HomeMy WebLinkAbout318 Strohm Cir - 211107101003INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION
P.O. Box 179 - 500 Broadway • Eagle, CO 81631
Telephone: (970) 328-8755
ORIGINAL PERMIT #1062-91
COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. ALTERATION PERMIT NO. 2224A-02 BP NO. GYPSUM
OWNER: RON DENNING PHONE: 970-524-5060
MAILING ADDRESS: P.O. BOX 4148, GYPSUM, CO 81637
APPLICANT: SAME PHONE:
SYSTEM LOCATION: 318 STROHM CIRCLE, GYPSUM, CO TAX PARCEL NO. 2111-071-01-004
LICENSED INSTALLER: AAAA SEPTIC PUMPING & SERVICE, JIM WILSON LICENSE NO. 28-02 PHONE: 970-524-9524
DESIGN ENGINEER: PHONE NO.
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: MINIMUM REQUIREMENTS FOR THE CONNECTION TO THE GARAGE
SPECIAL INSTRUCTIONS: INSTALL THE EFFLUENT LINE LEADING FROM THE GARAGE TO THE EXISTING 1250 GALLON TANK IN STEPS TO MAIN-
TAIN A MAXIMUM OF 1/4 INCH PER FOOTFALL. INSTALL CLEAN -OUTS AT EVERY STEP, AND DOUBLE ENCASE THE EFFLUENT LINE UNDER THE
DRIVEWAY WITH 6 INCH SCHEDULE 40 PVC PIPE. CALL EAGLE COUNTY ENVIRONMENTAL HEALTH FOR THE FINAL INSPECTION PRIOR TO
BACK FILLING ANY PART OF THE INSTALLATION, OR WITH ANY QUESTIONS REGARDING THE INSTALLATION. THE BUILDING CERTIFIC-
ATE OF OCCUPANCY WILL NOT BE ISSUED UN_T4rT_H_E_S7RfJZ6r9rTNrfFAS BEEN INSPECTED AND APPROVED.
ENVIRONMENTAL HEALTH APPROVAL: DATE: AUGUST 30, 2002
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 WILL RESULT IN 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: SQUARE FEET (VIA )
INSTALLED EXISTING CONCRETE TANK: 1250 GALLONS IS LOCATED 88 DEGREESAND 70 FEET INCHES
FROM THE NORTH EAST CORNER OF THE GARAGE.
COMMENTS: THE FINAL INSPECTION WAS DONE BY RICHARD RIGOLI OF EAGLE COUNTY ENVIRONMENTAL HEALTH
ON SEPTEMBER 11, 2002. THIS SYSTEM IS LARGE ENOUGH FOR A 4 BEDROOM RFSTnFNCF_
ANY ITEM NOT MEETING REQUIREMENTS WILL BE CORRECTF,D BIFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS
COMPLETED. 1 `
ENVIRONMENTAL HEALTH APPROVAL c, 'iJ G- G__. DATE: SEPTEMBER 30, 2002
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52-16V SI
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Incomplete Appli- cations Will NOT Be Accepted
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Huilding Permit #
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ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. O. bux i e 9
EAGLE, CO 81531
Eagle (970)328-8755, Fax (970)328-0349, El Jebel. (970)927-
822
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* FEE SCHEDULE
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* APPLICATION FEE $350.00
* THIS FEE INCLUDES THE ISDS PERMIT, SITE EVALUATION (PERCOLA.T
ON '.TEST,.
* SOIL PROFILE OBSERVATION) AND FINAL INSPECTION
I x
* ADDI'r'T01.1AL FEES MAY BE CHARGED IF A REINSPECTION IS NECESSAR .,
OR A
* PRE-C CNST]CUCTION SITE VISIT OR CONSULTATION IS NEEDED
* REINSPECTSON FEE $47.00, PRE -CONSTRUCTION SITE VISIT FEE
$85.00
* M7bKE ALL REMITTANCE PAYABLE TQ: °EAGLE COUNTY TREASURER"
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PROPERTY OWNER: JZC`� l�/------� �-� �'°� �e-no—
MAILILV'G ADDRESS: t/ PrIO-N:E:
APPLICANT/CONTACT PERSON: - �� eoi�cil � PHONE:
i 1 t - iv::: EP SYSTEMS CONTRACTOR: >-J � C_ � � PHONE:
c ,:JM A..Y , DEA : -- ADDRESS: '_ (��r, n✓e
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PERM= APP.71:i;:'."�:f'ION IS FOR: ( ) NEW INSTALI.ATION Y ALTERATION (
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) REPALR
LOCATION OF PROPOSED INDIV;IDU . ISEWAGE DISPOSAL SYSTEM:
Legal Description: s �l Kie��(ZC�iifd 5u B D''-u75
Tax Parcel Nu1nher_ LotSize •
i °%�C�
Physical Address: � i � � C ��5� r� �
LU;iLAJI U TYPE: (Check applicable category; /
�?C) Residential/Single Tamil; ,q• �/S'l 4umber of Bedro
Ins Q
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Numberof Be :� .
