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HomeMy WebLinkAboutpitkin.eh.264504202003 (1993)9 l 21 q -OV X -O -z -oo3 INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. -I,3 A TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use ( )Repair Work,(Pcevious Permit 1 .) ( Alteration of an existing s"atem, or installation /_(Previous Permit 1 4 J C1 ( )Use Permit as a result of sale ( )Othert ISSUED TO: Owneraille k Mailing Address % Agents Mailing Address DATE OF ISSUE Home Phone 1-2-7-33y/, Business Phone 161:5 Phone Sewage Disposal System Work to be performed by This permit valid only for premises )o cation by the following legal descriptions 4x ­r /.55AAUt1,4 /Z 4; -r -r,4-.f El LOT SIZE l, -S , WATER SUPPLY 5ti J,1 > AVERAGE PERCOLATION RATE A� M f f This Individual Sewage Disposal Permit is granted with regard to the following uses Nur.,bcr oft Dodicoms Lofts Garbage Disposals Dishwashers Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD _ t' `: 6) ' GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: Type o£ Tank or Treatment Units SCP T1 7 A N i Tank Capacity h 0 0 0 - _ Callon Minim= Method of Final Disposals A6'50Rp-Tied &.b Absorptiop Area / ] Square Feet Mintrium ascription (including brand name, if any) of other equipment or appurtnancess rG��o t1., ti •mac` tc.�.�ei.a c e ,t:a. is coo � QTR 0. K , P_ c�i+ yon y C-�A.n•�c� Yt� cw�i .G -e QQ s 00 ? S' c�,�„af.�l�c®oi... aZa.�y..� �-eek .A,� 5'!tl '� � a.,,-� .'�' Of. Otho Cvn" dation r' e� cat a c"��'� te %,2 eL STAGES REQUIRING INSPECTION BYUTHE HEAL H DEP TMENT:' U-14 {}Before Excavation { )Upon completion of excavation and prior to pJaCement of gravelBefore covering distribution (` system of absorption field ( )Prior to backfill of any component ( )Other, Specifyt Plans ami specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Permissd.on is hereby granted to the owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewa,o Disposal Re,rnilntions in effect on the date of issue. In addition to general provisions set forth on the reverse her=ef, this Permit ie subject to the following additional terns and conditions: APPROVED FOR ISSUE BY z.l%e, (title)_R444�•G Tht• above inM vidual sen+ago disposal system installed by has been in:ipectcd for use by a represent.itive of the Ass-en/Pit%in _L'nv:ronm.•n W Nca t.. Departincnt. TFe uwnor asauman a reoponnibility in Cosa of failure or inadequacy of thin sewage disposal system. Complete as -built drawing attached. DATE OF FINAL INSPECTION II'�: TITLE ` ASPEN*PITKIN ENVIE NIMENTAL HEALTH DEPAF% VIENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT PHONE 9 3 3� . Name oh OWNER -� Address of OWNER �� S �'� �N VIA's S g/E. S Name of APPLICANT t it _ I PHONE 1 PERMIT TO BE: ( )Picked Up ( )Mailed tot . TYPE OF PERMIT: ( )New Installation Repwrr ( )Owner ( )Applicant . 1 )Emergency Use ( iteration NOT due to failure WATION OF PROPOSED SYSTEHt L Legal Description L. 6. l s �• I� ,� Lot— S Block �a CIS Z' Filing �-- Subdivision 1.L1 -IAC.£ e 1 k Size of Lot S acres TYPE* OF STRUCTURE: ( Single Family Dwelling ( )Others Do you plan any further additions to the residence? ( )YES ( )NO No. of bedrooms No. of Lofts No. of Garbage Disposals No: of Automatic Dishwashers 0 No. of Automatic Clothes Washers (5 WATER SUPPLYs ( )Private well, Depth or ( 7Public, Name of System ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL_SEWAG£ DISPOSAL SYSTEM PROPOSED1 (Kseptic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound ( )Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Others The 'initial site inspection must be arranged with the Aspen/Pitkin .Environmental Health Department (925-2020, 8:10-9:30 a.m.) before a permit can be issued. The individual sewage disposal permit must be issued before a building permit can be obtained. FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION OF THE SYSTEM. i Application for an ind v ew a isposel i is hereby ubmitted. The undersigned ack owledges that the above information is true and that false o io wi inval a the on and any subsequent p rmi. Signature of Applicant DATE (T a lication becomes. invalid 1 tL 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. 4. Proposed and existing buildings, driveways, and other structures. 5. Streams, lakes, ponds, irrigation ditches, and other water courses. 6. Proposed and existing individual sewage systems on subject property. , 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 e in the amour. Of S /SQ Receipt Number 1 �Date Fee Received �' -/� _�_ by Admi istrativo Officer v 130 South Galena Street Aspen, Colorado 81611 303/920-6070 E 2� \00C� x �z 4LO (D a�. i l N X W ¢ !D +V� O 'dUJ�h Ln' O � VO:WHEET FOR SEPTIC SIZIQ NAME: -T r LOCATION: 02. SEPTIC TANK SIZE - # OF BEDROOMS = 00 GALLONS SPETIC TANK ABSORPTION SYSTEM j oa v # OF BEDROOMS X 2 (people/bedroom) X 75 (gal/person/day) (calculated average daily waste load) SOIL PROFILE. NOTE ANY PROBLEMS: PERC RATE: HOLE #1 HOLE #2 HOLE #3 PERC RATE AVERAGE = &, MPI (MINUTES PER INCH) SOIL CLASS. = LOADING RATE "L" t FIELD A= 1.95X"Q" = 1.95X`f50= 12-19 S ET f�(X415 INFILTRATOR FIELD (40% REDUCTION) l y g�-D X .60 = TRENCH ✓� y o ..R. 3 ' A = 1.5 X "Q" = 1.5 X = SQ FEET flus INFILTRATOR TRENCH (50% REDUCTION) X .5 = SQ FEET -tom