HomeMy WebLinkAbout1679 Ruedi Creek - 238736401001APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
N`IENTAL HEALTH OFFICE - EAGLE COUNTY
ENVIRO
P.O. Box 850
Eagle, Colorado 81631 No. is
PERMIT APPLICATION FEE: $150.0 328-7311 PERCOLATION TEST FEE: C
NAME OF OWNER: -72AMVAA
ADDRESS: / ! �C%1
NAME OF APPLICANT (if different from owner):
ADDRESS:
DESIGN ENGINEER OF SYSTEM (if applicable):
ADDRESS:
PHONE:
PHONE:
PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: 6211ZIW4
Licensed Installer (see attached list): YES NO
50.
ADDRESS: PHONE:
PERMIT APPLICATION IS FOR: (() New Installation ( ) Alteration ( ) Repair
LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM:
Street/Rural Address:
Lot Size:
Legal Description: l d
BUILDING OR SERVICE TYPE (check applicable category):
(�) Residential - Single Family ( ) Residential Quadplex
( j Residential - Duplex ( ) Commercial (state usage)
( ) Residential - Triplex _
NUMBER OF PERSONS: NUMBER OF BEDROOMS:
WASTE TYPES (check applicable categories):
( ) Commercial or Institutional ( ) Dwelling
( ) Non -Domestic Wastes -��
(� Tr.�ent Jse
( ) Garbage Disposal ( ) Dishwasher
(x) Automatic Washer ( ) Spa Tub
( ) Other
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( ) Septic Tank ( ) Composting Toilet ( ) Incineration Toilet
( ) Vault Privy ( j Greywater ( ) Chemical Toilet
( ) Pit Privy ( ) Aeration Plant ( ) Recycling, Potable Use
( ) Other ( ) Recycling, Other Use
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE: YES ( ) NO
IS SYSTEM DESIGNED FOR LESS THAN 2,000 GALLONS PER DAY: YES NO ( )
WASTEWATER FLOW REDUCTION PLAN: YES ( ) NO (�
(Ij Vez, Aee attached wastewateA 4tow Aeducti.on methods)
NOTE: The Envi&onmentat Health 044iceA may tceduce the nequined abzoApti.on 0Aea upon
appnovat o4 an adequate wa6tewateA 6tow Aeducti.on tan. -
SOURCE AND TYPE OF WATER SUPPLY:
( ) Well (�) Spring ( ) Creek/Stream
Give depth of all wells within 200 feet of system:
If supplied by community wa r,%give name of supplier:
SIGNATURE: DATE: e
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
INFORMATION BELOW TO BE FILLED OUT By ENVIRONMENTAL HEALTH OFFICER:
GROUND CONDITIONS: PeAcent GAound Stope
Depth to Bednock (pen 8' PtcoWe HoZe)
Depth to GAoundwateA T abte
SOIL PERCOLATION TEST RESULTS: nute/s pe/,L inch in Hote #1
Minutes pen inch to Hote #2
M,, nute6 p� inch to Hote # 3
FINAL DISPOSAL BV:
( ) Ab/s oApti on TAench, Bed on Pit ( ) EvapotAa.ws p i kati.on
( J Above GAound DZ6pmsat ( ) Sand FitteA
( ) UndeAgnound DiApeuat ( ) Walstewaten Pond
( ) OtheA
Amount Paid: �(�� , ®� Receipt NumbelL (D(�j j() Date: � 2
(Env. Health Department - Rev. 4--07-83)
PERCOLATION TEST FEE: 5�:7
I.S.3.S. Opp.
Ot-INER: l U 0 0
LEGAL DESCRi?Ti0N f /
RURAL ADDRESS: ! 5174 All"
TYPE OF D!JELLING: ` OF BEDpnnms: _
DATE OF PERCOLATION TEST: r TYPE OF SOIL:
TEST HOLES PRESOAKED? Yes No
INCHES OF
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PERCOLATION RATE:
RECOMMENDED MINIMUM SEPTIC TANK SIZE: 4060
RECOMMENDED MINIMUM LEACH FIELD SIZE:
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RECOMMENDED MINIMUM SQUARE FOOTAGE PER BEDROOM:
Site has been reviewed and tested for percolation ate.