me
( ) Commercial/'Indus rial* Type
4-- Thcs^ .-:;ysi'emis tLILL_i rr design icy a Regi5r_ered Profess _onal F;c-Igi_nep'
TYPE OF WATER SUPPLY: (Check applicable car_ecorv) 1
Surface
tX) Yublic: Name cif I-1 Yer: i -
APPLICANT SIGNATURE : Date.
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MOUNT PAID :
-APAID:J �/:RECEIPT � Q 156
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CHECK #: CASHIER:
DEPARTMENT OF
ENVIRONMENTAL HEALTH
(970) 328-8755
FAX (970) 328-8788
TDD: (970) 328-8797
TOLL FREE: 800-225-8136
www.eagle-county.com
EAGLE COUNTY, COLORADO
September 30, 2002
Ron Denning
P.O. Box 4148
Gypsum, CO 81637
Raymond P. Merry, REHS
Director
RE: Final of ISDS Permit #2224A-02, Tax Parcel #2111-071-01-004. Property
location: 318 Strohm Circle, Gypsum, CO.
Dear Mr. Denning:
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 (970) 328-8755.
Sincerely,
.. f
Janet Kohl +
Eagle County Environmental Health Department
ENCL: Informational Brochure
Final ISDS Permit
cc: files
OLD COURTHOUSE BUILDING, SS Broadway, P.O. Box 179, Eagle, Colorado 81631-0179
DEPARTMENT OF
ENVIRONMENTAL HEALTH
(970)328-8755
FAX (970) 328-8788
TDD: (970) 328-8797
TOLL FREE: 800-225-8136
www.eagle-county.com
EAGLE COUNTY, COLORADO
DATE: August 30, 2002
TO: AAAA Septic Pumping & Service
FROM: Environmental Health Division
Raymond P. Merry, REHS
Director
RE: Issuance of Individual Sewage Disposal System Alteration Permit #2224A-02,
Tax Parcel #2111-071-01-004. Property Location: 318 Strohm Circle, Gypsum,
CO., Denning residence.
Enclosed is your ISDS Alteration Permit 92224A-02. It 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. If you have not been contracted to install
this system please contact Eagle County Environmental Health.
Also enclosed is the ISDS Final Inspection Completeness Form. The items on this form need
to be completed before you call for your final inspection. Also, please note any special
conditions which may have been placed on the permit. Do not back fill any part of the
installation until it has been inspected. If.all items are not completed, a reinspection fee of
$47.00 must be paid before a reinspection is made.
Please call our office well in advance to allow for scheduling of final inspection. Your building
permit TCO will not be issued until final approval has been given for the ISDS Permit.
Permit specifications are minimum requirements only, and should be brought to the property
owner's attention.
This permit does not indicate conformance with other Eagle County requirements.
If you have any questions, please feel free to contact the Environmental Health Division at 328-
8755.
cc: files
Enclosures: ISDS Alteration Permit # 2224A-02; ISDS Final Inspection Completeness Form
OLD COURTHOUSE BUILDING, 551 Broadway, P.O. Box 179, Eagle, Colorado 81631-0179
ISDS Pesmit #12�Z- Date oq. -pz
I3DS Final Inanec^,ction
CWletenese Form
Tank is ExrsriN6- V1. Tank Material
Tank is located -20--ft. and LILdegrees from & (��oRNoP
IPoema"t lmdenz !
Tank is located ft. and degrees from
Tank set level. Tank lids within 8" of finished grade.
size of field fts units' lineal ft_
Technology
Cleanout is installed in between tank and
NIA There is a "T" that goes down 14 inches in the inlet and
/ outlet of the tank:
y Inlet.and outlet is sealed with tar•:tapeF rubber gasket etc.
a,A Tdmk..bds two - compartments with the.:i1air r-garp3 'tment closest to the :.,, �
house.
