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Pitkin L anty Environmental Health Departme.
Permit for an Individual Sewage Disposal System
0405 Castle Creek Road, Suite 10, Aspen, Colorado 81611
Phone 970-920-5070 / FAX 970-920-5077
Permit # 03081 Parcel ID # 2463-154-00-008
Type of permit New( ) Repair( x replacement due to failure) Addition/Remodel to House( )
Name of Owner Judy Malievsky
Street Address 0513 N. Thomas Road
Property legal description
Size of lot 3.88 acres
Water source Private well
# of bedrooms in house 4
Caretaker unit N/a
# of bedrooms in caretaker unit
Designed for what # rooms (list)
Designed by
Mailing Address
Owner
Total square footage of the house 3000 sq ft
# of offices, lofts & similar sized rooms in house
Total square footage of the caretaker unit
# of offices, lofts & similar sized rooms in caretaker unit
4 bedrooms
Perc rate 20 Profile hole depth
Minimum Septic tank capacity 1750 gallons
Permit information
Depth to groundwater or bedrock
Minimum Absorption area 876
Comments
ft w/ 30% reduction
Septic permit approved per compliance with a drawing faxed December 18, 2003. Any changes must be approved
by this department and the design engineer prior to them being made.
Minimum horizontal distances between components of the system and physical features shall conform to the Pitkin
County ISDS regulations. There must be a minimum 82 feet between the field and the river and 132 feet between
the field and the well.
The design is to use the existing 1000 gallon, two compartment tank followed by a new 1000 gallon, two
compartment tank. There must be an effluent filter on the outlet of the second tank. The effluent will be distributed
by a manifold to a bed with 56 gravelless chamber units (7 x 8). The bed must be level and buried with no more
than 4 feet of cover.
The existing failed drywell must be properly abandoned.
This department does not endorse any brand of products. This permit must be kept on-site during installation.
The engineer must do a final inspection of the installation and submit an as -built letter to this department. This
department must also be called for an inspection with a minimum of 48 hours advanced notice.
pP y L. Ida t LLLPermit a roved b iDate:
Plans and specifications of the proposed individual sewage disposal system have been reviewed and are considered
satisfactory. Permission is hereby granted to the owner or the agent to perform the work indicated in accordance with the Pitkin
County ISDS Regulation in effect at the time of issue. This permit becomes invalid 6 months from the date that the permit was
issued unless system construction has commenced or an extension has been approved in writing by the Department.
As -built drawin must be incl ed this permit before the final approval will be issued. ( l/ Ib,�
Installer: te,(t 1r 000001
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Final approval: Date: G' Zt-11
Dec 10 03 11:34a Pitkin Co Env. Health (970)920-5077 p.3
PITKIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM
0405 Castle Creek Road, Suite 10, Aspen Colorado 81611
Phone (970) 920-5070 Fax (970) 920-5077
Name of OWNER
Owner's Mailing Address
Primary Contact Person (all communication rega
Add
Cell P
Parral In
this permit will go through this person)
Phone :
v„a--;our$ 01rIC9
at 920-5960 or at www.Ditkinassessor orn) 11 3 JLILr
Street address of property CS -/2 A/ 3 u� AA n � e!) w
Legal Description: Lot �— ,Block Filing Subdivision
Size of lot — acres
Total square feet of house
Type of proposed structure:
Caretaker Unit: Attached ( ) Detached (
Permit is for: New home ( )
Water: Private way ( ) Spring
If
Name of syster
# of bedrooms (potentiei) in house
# of
Repair due to failure ( V/) Remodel/Addition (
Stream( ) CommunitylPublic Water System (
un
Emergency use ( )
The fee for a ISDS application is $600 for a permit that takes 6 hours or less for the department to approve. If approval takes
longer than 6 hours, a rzta of $100 per hour will be charged. The maximum fee is $1000. The ba
time of application. The remainder, if any, will be due in Nvo stages: first, at the tim6t70 is due at the
e of issuance of the sic fee of Of $$ permit; second,
before final approval of the ISQS permit.