Date Environmental Health Officer
COMMENTS:
0 ,4� of
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Community Development Department
(970)328-8730
FAX (970) 328-7185
TDD (970) 328-8797
Email: eccmdeva@vail.net
http: //www.eagle-county.com
August 17, 2001
Tom Golac
15401 Frying Pan
Basalt, Colorado 81621
Re: Site Review
EAGLE COUNTY, COLORADO
Parcel #1, Rueidi Creek
Eagle Country
Dear Mr. Golac:
Eagle County Building
P.O. Box 179
500 Broadway
Eagle, Colorado 81631-0179
This letter will confirm my site review of the above captioned property on August 16, 2001 to
determine if the property line adjustment allows an adequate area for the installation of an
individual sewage disposal system (ISDS). Your proposed site plan indicates moving the lot line
from the northern most parcel to the south (Parcel #1) by 217.79 feet. This lot line adjustment
will increase the northern parcel by approximately 2.5 acres, providing an area sufficient in size
to accommodate an ISDS for a three -bedroom single family residence.
A permit application and fee are required by Eagle County to install an individual sewage
disposal system. Satisfactory site plan, percolation test and soil profile review are part of the
permitting process. If the percolation test results show that the soil us unsuitable for a
conventional system, a Registered Professional Engineer will be required to design the system.
A permit application and instruction sheet is enclosed.
If you have any questions regarding this matter please call me at 970-328-8758.
Sincerely,
William T. Carlson, REHS
Environmental Health Specialist II
Enclosure
COLORADO DEPARTMENT OF HEALTH
ACCOMMODATIONS INSPECTION REPORT
Name /"- C, Co. n Acct. No. Category No.
Location / ,Ta , �� t, t, l Zip
Owner Address Zip
Operator Address Zip
Units Capacity Male Female Juv.
r
Water, Source -Type Sewage, Type -Method ->Y �'�• (, Food Source
Swimming Pool
An inspection of the above noted facility.on this date reveals the violations and deficiencies
listed below which you are hereby ordered to correct:
U
✓2
)ate Received By Inspected By Score
:S:MFD:57 (5-75-10)
r- I I/ r I A
'. FP JOB NAME: J.0P .NO.
9
JOB LOCATION
BILL TO
DATE STARTED
..a
DATE BILLED
S
JOB COST SUMMARY
TOTAL SELLING PRICE
TOTAL MATERIAL
TOTAL LABOR
PERMIT # 639 INSURANCE
SALES TAX
.OWNER: Thomas Golec
15401 Frying Plan Road - Basalt, CO
MISC. COSTS
LOCATION: 15401 Frying Plan Road - Basalt ;1 acres)
Tr 37 - 38; Sec. 1, T8S, R85W of 6th pm
INSTALLER: Owner
SIZE OF TANK: 1,000 gallons (Degrees: 1600 - 36 feet)
DWELLING: Single Family - 2 bedrooms x 300 dq . ft. TOTAL JOB COST
PERC RATE: one inch/20 minutes -(600 sq.ft. leach field)
GROSS PROFIT
LESS OVERHEAD COSTS
OF SELLING PRICE
Finalized: 10-18-83 By: Erik Edeen
NET PROFIT
DER Printed in USA
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GRAPHIC SCALE
0 50 100 1 200
( IN FEET
1 inch = 100
NOTES:
A PARCEL OF- LAND_ SITUATED IN SECTION
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400
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BOUNDAR ADJUSTMENT
OWNSHIP SOUTH RANGE WEST OF THE SIXTH P WTCIPAL
OUNTY OF
EAGLE STATE OF COLORADO
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TITLE CERTIFICATE
Y
I. DO HEREBY CERTIFY THAT I HAVE EXAMINED
THE TITLE TO ALL LANDS SHOWN ON THIS PLAT AND THAT TITLE TO SUCH LAND
IS VESTED IN FREE AND CLEAR OF
ALL LIENS AND ENCUMBRANCES, EXCEPT AS FOLLOWS:
DATE:
T.