N fA.::.Ndahrtre distaiace: and relative direst-
tA J.A— Depth of field. ft.
i A .Soil interface raked_
►`I JA Inspection portals at the _end of each trench_.
Proper distance to setbacks.
/AI.A Chambers properly installed as per maaufacturer$ specifications:
(Chambers latched, end plates properly installed, rocks •removed from
trenches, etc.)
Type of pipe used for building sewer Line leach field
/ Other
V Inspection meets r-2=irements.
Copy form to installer'& file if recoemendations for improvement Pere
suggested.
ACTION TAKEN:
setbacks
Well Potable House Property Lake Dry Tank Drain
Water Lines line Stream Gulch
Field 100 25 20 10 s0 25 10 10
�', IL 50 10 5 10 s0 10 * 10
- lE-#�:L-TH
P.O. BOX 179
EAGLE, CO 81631
SHEET NO. OF
CALCULATED BY-kl1 \ ( DATE CIGI
CHECKED BY.
DATE
Ynuuuc; 1 m+i Iwngn anteal v-1,twcul [� i®ric.. woro�, mus. vi+r r. ry wun rnu� ruu rncc rvvvcaavnv
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
EAGLE COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. Box 179 - 550 Broadway • Eagle, Colorado 81631
Telephone: 328-7311 or 949-5257 or 927-3823
YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. PERMIT NO. 1062
Please call for final inspection before covering any portion of installed system.
OWNER: Keven P. and Teresa A. Kroehler PHONE: 524- 731
MAILING ADDRESS:—P. 0. BOX 646, Gypsum, CID 81637
AGENT: PHONE:
SYSTEMLOCATION: 318 Strohm Circle, Gypsum, Lot 6A, Bertroch Subdivision, Filing #6
LICENSED INSTALLER: Gary Bertroch LICENSE NO. 28-91
DESIGN ENGINEER OF SYSTEM*
INSTALLATION IS HEREBY GRANTED FOR THE FOLLOWING:
1250 GALLON SEPTIC TANK OR GALLON AERATED TREATMENT UNIT.
DISPERSAL AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 697 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: 143.7.5 lineal feet (23 units) . Place inspection portals at end of
each line.
ENVIRONMENTAL HEALTH OFFICER: DATE: 49 "
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, C.R.S. 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. SECTION Ill, 3.21 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM
TO BE LICENSED ACCORDING TO THE REGULATIONS.
FINAL APPROVAL OF SYSTEM: (r0 BE COMPLETED BY INSPECTOR):
NO SYSTEM SHALL BE DEEMED TO BE IN COMLIANCE 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: SQUARE FEET.
INSTALLED SEPTIC TANK: 1250 GALLONS TO DEGREES FEET
SEPTIC TANK CLEANOUT TO WITHIN 8" OF FINAL GRADE, OR:
PROPER MATERIALS AND ASSEMBLY YES NO
COMPLIANCE WITH COUNTY/STATE REGULATION REQUIREMENTS: YES NO
ANY ITEM CHECKED NO REQUIRES CO RECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE-INSPECTJPNI WHEN WORK IS COMPLETED.
