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HomeMy WebLinkAbout14936 Hwy 6 - 211101100002INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, CO 81631
Telephone: (970) 328-8755
COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1840-99 BP NO. MI-11173
OWNER: JAMES A. FITZSIMMONS PHONE: (H) 970-524-9722: (B) 970-328-6621
MAILING ADDRESS: 3316 GYPSUM CREEK RD., GYPSUM, CO 81637
APPLICANT: SAME PHONE:
SYSTEM LOCATION: 1493614WY 6, GYPSUM, CO TAX PARCEL NO. 2111-011-01-002
LICENSED INSTALLER: CORKY'S GAS, JAMES A. FITZSIMMONS LICENSE NO. 7-99 PHONE: 970-328-6621
DESIGN ENGINEER: PHONE NO.
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK 844 SQUARE FEET OF TRENCH ABSORPTION AREA VIA 28 INFILTRATOR UNITS AS REQUESTED
SPECIAL REQUIREMENTS: DO NOT INSTALL IN THE AREA WHERE THE FIRST PERC HOLE RAN DRY DUE TO HIGH PRESENCE OF EVAPORITE.
INSTALL THE LEACHFIELD IN THE AREA OF THE OTHER PERC HOLES. INSTALL IN SERIAL DISTRIBUTION WITH A CLEANOUT BETWEEN TH
TANK AND THE HOUSE AND INSPECTION PORTALS IN EACH TRENCH. RAKE ALL TRENCH SURFACES TO PREVENT SMEARING OF SOILS. D
NOT INSTALL IN WET WEATHER. CALL EAGLE COUNTY ENVIROMENTAL HEALTH BEFORE BACK FILLING ANY PART OF THE INSTALLATIO
OR WITH ANY QUESTIONS REGARDING INSTALLATION. BUILDING CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED UNTIL SEPTIC SYS-
TEM RECIEVES FINAL APPROVAL.
ENVIRONMENTAL HEALTH APPROVAL: DATE: APRIL 9, 1999
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 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: 844 SQUAREFEET(VIA 28 TNFTT,TRATOR TTNTTS )
INSTALLED CONCRETE SEPTIQ7ANK: 1000 GALLONS IS LOCATED 63 DEGREES AND 7 7 "FEET FROM THE CTYANOUT
COMMENTS:
ANY ITEM NOT MEETING REQUIREMENTS WILL BE CORRECTED BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN
WORK IS COMPLETED.
ENVIRONMENTAL HEALTH APPROVAJ DATE: jJJLY0,1999
incbmplete Applications Will NOT Be Accepted
('Site Plan MUST be attached)
ISDS Permit # �� r
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 (El Jebel)
**************************************************************************
* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
*
*
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
**************************************************************************
PROPERTY OWNER:
° r l2 S 11'h,�'J � �✓S
MAILING ADDRESS: _33 G e,5 U fh C K �-. Cr-1p..sUM Co/0- PHONE: 54-mu-tt
APPLICANT/CONTACT PERSON: 54fn C PHONE:
LICENSED SYSTEMS CONTRACTOR: aAMr-S d -1: 1115imm ox'y PHONE:
COMPANY/DBA: 6 og Ky s G-P,,j % ADDRESS : 331 G � ps�� clf�'� , GVIIICOIQ 5 .07
***************************************************************************
PERMIT APPLICATION IS FOR: ( ) NEW INSTALLATION (ALTERATION (.) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: (*4A 'OESC ` eCLtN 6K-- 3! n(--c C14 0GO 04-OLI q
Tax Parcel Number: ;2 1)1" 0 / 1 0 000 2- Lot Size: 3 s A
Physical Address: 17`70k Z-J
BUILDING,TYPE: (Check applicable
( Residential/Single Family
( ) Residential/Multi-Family*
( ) Commercial/Industrial*
ategory)
Number of Bedrooms
Number of Bedrooms
Type
TYPE OF TER.SUPPLY: (Check applicable category)
(1'�Well ( ) Spring ( ) Surface
( ) Public Name of Supplier:
*These systems require design by a Registered Professional Engineer
SIGNATURE: Date:
AMOUNT PAID: � o RECEIPT #: DATE:
CHECK #: CASHIER:
ISDS Permit # 0 4o-Qq
Date 7 I's i /9
ISDS Final Inspection
j Completeness Form
_Tank is gal. Tank Material
1
Tank is located � ft. and degrees from
(permanent landmark)
V Tank is located _ `-�3 degrees from ) ft. and i�t!�-OZ�
` / (permanent landmark)
Tank set level. Tank lids within 8" of finished grade.
Size of field ftz f �� U ` units lineal ft. `
Technology
� C-eanout is installed in between tank and house(+ 1/100ft).
y There is
a 'IT" that goes down 14 inches in the inlet and
1� outlet of the tank.
Inlet and outlet is sealed with tar tape, rubber gasket etc.
