HomeMy WebLinkAbout918 Mayne St - 211108402001INDIVIDUAL 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. Please call for final inspection before covering any portion of installed system. PERMIT NO. 1432
OWNER: Vern L. & Viola A Ullerick
MAILING ADDRESS: P.O. BOX 216
APPLICANT: same
524-7502
city: Gypsum State: CO zip: 81637
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PHONE:
SYSTEMLOCATION: Lot #13, Horse Pasture, Gypsum TAX PARCEL NUMBER: 2111-084-02-001
LICENSED INSTALLER: 90,11scar.;Homes '
— - ------ - LICENSE NO ? -94
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1000 GALLON SEPTIC TANK
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 562.5 SQUARE FEET OF TRENCH BOTTOM.
SPECIAL REQUIREMENTS: Install 562.5 $F of absorption trenches. Call if
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ENVIRONMENTAL HEALTH APPROVAL:
t
have questions regarding
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DATE:
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CONDITIONS: �/ f / l�
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: 570
SQUARE FEET.
INSTALLED SEPTIC TANK: 1250 GALLON 185 DEGREES FEETFROM house is not constucted
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:
ENVIRONMENTAL HEALTH
'LICANT / AGENT:
!MIT FEE
(HE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
OWNER:
PERCOLATION TEST FEE RECEIPT #
CHECK#
DATE: i �''
DATE:
Incomplete Applications Will NOT Be Accepted
(Site Plan MUST be attached)
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)
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* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FE �.00
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
PROPERTY OWNER: L Y �`� !� �v �� A
MAILING ADDRESS: PHONE:
APPLICANT/CONTACT PERSON:
LICENSED SYSTEMS CONTRACTOR:
PHONE:
PHONE:
COMPANY/DBA: ADDRESS:
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PERMIT APPLICATION IS FOR: ( NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
LOCATION OF PROPOSED INDIVI/DUAL SEWAGE DISPOSAL SYSTEM:
Legal Description: AfC)-,-� -`- ra 'S r L! ye- - (1' o /0 -
Tax Parcel Number:
Physical Address:
Lot Size: _
BUILDING TYPE: (Check applicable category)
(Residential/Single Family Number of Bedrooms
( ) Residential/Multi-Family* Number of Bedrooms
( ) Commercial/Industrial* Type
TYPE OF WATER SUPPLY: (Check applicable category)
( ) Well ( ) Spring ( ) Surf
ace
(Public Name of Supplier:
*These systems require design by a Registered Professional Engineer
SIGNATURE: Date:
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AMOUNT PAID: ,�� RECEIPT #: DATE: -3 L�
CHECK #: CASHIER: I '
COMMUNITY DEVELOPMENT
DEPARTMENT
(303)328-8730
EAGLE COUNTY, COLORADO
December 8, 1994
Vern & Viola Ullerick
P.O. Box 216
Gypsum, CO 81637
500 BROADWAY
P.O. BOX 179
EAGLE, COLORADO 81631
FAX: (303) 328-7185
RE: Final of ISDS Permit No. 1432-94 Parcel # 2111-084-02-001,
Property located at: Lot #13, Mayne Street, Horse Pasture,
Gypsum.
Dear Mr. & Mrs. Ullerick,
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,
Jeff Fed ri�
Environmental Health Specialist
ENCL: Information Brochure
Final ISDS Permit
enclosures
PERCOLATION TEST
EAGLE COUNTY ENVIRONMENTAL HEALTH DEPT.
OWNER:
LEGAL DESCRIPTION;_
MAILING ADDRESS:
TYPE OF DWELLING:NUMBER OF BEDROOMS
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TEST HOLES PRE-SOAKED: YES >L- NO
TIME Wi�mrD nanmt
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PERC RATE: ��� j�,L --� MINIMUM: SEPTIC TANK SIZE:
MINIMUM LEACH FIELD SIZE:
COMMENTS:
40
PERC TEST DONE BY:
DATE:
n, i -onm n-!Health Officer
rev. 6/90ks
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1432-94 ULLERICK 2111-084-02-001
1021 Horse Pasture, Lot #13
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JOB COST SUMMARY
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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
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