COMMENTS: Tf ot-� Au , dw. j,,.,e_1 teals` /nor//
s 74, 1i
ENVIRONMENTAL HEALTH OFFICER: > DATE: ` F
ENVIRONMENTAL HEALTH OFFICER: DATE:
(RE -INSPECTION I SARY)
RETAIN WITH RECEIPT RECORDS
PERMIT
APPLICANT/AGENT:
AMOUNT PAID:
RECEIPT #:
OWNER:
— CHECK #:
CASHIER:
ISDS Permit #
Building Permit #
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PEERRMIT�
ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY
P.O. BOX 179
EAGLE, CO 81631
328-8730/927-3823(Basalt)
PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $125.00
PROPERTY OWNER: &Loiy i A4 i5z.Es;4 A
MAILING ADDRESS: Pv 6ax G� PHONE: ��a2 -- 4;1 7113 /
APPLICANT/CONTACT PERSON: PHONE: 5 oZ`t` - 97,S % A'Z , - 7,51
LICENSED SYSTEMS CONTRACTOR: G/v
ADDRESS: 5 j1tcKs6,4jC LII , PHONE: o?Y - Ci 7 _7,c�,
PERMIT APPLICATION IS FOR: X NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: ,1a-r �S,&0Z,,,s«v Fe-l"'6 mil®
Parcel Number: Lot size:
Physical Address: qu57o G gc&,F G�,?s✓r✓�
BUILDING TYPE: - (Check applicable category)
(>q Residential / Single Family Number of Bedrooms
( )-Residential / Multi -Family* Number of Bedrooms
( ) Commercial / Industrial* Type
HOT TUB - Yes ( ). No
WATER CONSERVATION PLAN: Yes ( ) No {iy
TYPE OF WATER SUPPLY: Well( ) Spring ( ) Surface ( )
Public (>) Name of Supplier: �u-?u
Give depth of all wells within 200 feet of system:
*These systems require design by a Registered Professional Engineer
NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION
MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
SIGNATURE:
DATE:
00
AMOUNT PAID: (� % RECEIPT# ` DATE:
CHECK # / CASHIER:
TIME LOG
Travel Perc Final
August 23,
C
1991
Mr. and Mrs., Kroehler
Box 646
o
,Gypsum, CO 81637
RE: Final of
ISDS Permit No. 1062
Dear -Mr. and Mrs. Kroehler:-
This letter is to inform you that the above. referenced ISDS
Permit has been inspected and f"inalizr-d. Enclosed is a copy to
retain for your records. Also enclosed are informational sheets
regarding the care of your septic system.
1991
Mr. and Mrs., Kroehler
Box 646
o
,Gypsum, CO 81637
RE: Final of
ISDS Permit No. 1062
Dear -Mr. and Mrs. Kroehler:-
This letter is to inform you that the above. referenced ISDS
Permit has been inspected and f"inalizr-d. Enclosed is a copy to
retain for your records. Also enclosed are informational sheets
regarding the care of your septic system.
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328.8730
EAGLE COUNTY, COLORADO
June 10, 1991
Mr. Gary Bertroch
P.O. Box 204
Gypsum, CO 81637
725 CHAMBERS AVE.
P.O. BOX 179
EAGLE, COLORADO 81631
FAX (303) 328-7207
RE: Issuance of Individual Sewage Disposal System Permit
No. 1062
Dear Mr. Bertroch:
Enclosed is your ISDS Permit No. 1062. The enclosed copy of the
permit must be posted at the installation site. You must call
our office for final inspection before covering any portion of
the installed system; the deadline for final inspections is
December 1.
If you have any questions, please feel free to contact us at the
following numbers for your calling area: Basalt/El Jebel
927-3823, ext. 730; Eagle Valley 328-8730.
sincerely,
0�1-e-c
Roger Hosea
Assistant Environmental Health Officer
Community Development
RH/mk
cc: Keven P. and Teresa A. Kroehler
ISDS File
Building Permit File
Chrono File
e
ISDS PERMIT # J Ga Z
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER:- Jaeyeyl le
LEGAL DESCRIPTION: GO �, 4 73 Py'��'d
MAILING ADDRESS:�('�-�sUy�•7
TYPE OF DWELLING: NUMBER OF BEDROOMS LI
TEST HOLES PRE-SOAKED: YES
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PERC RATE: /� MINIMUM SEPTIC TANK SIZE:
MINIMUM LEACH FIELD SIZE: G % 7 Z
COMMENTS: I t/ 3 ; 75' (//I��n
PERC TEST DONE BY:
%r &� DATE:
ronmental Health Officer
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INDIVIDUAL 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. 2225-02 BP NO. 14460
OWNER: COLORADO PARADISE, LLC PHONE: 970-926-5656
MAILING ADDRESS: P.O. BOX 4, EDWARDS, CO 81632
APPLICANT: SCOTT MITCHELL PHONE: 970-471-0355
SYSTEM LOCATION: 777 HOLY CROSS DRIVE, EDWARDS, CO TAX PARCEL NO. 2105-314-00-013
LICENSED INSTALLER: WHISTLE PIG RANCH, LLC LICENSE NO. 67-02 PHONE: 970-471-0355
DESIGN ENGINEER: LKP ENGINEERING, LUIZA PETROVSKA PHONE NO. 970-926-9088
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: MINIMUM REQUIREMENTS FOR A 4 BEDROOM RESIDENCE
1500 GALLON SEPTIC TANK, 1389 SQUARE FEET OF ABSORPTION AREA CREDIT, VIA 56 INFILTRATOR UNITS IN A SHALLOW BED, AS PER ENGIN-
EER'S DESIGN REVISIONS DATED 9/17/02.