BY:
TITLE:
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NOTICE: ACCORDING TO COLORADO LAW YOU MUST COLOAENCE ANY LEGAL
ACTION BASED UPON ANY DEFECT IN THIS SURVEY WITHIN THREE YEARS
__-AFTER YOU FIRST DISCOVER SUCH DEFECT. IN NO EVENT YAY ANY ACTION
BASED UPON ANY DEFECT IN THIS SURVEY BE COI,IENCED MORE THAN TEN
_
YEARS FROM THE DATE OF CERTIFICATION SHOWN HEREON.
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RTIFICATE OF TAXES PA
1. THE UNDERSIGNED, DO HEREBY CERTIFY THAT THE ENTIRE AMOUNT OF
TAXES AND ASSESSMENTS DUE AND PAYABLE AS OF
UPON ALL PARCELS OF REAL ESTATE DESCRIBED ON THIS PLAT ARE PAID IN
FULL.
DATED THIS DAY OF . A.D.. 20
TREASURER OF EAGLE COUNTY
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SURVEYOR'S STATEMENT
MERIDIAN
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NTY COMMISSIONERS' CERTIFICA
THIS PLAT APPROVED BY THE BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY,
COLORADO THIS DAY OF , A.D., 20 -, FOR FILING
WITH THE CLERK AND RECORDER OF EAGLE COUNTY AND FOR CONVEYANCE TO THE
COUNTY OF THE PUBLIC DEDICATIONS SHOWN HEREON; SUBJECT TO THE PROVISION
THAT APPROVAL IN NO WAY OBLIGATES EAGLE COUNTY FOR MAINTENANCE OF ROADS
DEDICATED TO THE PUBLIC UNTIL CONSTRUCTION OF IMPROVEMENTS THEREON SHALL
HAVE BEEN COMPLETED IN ACCORDANCE WITH EAGLE COUNTY SPECIFICATIONS AND
THE BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY HAS BY 'A SUBSEQUENT
RESOLUTION AGREED TO UNDERTAKE MAINTENANCE OF THE SAME. :THIS APPROVAL
DOES NOT GUARANTEE THAT THE SIZE, SOIL CONDITIONS, SUBSURFACE GEOLOGY,
GROUNDWATER CONDITIONS, OR FLOODING CONDITIONS OF ANY LOT SHOWN HEREON
ARE SUCH THAT A BUILDING PERMIT, SEWAGE DISPOSAL PERMIT OR ANY OTHER
REQUIRED PERMIT WILL BE ISSUED. THIS APPROVAL IS WITH THE UNDERSTANDING
THAT ALL EXPENSES INVOLVING REQUIRED MPROVEMENTS FOR ALL UTILITY SERVICES,
PAVING, GRADING, LANDSCAPING, CURBS, GUTTERS, SIDEWALKS. ROAD LIGHTING,
ROAD SIGNS, FLOOD PROTECTION DEVICES, DRAINAGE STRUCTURES', AND ALL OTHER
IMPROVEMENTS THAT MAY BE REQUIRED SHALL BE THE RESPONSIBILITY OF THE
SUBDIVIDER AND NOT THE COUNTY OF EAGLE'.
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CHAIRMAN, BOARD OF COUNTY COMMISSIONERS
EAGLE COUNTY, COLORADO 'r
WITNESS MY HAND AND SEAL OF THE COUNTY:OF FAGLF
CLERK TO THE BOARD OF COUNTY COMMISSIONERS
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CLERK AND RECORDER'S CERTIFICATE
THIS PLAT IS FILED FOR RECORD IN THE OFFICE OF THE CLERK AND
RECORDER OF EAGLE COUNTY. COLORADO, AT O'CLOCK '.M., ON
THE DAY OF 20 , IN BOOK AT
PAGE , REC. NO. j
CLERK AND RECORDER
BY:
DEPUTY