HomeMy WebLinkAbout173 Little Dipper Rd - 194135202025INDIVIDUAL 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. 1366
Please call for final inspection before covering any portion of installed system.
OWNER: Gary Yantis PHONE: 541-0505
MAILING ADDRESS: 11900 W. 87th St Pkway Suite 220 city: Lenexa st�18: KS ZIP: 66215
APPLICANT: George Roberts PHONE: 949-1446
SYSTEM LOCATION: 173 Little Dipper RD TAX PARCEL NUMBER: 1941-352-02-025
LICENSED INSTALLER: Rex BOssoW LICENSE NO: 24-94
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 1139 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Install 31 infiltrators, install inspection portals and rake trench
bottom and side walls. Call for final inspection before back filling
ENVIRONMENTAL HEALTH APPROVAL: 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 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: 1,139 SQUARE FEET. 31 infiltrators
INSTALLED SEPTIC TANK: 1250 GALLON north DEGREES 25 FEET FROM north facing corner 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 APPROVAL: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT A CHECK #
Incomplete Applications Will NOT Be Accepted
(Site Plan MUST be attached)
a
ISDS Permit, # o (�- V
Building Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
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 $200.00
* MAKE ALL REMITTANCE PAYABLE"_�O: "EAGLE COUNTY TREASURER"
PROPERTY OWNER: Gary Yantis
MAILING ADDRESS: 11900 W. 87th St. Pkway Ste 220 Lenexa:; PHONE: 541-0505
KS.66215
APPLICANT/CONTACT PERSON: George Roberts �,0,�y6 A� PHONE: 949-1446
LICENSED SYSTEMS CONTRACTOR: �\AHONE: 471-0771
P16 s50 LJ:?
COMPANY/DBA: Blade Runners ADDRESS: P.O. Box 656, Edwards-, CO 81632
PERMIT APPLICATION IS FOR: (-X) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Kidce 4-7, 1-6f q7 s,.
Legal Description: J Lot.47 South, Filing 2, Bellyache Subdivision
Tax Parcel Number: 5 ��` ' Ye / /14/i 352-OZ-025 Lot Size: 1 .5 acres
Physical Address:
173 Little Dipper Rd., Wolcott, Colorado
BUILDING TYPE:. (Check applicable category)
(X) Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
Number of Bedrooms
Number of Bedrooms
Type
TYPE OF WATER SUPPLY: (Check applicable category)
( ) Well ( ) Spring ( ) Surface
(X) Public Name of Supplier: Bellyache Metro Board
*These systems
a Registered Professional Engineer
SIGNATURE: Date:
AMOUNT PAID: 3z,_DD•C RECEIPT #: ZZ'S DATE:
CHECK CASHIER:
-- 4
ISDS PERMIT ;%_
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER:
LEGAL DESCRIPTION:
MAILING ADDRESS:
TYPE OF DWELLING: �` NUMBER OF BEDROOMS
TEST HOLES PRE-SOAKED: YES NO
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Time to drop* last inch 40
MINIMUM SEPTIC TANK S
PERC RATE: IZ �-�
MINIMUM LEACH FIELD SIZE: , 1.3q 0 .. -
rev. 6/90ks
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ON
1366-94 - #1941-352-02-025
Lot 47 S. Bellyache Ridge YANTIS
JOB NAME _ 173 Little Dipper Rd., Wolcott, CO
JOB NO. ( �
JOB LOCATION
BILL TO
DATE STARTED
DATE COMPLETED
DATE BILLED
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
INSURANCE
SALES TAX
MISC. COSTS
TOTAL JOB COST
GROSS PROFIT
_
LESS OVERI,EAD COSTS
% OF SELLING PRICE
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