SPECIAL INSTRUCTIONS: INSTALL AS PER ENGINEER'S DESIGN DATED 9/17/02, WITH A CLEAN -OUT BETWEEN THE TANK AND THE HOUSE AND IN-
SPECTION PORTALS IN EACH ROW OF INFILTRATORS. MAINTAIN 6 INCHES OF SPACING BETWEEN EACH ROW OF INFILTRATOR UNITS RAKE ALL
SURFACES TO PREVENT THE SMEARING OF SOILS, AND DO NOT INSTALL IN WET WEATHER BE SURE TO MAINTAIN ALL APPLICABLE SET -BACK
REQUIREMENTS. CALL EAGLE COUNTY ENVIRONMENTAL HEALTH AND THE DESIGN ENGINEER FOR FINAL INSPECTION PRIOR TO BACK -
FILLING ANY PART OF THE INSTALLATION, OR WITH ANY QUESTIONS REGARDING THE INSTALLATION. THE BUILDING CERTIFICATE OF
OCCUPANCY WILL NOT BE ISSUED UNTIL THE SEPTIC SYSTEM HAS BEEN INSPECTED AND APPROVED.
ENVIRONMENTAL HEALTH APPROVAL: RAYMOND P. MERRY DATE: SEPTEMBER 27, 2002
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 WILL RESULT IN 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: RAISED BED UTILIZING 1389 SQUARE FEET OF ABSORPTION CREDIT VIA 56 STANDARD
INFILTRATOR UNITS IN SERIAL DISTRIBUTION.
INSTALLED: 1500 GALLON, TWO -COMPARTMENT, PRE -CAST CONCRETE TANK LOCATED 340 DEGREES NORTH AND 13 FEET 6 INCHES
FROM CLEAN -OUT FROM HOUSE, PURSUANT TO ENGINEER'S DESIGN STAMPED, SIGNED AND DATED SEPTEMBER 17, 2002 AND ENGINEER'S
CERTIFICATION STAMPED, SIGNED AND DATED AUGUST 3, 2005.
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 APPROVAL DATE: AUGUST 3 2005
Incomplete Applications Will NOT Be Accepted
(Site -Plan MUST be attached)
ISDS Permit #
Building Permit # ! 4
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
ENVIRONMENTAL HEALTH OFFICE - EAGLE COUNTY
P. O. BOX 179
EAGLE, CO 81631
Eagle (970)328-8755, Fax (970)328-0349, E1 Jebel (970)927-3823
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* FEE SCHEDULE
* APPLICATION FEE $350.00
* THIS FEE INCLUDES THE ISDS PERMIT, SITE EVALUATION (PERCOLATION TEST,
* SOIL PROFILE OBSERVATION) AND FINAL INSPECTION
* ADDITIONAL FEES MAY BE CHARGED IF A REINSPECTION IS NECESSARY, OR A
* PRE -CONSTRUCTION SITE VISIT OR CONSULTATION IS NEEDED
* REINSPECTION FEE $47.00, PRE -CONSTRUCTION SITE VISIT FEE $85.00
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
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MAILING ADDRESS: i, C 4, ,G�a , , "b, �& PHONE - 94 •S
APPLICANT/CONTACT PERSON: Sa4_22— A_64 !£G PHONE :7A_D � 036T z_
LICENSED SYSTEMS CONTRACTOR: &,V,, PHONE: � •4,F/ p3ss
COMPANY/DBA: ADDRESS: .e�, tie.��Z
***************************************************************************
PERMIT APPLICATION IS FOR: NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
7
Legal Description:
Tax Parcel Number:
Physical Address:
BUILDIN TYPE: (Check applicable category)
( Residential/Single Family
Residential/Multi-Family*
( ) Commercial/Industrial*
Tw,
Number of
Number of
Type
Bedrooms.3
Bedrooms
*These systems require design by a Registered Professional Engineer
TYPE OF WATER SUPPLY: (Check applicable category)
(�} Well ( ) Spring ( ) Surface
( ) Public Napte— . SupfJlxer: . _ i
APPLICANT SIGNA
Date?
AMOUNT PAID: RECEIPT DATE: G'
CHECK #: ( CASHIER:
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