPT #: l� �> I DATE:)IoIG CHECK #: �� CASHIER: COMMUNITY DEVLOPMENT DEPARTMENT (303) 328-8730 DATE: im FROM: EAGLE COUNTY, COLORADO June 9, 1994 Rose Lane Excavating Environmental Health Division 500 BROADWAY P.O. BOX 179 EAGLE. COLORADO 81631 FAX: (303) 328-7185 RE: Issuance of Individual Sewage Disposal System Permit No. 1355, Tax Parcel # 2471-063-01-002 Property Located at: 105 Hawk Lane, Ruedi Shores Enclosed is your ISDS Permit No. 1355 is valid for 120 days. The enclosed copy of the permit must be posted at the installation site. Any changes in plans or specifications invalidates the permit unless otherwise approved. Please call our office well in advance for the final inspection. Systems designed by a Registered Professional Engineer must be certified by the Engineer indicating that the system was installed as specified. Eagle County does not perform final inspections on engineer designed systems. Permit specifications are minimum requirements only, and should be brought to the property owner's attention. This permit does not indicate conformance with other Eagle County requirements. If you have any questions, please feel free to contact Shannon Garton or Laura Fawcett at 328-8755. cc: files COMMUNITY DEVELOPMENT DEPARTMENT (303)328-8730 EAGLE COUNTY, COLORADO December 12, 1994 500 BROADWAY P.O. BOX 179 EAGLE. COLORADO 81631 FAX: (303) 328-7185 Charles & Irene Segal 1835 S. Sherman St. Denver, CO 80210 RE: Final of ISDS Permit No. 1406-94 Parcel # 2471-063-01-002, Property located at: 105 Hawk Lane, Ruedi Shores, Basalt. Dear Mr. & Mrs. Segal, 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 building 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, Je efFedri Environmental Health Specialist ENCL: Information Brochure Final ISDS Permit enclosures COMMUNITY DEVELOPMENT DEPARTMENT (303)328-8730 EAGLE COUNTY, COLORADO December 2, 1994 Charles & Irene Segal 1838 S. Sherman St. Denver, CO 80210 Dear Applicant, 500 BROADWAY P.O. BOX 179 EAGLE, COLORADO 81631 FAX: (303) 328-7185 The Environmental Health Division would like to notify you to make a formal request to extend your Individual Sewage Disposal System(ISDS) Permit #1355-94 into the 1995 construction year. The Environmental Health Division discontinued percolation tests on November 15, 1994 and final inspections on December 2, 1994 due to climatic conditions. ISDS permits are active for 120 days after the date of issue if no Building Permit has been issued for the same property. If a Building Permit has been issued for the same property the ISDS will expire at the same time as the building permit. If you still plan to apply for a Building Permit this year or in the early months of 1995 you will need to have a percolation test conducted before your Building Permit will be released. You will have to contact a Registered Professional Engineering(RPE) firm to conduct your percolation test. If you have had your permit issued and have not had your final inspection completed, but plan on constructing the system in the next few weeks, please give our office a call and we will evaluate your permit on a case by case situation. Please give the Environmental Health office a call at 328-8755, if you have any questions regarding your permit extension process. cc: ISDS Permit #1355-94 File ISDS PERMIT # 1/( PERCOLATION TEST C EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.� OWNER: LEGAL DESCRIPTION: Lo !' i C Z t d GIt ..Sly©re 5 MAILING ADDRESS: TYPE OF DWELLING: bztda lG_e'd NUMBER OF BEDROOMS 3 TEST HOLES PRE-SOAKED: YES NO TTME WnTL'D nF'Dmv TwTnv�� nc+ zrT T T\r..,,. 1 2 3 --- --- 2 --- 3 1 2 3 1 ��.� 2 auiL rnvr 1t 0' z1 k() 2 3' G l 1)3 7) q. �� 3 5 a� i3,3 1 C� _ I 4' 126 5 1 40 IQ 5' J - 125 1(6" 71 8 a, 3A Time to drop last inch PERC RATE: MINIMUM LEACH FIELD SIZE: COMMENTS: PERC TEST DONE BY: MINIMUM SEPTIC TANK SIZE: DATE: 5 vironmental Health Officer rev. 6/90ks I SDS PERMIT J f-',55 PERCOLATION TESTfi rc, EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. ie .mot OWNER: - LEGAL MAILING ADDRESS: -S 4cw k L TYPE OF DWELLING: NUMBER OF BEDROOMS TEST HOLES PRE-SOAKED: YES- A NO TIMEwarrry nrvrrTi 'r'KTr4T_TVC! rltl rAT-T- 13 n rnt, i■��i-n�■�■ice OWN mimmmi_ Time to drop last inch PERC RATE: (� 0 MINIMUM SEPTIC TANK SIZE: MINIMUM LEACH FIELD SIZE: i, o 4 6 14 \f—t,-0 ;Y\ 1, -7 5 COMMENTS: �Q2Lkc, (Po X Dj 7-1 hw""JFM TV x 6 q_s ha I I ro, PERC TEST DONE BY: rev. 6/90ks k,4 \\ �GrNTF ut �a Gc�l.r 240— ivirtG ov�z y'PI-`FWD• ND INa4:41,9lz F(l~17N lose It;, - -� i J AT , IY`1G- FA L.- 2 4?Ft N F 110 qp 10. 'o 44 rz i �JJ Mtn" Ili-T4-i 1355-94 - Parcel #2471-063-01-002 JO, 103-a ?-.Lane StGAL Ruedi Shores Sub. Lot 2 Filing 2 JOB NO. - JOB FOLDER Product 278 NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MA 01471 JOB FOLDER Printed in U.S.A i It 74.-ta EAGLECouNTY Eagle County OWTS Systems Cleaners Reporting Form NOTE: Required to be submitted to Environmental Health within 10 days of cleaning an O�WrrS�system Systems Cleaner Company /Tct I/GC/ ,C(S A -KC License Number e4?-Zd ZO Email Address bC(A,A .�„raKs�..�,,,rt,gti uaPhone 11?C)'30-.)g6t Tax Parcel # Person Requesting Servile S'Vc,� &�'.i-Ty Property Owner Septic System Permit Nu ber 1355 TankSizeIUUD & Date of service ` Or)2 ( Tank Material C M1A}7— Sewage Disposal Site I �L General Condition and Functionality of the System 31"G a [/Gcc,t-c. Recommended Site sketch showing location of the septic tank access lids measured from at least 2 fixed points (Photos Encouraged) Signed 1 Date _ G — vzl --2- l cc) | f - E | 0 E E } 7 , \ k ( ! 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