Application for an individual sewage disposai system is hereby submitted. I hereby certify that the above information is true and
accurate and that I have provided true and accurate information on locations of all existing and proposed wells, contour
intervals, buildings, property lines, ditches, slopes, waterlines, springs, suction or irrigation lines, drinking water cisterns, drain
tiles, irrigation ditches, lakes, water courses, streams, floodpiains, dry gulches, and e)asting septic systems. i hereby certify
that any such features not shown on attached site map are not present, issuance of the permit does not imply the approval of
any other permit required for construction pursuant to Pitkin County codes. No construction may be undertaken until all
approvals ,and permits have been obtained.
The Pitkin County Environmental Health Department, Pitkin County and employees of these agencies will be held harmless
should the individual sewage disposal system fall or malfunction. The permit to construct Is Issued on information submitted by
the applicant or his/her representatives. The owner assumes full responsibility in case of failure of the system.
Signature of applicant Date /Z�-3
Received by—C ��Receipt _9 I_ Date I_//_1
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Pitkin County Environmental Health Department
Contact Log Sheet
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Comments Action to • ' Taken
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DEC -18-2003 04:24 PM
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Pitkin County Environmental Health
OWNERIBUILDER ACKNOWLEDGMENT
4.10.1 Permit Application required:
If the ISDS is designed by the owner/builder, he/she must sign an
acknowledgment assuming full responsibility for costs or delays incurred
because of errors resulting from his/her lack of knowledge of the pertinent
Regulation, or failure to properly design and build an ISDS in conformance with
the Regulation.
I assume full responsibility for costs or delays incurred because of errors
resulting from my lack of knowledge of the pertinent Regulation, or
failure to properly design and build im ISDS in conformanoe with the
Regulation.
Owner/ Builder Signatu e
000004
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Carla Block, 03:45 PM 12/11/2¢0 , judy m Page 1 of 1
X -Sender: carlab@commons
X -Mailer: QUALCOMM Windows Eudora Pro Version 4.2.0.58
Date: Thu, 11 Dec 2003 15:45:05 -0700
To: nancym@ci.aspen.co.us
From: Carla Block <carlab@ci.aspen.co.us>
Subject: judy m
X-MailScanner-Information: Please contact the ISP for more information
X-MailScanner: Found to be clean
She called. did you get the fax from her daughter with the house plans?
I asked her to look for a survey on the property. She has called duane and left messages.
She asked if she could split the payment up - I said yes. She will send in $200 with her application and
then hopefully pay the rest in the next 2 months. I said that would be OK because hers was a special
situation - failed system, and something she didn't anticipate.
cb
Carla Block, REHS
Pitkin County Environmental Health
970-920-5438
000005
Printed for Nancy MacKenzie <nancym(aco.pitkin.co.us> 12/12/2003
To: Judy Malievsky From: Nancy MacKenzie
Fax: 963-3770 Pages:2 (Including cover sheet)
Phone: 963 - 3770 Date: 6/3/04
Re: ISDS Permit — 0513 N Thomas Rd cc:
Please find following your ISDS Permit which has received final approval from the
Environmental Health Department.
Phone 970-920-5070
Fax 970-920-5077
0405 Castle Creek Road, Aspen CO 81611
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DEC -18-2003 12:49 FROM:ROARINGFORKCOOP 9707044239 TO:970 920 5077 P.001,003
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PITKIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
0405 CASTLE CREEK ROAD, SUITE 10
ASPEN, COLORADO 81611
PHONE 970-920-5070
FAX 970-920-5077
DATE: 12/10/03
TO: JUDY MALIEZSKY
FROM: NANCY MACKENZIE
RE: 0513 N. THOMAS RD, FAILED SEPTIC SYSTEM, EFFLUENT SURFACING
Dear Judy,
On December 8th I stopped by your house and viewed the area where your drywell is located.
