HomeMy WebLinkAboutpitkin.eh.246315400005 (1989)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design
Soil Information
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Water Permit & Information
Land Use Approvals
Second System on property
Third System etc
(All relevant older documents in the same order as above)
(A red sticker will be placed on both sides of the file tab when doc. is scanned)
v ASPEN*PITKIN �9-to3-15`/ —60 —oos'
ENVIRONMENTAL HEALTH OEPAii'rMEN1T
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO.
TYPE OF PERMIT:
( )Initlal Construction ( )Emergency Use ( )Repair Mork,(Piavlous Permit 1 ))Alteration of an ex sti grlyst<m,
or installation (Previous Permit
( )Use Permit as a result of Sale ( )Olhon
ISSUED T0: DATE OF ISSUE./
Ownerj!29 Home PhoneBusiness Phone 2-5-- p 030
Mai 1_ing
Address
Agent N.IYI r uvun
Address ��7 N THOMAS EA 0
Sewage Disposal System Work to be performed by 21piC g- t •'' —
This permit valid only for premises location by the do lowing legral description: 'TKAeT % N See -e ' J A P
od
LOT SM NATER SUPPLY (.L �i AVERAGE PERCOLATION RATED �,^ �
T,lis Individual Sewage Disposal Permit is granted with regard to the following m�Ce:�14MIILy TESI t]rftfC ,6
Nw,Lrr of: Dodreoms -jLofts- 0 Garbage Dispos�aalsww—_CL_ DishwashersClothes Mashers Q -
CALCULATED AVERAGE DAILY WASTE LOAD .3GALLONS. _ -
THF Nr^TLME OF THE SYSTEM INCLUDEDT,/ UNDER THIS PERMIT: �t��
Typo of Tank or 'treatment U it,
,/C.- f 4AJK- Tank Capacity 7SED _Gallon Nlninu:a
Crthod of final Disposal: � /y4 e Ext S T, /nib) Abacrptioe Area Square Feet Minimum _
Description (including brand Beret if any) of other equipment or appurtnancear
Other Condition! or Specifications:
PEOeAce M e -TAS SOD - G A L LW SE PTIC� 77MJA::� 0/1l1 -X
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Before Excavation ( )Upon completion of excavation and prior to plaeement of gravel (.)Before covering distribution
system of absorption field
(A 'rfor to backfill of any component ( )Other, Specify:
Plana aNd specifications of the proposed -sewage disposal system have been reviewed and are considered satisfactory. Pemisnion
in hereby grar.trd to tl,n owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual
Snwage Uinposal Roenlations in cffo:t on the date of issue. In addition to general provision. act forth on tlLc reverse ber^_ef,
this Permit is sun)cct to the following additional terns and conditions:
Aspen/Pitkin Environmental
APPROVED FOR ISSUE BY le) Health Officer_
Th.r a'vwc inSividunl sc•.:a•)a disposal aYs;em lnstallcd by _
Cana brrn In -.pr crud foe une by n rc Peracn eat the of the Asl:enl'ithin L:viccn-ut�)Icsit Ocpar :sent. Th,• uvnur assu-an ail
n•::;wns:billty in cnsc Of fallure or tnadf,goacy of chi. sewage daspo.al sy+tcm. Complete as -built drawing attached.
DATE OF FINAL. 1NSFECT ON � _ � _ Aspen/Pitkin Environmental
Health Officer
130 South Galena Street Aspen, Colorado 81611 303/820-6070
'/% /j C C, O' ``", a A C
aye 3 -JS i-00 -620S-
ASPEN#PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FORAN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
-S````
Name of OWNER (TX6G t l PHONE
Address of OWNER /J OX-�r�rl�� X00 �� ce&
Name of APPLICANT >�i�Ts� /�rr�L� PHONE
PERMIT TO BES ( )Picked Up - ( )Mailed tot TYPE OF PERMIT: ( )New Installation ( )Repair
( )dater ( )Applicant . 1 )Emergency Use alteration NOT due to failure
_ [OCA?ION OF PROPOSED SYSTEMS
Legal Description 5k/V.
/(w
Lot Block Filing Subdivision Size of Lot acres
TYPE -OF STRUCTURES YYafngle Family Dwelling f )Others Do you plan any further a dations to the
/ / S �L residence? ( )YES NO
No. of bedrooms / No. of Lofts %f No. of Garbage Disposals Y1 No. of Automatic Dishwashers
No. of Automatic Clothes Washers
WATER SUPPLY: ( )Private Well, Depth or O Public, Name of System
( )Spring
( )Stream or Creek _
TYM OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED,
.)Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Hound
( )Recycling, Potable use ( )Recycling, other use ( )Vault Privy ( )Others
TheInitialsite inspection must be arranged with the Aspen/Pitkin Environmental Health Department 1925-2020. 8:30-9:30 a.m.)
before a permit can be issued. The individual sewage disposal permit must be issued before a buildingpermitcan be obtained.
FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION
OF THE SYSTEM.
Application for an lndivig6al s wage disposal permit is hereby submitted. The undersigned acknowledges that the above information
Is tree and that false r fo h on will inv idate the application and anysubsequent F"'14 -
Signature
Signature of Applicant DATE ��
(This application becomes. invalid 3 mantAs from the above date.)
NOTE: PLOT PLAN must be filed with this application.
Please locate the following items by measured distances:
1. Property lines and dimensions.
2. Proposed and existing water wells on subject property and
adjacent property.
3. Domestic water service lines.
{. Proposed and existing buildings, driveways, and other
structures.
S. Streams, lakes, ponds, irrigation ditches, and other water
courses.
6. Proposed and existing individual sewage systems on subject .
property. I
SUBMIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTALLATION IS TO
BE CHANGED FROM ORIGINAL PLAN.
The undersigned hereby acknowledges receipt of this individual sewage disposal permit application and a permit fee in the amount
of 3 Op Receipt Number Date Fee Received by �-'. L
Administrative officer
130 South Galena Street Aspen, Colorado 81611 303/980-9070
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