HomeMy WebLinkAbout155 Gore Range Ct - 185521100104INDIVIDUAL 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. 1506
Please call for final inspection before covering any portion of installed system.
OWNER: Blair and Diane Bakken PHONE: (970) 926-2090
MAILINGADDRESS: P.O. Box 55 Qlry: Wolcott State: CO Zip: 81655
APPLICANT. Blair Bakken PHONE: (970) 524-7551
SYSTEMLOCATION: 0155 Antelope Cr., Wolcott, CO TAX PARCEL NUMBER: 1855-211-00-104
LICENSED INSTALLER: Blair Bakken LICENSE NO: 53-95
DESIGN ENGINEER OF SYSTEM:
INSTALLATION HEREBY GRANTED FOR THE FOLLOWING:
1 000 GALLONSEPTICTANK for 3 bedrooms; 1250 for 4 bedrooms
ABSORPTION AREA REQUIREMENTS:
SQUARE FEET OF SEEPAGE BED 604 SQUARE FEET OF TRENCH BOTTOM. for 3 bedrooms; 805 sq. ft. for 4 bedroom
SPECIAL REQUIREMENTS: Install no deeper than 2-2 1/2' deep at trench bottom. Install inspection
portals at the end of each ser-iallv distributed trench. Rake trench side -walls and call
the County for final ins e i rto ac n .
ENVIRONMENTAL HEALTH APPROVAL: DATE: August 1, 1995
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: 805 SQUARE FEET.
INSTALLED SEPTIC TANK: 1250 GALLON 125 N DEGREES 30 FEETFROM Cleanout next to house.
SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND
PROPER MATERIAL AND ASSEMBLY X YES —NO
COMPLIANCE WITH COUNTY STATE REQUIREMENTS: �_ YES —NO
ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED.
COMMENTS: 22 Biodiffusers were installed in 3 trenches. Leach field is 11'8" SW of septic
tank.
ENVIRONMENTAL HEALTH APPROVAL: DATE:SePtember 29,1995
ENVIRONMENTAL HEALTH APPROVAL: DATE:
(RE -INSPECTION IF NECESSARY)
RETAIN WITH RECEIPT RECORDS
APPLICANT / AGENT:
OWNER:
PERMIT FEE PERCOLATION TEST FEE RECEIPT # CHECK #
dote Plan MUST be attached)
ISDS Permit # �J 1. q1)
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)
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* PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00
*
*
* MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER"
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PROPERTY OWNER: el- A 01 w PHONE:
MAILING ADDRESS:
APPLICANT/ CONTACT PERSON* �L-Mtet i sa m m , PHONE: 7 575- A
MAILING ADDRESS: Po ao x vtv ol-e0- 7 G 0 e88 6 T
LICENSED ISDS CONTRACTOR:) ��,( �-1 PHONE: )
COMPANY/DBA: ADDRESS:
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PERMIT APPLICATION IS FOR: (---ed. New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Building Permit # (if: known)
Legal Description: Subdivision: ,/�' PJE %
Le , �Tn PO
9 P �iling:_Block: Lot No. HrA?'%
Tax Parcel Number: Lot Size: 40 A C.PLe-S
Street Address:
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BUILDING TYPE: (Check applicable category)
(P,g Residential/Single Family Number of Bedrooms 73
( ) Residential/Multi-Family* Number of Bedrooms
( ) Commercial/Industrial* Type
TYPE OF WATER SUPPLY: (Check applicable category)
() Well ( ) Spring ( ) Surface
( ) Public Name of Supplier:
*These systems require design by a Registered Professional Engi
SIGNATURE: Date: Z�75,�
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TO BE COMPLETED BY THE COUNTY _
AMOUNT PAID: C7'Zd RECEIPT # : l D 0-5-/ 57 DATE: % / 2- A
CHECK # : ly'�-17 4-1 CASHIER:
Community Development Department
(970)328-8730
Fax:(970) 328-7185
TDD: (970) 328-8797
EAGLE COUNTY, COLORADO
September 28, 1995
Blair and Diane Bakken
P.O. Box 55
Wolcott, CO 81655
Eagle County Building
P.O. Box 179
500 Broadway
Eagle, Colorado 81631-0179
RE: Final of ISDS Permit No. 1506-95 Parcel #1855-211-00-104.
Property located at: 0155 Antelope Cr., Wolcott, CO.
Dear Mr. and Mrs. Bakken,
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,
Janet Kohl
Environmental H alth Department
ENCL: Information Brochure
Final ISDS Permit
enclosures
COMMUNITY DEVELOPMENT
DEPARTMENT
(303) 328-8730
Date:
TO:
FROM:
RE:
725 CHAMBERS AVE.
P.O. BOX 179
EAGLE, COLORADO 81631
FAX (303) 328.7207
EAGLE COUNTY, COLORADO
August 1, 1995
B Cross 55
Environmental Health Division
Issuance of Individual Sewage Disposal System
Permit No. 1506-95 Tax Parcel #1855-211-00-104
Property Location: 0155 Antelope Cr., Wolcott, CO.
Enclosed is your ISDS Permit No. 1506-95 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. Please call
our office well in advance for the final inspection.
Systems designed by a Registered Professional Engineer must be
certified by the Engineer indicating that the system was
installed as specified. Eagle County does not perform final
inspections on engineer designed systems. Engineer as builts must
be submitted for permit to be finalized and C.O. issued.
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
ISDS PERMIT
OWNER:
PERCOLATION TEST
EAGLE COUNTY $NVIRONMENTAL HEALTH DEPT.
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LEGAL DESCRIPTION:
MAILING ADDRESS:
TYPE OF DWELLING: � NUMBER OF BEDROOMS
TEST HOLES PRE-SOAKED: YES J� NO
TIME 1 � XZJC�Wnmrn ncnmv
NMIIM-MgI
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MEI
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Time to drop last inch 2_0
PERC RATE: Z O GI u%SE2PPTICCIZE: %GZ30 wt=_1QK)m*
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MINIMUM LEACH FIELD SIZE:— Czz, (gpl14
COMMENTS: cep DCLA � .V\, 7 -?�
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PERC TES O, E Y :
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DATE:
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ISDS Final Inspection
Completeness Form
Tank is Z5p gal. Tank Material �C1/j.V C
Tank is located ft. and I2S degrees from
is ocated f and degrees
dVC/�T 1 V
from
(permanent landmark)
'—
Tank set -level.
lids within 8"
of finished grade.
Size of field 01. ft2
a units
lineal ft.
Technology 6747 itQet,
VU
Cle n�is insta ed in
between tank and
house(+ 1/100ft).
There is a "T".that goes
down 14 inches in the inl t and
outlet of the tank.
�.
Inlet and outlet is sealed with tar tape,
rubber gasket
etc.
Tank has two compartments with the larger compartment
closest to the house.
Measure distance and relative direction to field.) bi d� —
u A lJ
Depth of field �� � ft.
Soil interface raked. _
Inspection portals at the end of each trench.
Proper distance to setbacks.
Other
Inspection meets requirements.
Copy form to installer's file if recommendations for
improvement were suggested.
ACTION TAKEN:
Setbacks
Well Potable House Property Lake Dry Tank Drain
Water Lines line Stream Gulch
Field 100 25 20 10 50 25 10 10
Tank .50 10 5 j10' 50 10 * 10
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1506-95 Tax #1855-211-00-104
JOB NAME 0155 Antelope Cr. BAKKEN
Wolcott, CO
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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 2713 C% NEW ENGtAND BU$INESS SERVICE, INC., GROTON, MA 01471
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