Tank has two comps tments with the larger compartment closest to the
hIfurqe
e is �t C\a'_' distance and relative direction to fiel� �, �,�.�.•: .h, ;
V' Depth of field 13 _,D t ft .
Soil interface raked.
Inspecti,41 portals at the end of each trench.
Proper distance to setbacks.
Chambers properly installed as per manufacturers specifications.
(Chambers latched, end plates properly installed, rocks removed from
trenches, etc.)
Type of pipe used for building sewer line leach field 3S
oN I � t CA
' �-
Inspection meets requirements.
'�'
Copy form to installer's file 'f recommendations for improvement were
suggested.
ACTION TAKEN:
Setbacks
Well Potable
Water Lines
Hous
Property
line
Lake
Stream
Dry Tank Drain
Gulch
Field 100 25
a 20
10
50
25 10 10
Tank 50 10
5
10
50
10 * 10
CALCULATED ett DATE
CHECKED BY DATE
SCALE
Y
. _........ .. _.......................
...............................................
.. ........................... .... ...................... ......... .......... ......... ................. .............._.._..._...... ... .................
....
: -• _ :.••rs, : �•' .:d••••. �.Y£8Sl p .nc urol0n Rass 0'471 •. ^^••?+!YrF T7L' Fr:i ! •500•ii5:'9:
ISDS PERMIT # rb©- ei r
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEATLH
•PHSYSICAL ADDRESS: 14ct,--)4e 14tuv 62
LEGAL DESCRIPTION:
MAILING ADDRESS:
TYPE OF DWELLING: 1= NUMBER OF BEDROOMS:
TEST HOLES PRE-SOAKED: YES NO
SOIL
TIME WATER DEPTH INCHES OF FALL RATE PROFILE
01 S'�Jb'� UvA&-)
mm,
wwwwwo
mmmomm
mmm
mm
mmmmmmm
I
im
mmmmmm
g
lommmmommm:
momommmon
mmm-
mmmmmi
on
mmmmo
mmm
me'v,
mmmmm.4mmmmm
fop , I
,�;of
)!�o M
fori I-e-)
TIME TO DROP LAST INCH:7, _6 PERC RATE: I� �jo (f,= vjai'Ef''
I jo
MINIMUM LEACH FIELD SIZE:9gq Ff2 MINIMUM SEPTIC TANK SIZE: IQD03al
AL HEALTH SPECIALIST
� 99
DATE
JOB- NAME
1840-99 Tax# 2111-011-00-002
14936 Hwy 6 FITZSIMMONS
Gypsum
JOB NO.�
In.- 1 11.1111.1
•
DATE STARTED
/ / I
i
DATE COMPLETED
DATE BILLED
WMAWA
'AN
11111111��JL ffil
� �•
, ! � lei �,� `� � � ,�
� ��
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._ COS4 SUMMARY
044A
WIA, M
TOTAL SELLING PRICE
JOB FOLDER Product 277 JOB FOLDER
18c(o�4`j �rfzsirnr��rs
114g34, 1i1�Jr�fo / surn
l8�o�2q �f �'ZS'imrn.�rY�S
1gg3(1 Efw� � , C }�s0yn
I,-lq" Ps
--E
CURVE
RADIUS
LENGTH
TANGENT
CHORD BEARING
I DELTA
C-1
2810.00
269.11
- 134.66
269.01-_,. S 78'45 39
W 05'29 143
c—r -
2slo.00
1 .64
s5
82.84
165.61 S 8311 35
W 03'22 38
C-3
2810.00
718.48
361.21
716.52 N 87-47 36
W 14'38 59
TITLE t,C RTIFI _ATL CERTIFICATION- OF DEDICATION N D OWN HIP
:
P LAT
hereby certify t n IKnow_
- does c eb ce t t
- all men
� b thr.ae resents that The James A.
-d
e Fitzsimmons
Trust dated November 1. 1993 Jom a. Fitzsimmons.
. _.car ; _ Settlo
h. v n Ir . 7 rr � Y n to
s...
a e e a �C Title to all land- .#., shown upon this Plat and that Title,
P
.. - �d ,IY m A ,�
arid � c.. F It_�nnmlon� and ur c, r ! t , a � V. Fr ..� nr�luns Trustee(s)
:.
_ tJtn sole vwr�Er-s. .� t _- ,- -. .,
( 1 r fee simple, iYlort a ee of .or Ilenholder of _ �9 9
_ _ _ _.I.h I rnJ.• 1.
n — -- --
_- all Ur,�t rEilt ii.•`crt� nituJtrd .iri E.] la L<•unt t-ul^r . _ P N r ., � ado
< LINE
I
,DIfitECT ON
DISTANCE '
L1
S 00 '44'46 E.
. 44.32' .:
L2
S 00'44'46'• E
' 36.83'
L3'
N 00'44.45-' W
71:80
-_ _ de -scribed It . � u� toll _ v�. n Edre ► or land Iu.atrd IrTrar_t-----------------------------
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Principal M _t Meridian and Section t T n
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