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Home My WebLink About904 Second St - 211108205001-- = 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. 1397 Please call for final inspection before covering any portion of installed system. OWNER: Donald & Ann Gilmer PHONE: 328-7169 MAILINGADDRESS: P. O. Box 1391 city: Eagle State: CO zip: 81631 APPLICANT: Donald & Ann Gilmer PHONE: 328-7169 SYSTEM LOCATION:_904 2nd St., Gypsum CO TAX PARCEL NUMBER: 2111-082-05-001 LICENSED INSTALLER: LICENSE NO: DESIGN ENGINEER OF SYSTEM: INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: 1000 GALLON SEPTIC TANK ABSORPTION AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED 427 SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: Install 12 Infiltrator Units or 160 feet of SB2. Install inspection portals at the end of each trench. Do not backfill system until final inspection is completed. ENVIRONMENTAL HEALTH APPROVAL: DATE: CONDITIONS: i. 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: 600 SQUARE FEET. 16 infiltrators INSTALLED SEPTIC TANK: 1_ 50 GALLON 350 DEGREES 10 FEETFROM north facing side of house SEPTIC TANK ACCESS TO WITHIN B" 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: no clean out or inspection portals 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# CHECK# Incomplete Applications Will NOT Be Accepted , ;5ite Plan MUST be attached) ISDS Permit # ( 3q-7- q 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•:TO: "EAGLE.COUNTY TREASURER" PROPERTY OWNER: o �� ,,��,, Q n �� rrt /` MAILING ADDRESS:. b _ PHONE: APPLICANT/CONTACT PERSON: f� �, .� ,' I el� ,, (r i 1 m e r PHONE: 3,28 8 714, LICENSED SYSTEMS CONTRACTOR: Jor" �C�i,..e� X �7 PHONE: 32R ?1f69 COMPANY/DBA: `� ADDRESS: ************************************************************* ************* PERMIT APPLICATION IS FOR: ( NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Legal Description: 7 Tax Parcel Number: 1 i l - o t 00 j Lot Size: /�►.��Pa ! , Cr H -00�t�.... Physical Address: go y � 4 c 0Air , _ 1/?0 , BUILDING TYPE:. (Check applicable category) (x.} 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 (jC') Public Name of Supplier: I WA o *These systems require gesign by a Registered Professional Engineer SIGNATURE: Date: AMOUNT PAID:, 4150 ' RECEIPT #: 123Sz DATE: CHECK CASHIER: Incomplete Applications Will NOT Be Accepted ' (Site Plan MUST be attached) 7es a / a .1, ----� ISDS Permit # _ ^_ 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" ************************************************************************** PROPERTY OWNER: _ b r . Co ++o n MAILING ADDRESS,. a . 6/3 C PHONE � R - 7 16 9 APPLICANT/CONTACT PE SO r PHONE: 3a 8 - 7 / 62 LICENSED SYSTEMS CONTRACTOR: PHONE: COMPANY/DBA: ADDRESS: *************************************************************************** PERMIT APPLICATION IS FOR: (vrNEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: -T'-Aaf U, Sel4lion $ %�wHsl.; p S Soof-�-, R,jAle- 8'S W, c-14/,e Legal Description: (p*3 Pr'-!►4jp&j me✓ chan in town :a 6weiyaan= ifvvAlq p4E41/,e (f0, Tax Parcel Number: U5 -CID I Lot Size: Qere-S Physical Address: 4r-ee.4' BUILDING TYPE: (Check applicable Residential/Single Family ( ) Residential/Multi-Family* ( ) Commercial/Industrial* n t-I+ 4o isyPSu,xr ��J,s�" C1,oro category) Number Number Type _ of Bedrooms of Bedrooms TYPE OF WATER SUPPLY: (Check applicable category) ( ) Well ( ) Spring ( ) Surface Public Name of Supplier: *These systems requite design by a Registered Professional Engineer SIGNATURE: kj,,, JgJL 4q Date: `74,gcj, Z6 J99,o� ************************************************************************** AMOUNT PAID: c�200 • oa RECEIPT #: 8Y DATE: CHECK #: 9 ySl CASHIER: ISDS PERMIT /j92 PERCOLATION TEST EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT. -)OWNER: �r C"(}C,::j ( i�(;i1 �'� I ►�� u��P�i`�C /t/ LEGAL DESCRIPTION:I MAILING ADDRESS: TYPE OF DWELLING: NUMBER OF BEDROOMS TEST HOLES PRE-SOAKED: YES- NO TTMP. wAr"Vn nanmv �f.iT.... .. 1 2E�. 1 2 3 1 2 3 Snit, 1 2 bU1L YKOFILi p' :C� �(�1L Cab 0-4 - i 1-7• 0 I' D 1.95 1,5 4' ,,L 81 ► `� C. ,., 10 cj i :� C�J � 5 i � � � �5 U 3, o Time to drop last inch G PERC RATE: � MINIMUM SEPTIC TANK SIZE: MINIMUM LEACH FIELD SIZE: \r T5 X 0 )(det,9n Flow) PERC TEST DONE BY: \x.(,kl.-. DATE: ronmental Health Officer rev. 6/90ks JOB IVAM. 1397-94 - Parcel #2111-082-05-001 Tr72,Sec8,Town5S,Range85Wof the 6th P. M uA,- 904 2nd St., Gypsum GILMER JOB LOCATION BILL TO DATE STARTED DATE COMPLETED DATE BILLED 3 j 22-Nt — YLe� ck iM SS i G 6bka len 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 278 ®® NEW ENGLAND BUSINESS SERVICE, INC„ GROTON, MA 01471 JOB FOLDER Printed in U.S.A. v Ll I o a ' is v . Q 1 _ . O OC, lei Nou tie. o , . 0 QQ� �lx b, \ R e Y._ I r N p. Ill, 4�$ xr, \Cta � t �_ `P1 c �f •, �t I 000 b 4 jJ 1 0 f4 IL •� �_• * 4 Q 7 ' Val • a t 1 4 1 1 � Tbp --- —~—---.—�. — fiE G oNp S TR fEr