Effluent was surfacing which is an immediate potential health hazard. I spoke with you yesterday,
and informed you that I would not send you a Notice Of Violation letter if you would immediately
start correcting this problem including the following:
1) Complete and return an `Application For Individual Sewage Disposal System' with the
permit fee within 3 days.
2) Immediately fax a sketch of the floors plans so we can work on the sizing and designing
the new system.
3) Have your installer, Duane Piffer, call me by today so we can work out details of getting
your system replaced immediately.
Thanks,
Nancy, 920-5076
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PITKIN ENVIROCIENTAL HEALTH DEPARTMEN .
ISDS DESIGN CALCULATIONS
Owner's Name Parcel ID # :_
,A
House Size (sq. ft.) � (75 gpd, 100 gpd, or 130 gpd) 100
Number of Bedrooms in Main House
Number of Offices, Libraries, Studies, Similar -sized Rooms in Main House
Number of Bedrooms in Detached Caretaker unit
Number of Offices, Studies, Similar -sized Rooms in Caretaker Unit
(If the caretaker unit is ATTACHED, treat as if part of main house.)
Average Daily Waste Flow 800
State Review Required? no
Perc Rate - (T)
Design Flow (Q) = # potential bedrooms X 2 people/bedroom X gpd X 1.75
Q= 1400
Minimum tank capacity 1750 gallons
Absorption Area (=Q/5 X SQRT perc rate)
A = 1252.1981 sq. ft. of absorption area required
81 gravelless chamber units without reduction
# of Perc Holes Required: 3
1 in every soil type? Spaced uniformly over proposed area?
A maximum: 50%
only if the lot size and soil conditions are optimal.
If a reduction is being proposed, describe why lot size and soil conditions are optimal:
A = 626.09903 sq.ft. with 50% reductionTRENCHES 876.53865 sq ft 30% reduction BED
40 gravelless chamber units with reduction 57 chamber units with reduc.
Type of system: []Absorption trenches []Absorption bed [] Graveness chambers
[]Dry well []Seepage Pit []Other (type)
SETBACK FROM WELL
# of feet = 132
SETBACK FROM POND, STREAM OR IRRIGATION DITCH
# of feet = 82
SETBACK FROM DRY GULCH
# of feet = 57
DEC -18-2003 12:49 FROM:ROARINGFORKCOOP
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PITKIN COUNTY HEALTH DEPARTMENT r-�� a
' PERMIT NUMBER RECEIPT NUMBER
Owner N/. C r— . .
Phone
Address /J E n v j �O o n �a / ��2L
Contractor k-4 V 6 NC.9 Phone
Address CD►JAALG-
Location of system —? r,,, ; , - n -r /I -. 4.. „/ /.,-Lot Size
Legal desc
iption
SCC
C1
Date
j
Siganture
of owner
Percolation test data o
minutes per inch
Minimum recommended absorption system size
Minimum recommended tank size
Permit application valid one year from date. Application to become permit and
final only after lower portion is completed and signed. Retain this form at
the construction site.
DRAWING OF SYSTEM
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Date Sanitari
20 NO 000014
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COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
A C T I V I T Y R E P 0 R T
Section
FILE REFERENCE:
INDIVIDUAL OR
ESTABLISHMENT -
ADDRESS:
Code
County
NARRATIVE:
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LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:
DATE: 191, REPRESENTATIVE:
ES: 7 (Rev. 6-70-100) 000015
SERVICE REQUESTE
ACTION REPORT
ACTION BY DISPOSITION
000016
DATE
SH -M-71 (4-71-50)
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COLORADO
DEPARTMENT OF HEALTH
�.s r
COUNTY
REQU
FOR SER CE
PROGRAM L
RECEIVED BY
DATE
LOCATION
,
NAME
REPORTED BY
ADDRESS
TELEPHONE
SERVICE REQUESTE
ACTION REPORT
ACTION BY DISPOSITION
000016
DATE
SH -M-71 (4-71-50)