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Please See Building and Land Use Approvals Files for additional information.
/Ia-00-o/y
• ASPEN40PITKIN •
ENVIR�DNIMENTA DlsosEALTH a CPRTMENT
TYPE OF PERMIT:
( )Initial Construction ( )Emergency UseRepair Work,(Pievious Permit 1
or Installation
( )Use Permit as a result of sale - ( )Other,
ISSUED TO:
.) 1 )Alteration of an existing system,
(Previous Permit 1 ,1
DATE OF ISSUE
Ownerhf I GkLRG Home Phonct7 35's Business Phone��%Z��
Mailing
Address �77� A'16An 0Ae,60,vl)1rCF 0z,0x?lD0
Agent R 114 Phone
Mailing
Address
Sewage Disposal System Work to be performed by ObMe_k AAD �7OEp ��(oo 7/,/ /�/
This permit valid only for premises location by the following legal deueriptiont&-L'.1Tp `) )( p/ 60o r C� r'I�'
LOT SIZE WATER SUPPLY 10,CLL AVERAGE PERCOLATION RATr. $N.
11 AAr—M
This Individual Sewage Disposal Permit is granted with regard to the following usat SjljtPe /Ly E,jlocdag-
Nmeber oft Dodreoms —4— Lofts_0 Garbage Disposals/_� Dishwashers_ Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD _ J`�(J GALLONS.
THE NATURE OF THE SYSTEM INNCCLUDED UNDER THIS PERMIT:
of Tank or Treatment Units SCPrIC, IHA/K Tank Capacity _Callon Mlnimua
1 of Final Dtsposala SEEPAGE Al- Absorptiop Area _ S Y!2_ Square rest Mintnum
iptionof other equipment or/IISncludlnq brand name, it any) appurtnancen
IVDAI C .
Other Conditions or Specifications. PT
hGOVE-DMINA6E TO
,PE yds' p ;2D°7Ofo rlo Gle�e6q6E PISP05f11-
D/dEki- sUR�•9� /,r/�T�e 11U14Y )C ee6M OEEO46-e PfT-,
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Before Excavation1�Vpon completion of excavation and prior Lo pincement of gravel Before covering distribution
,, 1\ C system of absorption field
�fl Prior to backfill of any component ( $Other, Specify,
Plans an,l specifications of the proposed sewage disposal syntem have born reviewed and are coneidercd satisfactory. Permission
is hcreLy gra;ited to t6r owner or his agent to perform the work indicated at»ve in accordance with the Pitkin County Individual
Sewagc Disposal Remtlations in affect on the date of Issue. In addition to general provisions set forth on the reverse hereof,
this Permit is subject to the following additional terms and conditionst"Opc .
APPROVED FOR ISSUE BY(1 U/ YL.o� (title)1
Thr above inAivldual sevago disposal system installed by Q E
has been inspected for une by a represent.,tive cf the Aspen Pit to[nviron.x ata 11calth Ocp..rtment. Thu uwnur anaumos all
rueponsibilaty in case of failure or inadequacy of tthhits ucrw�a,)a disposal system. Complete as -built drawing attached.
DATE OF ,UN`AL INSPECTjON /.%
BY: �iU� ��i .t�0, t— TITLE eOr,
'J30 /SSouth Galena Street Aspen, Colorado 811311 303/925-2020
GENERAL PROVISIONS OF AN
INDIVIDUAL SEWAGE DISPOSAL PERMIT
This Permit must be retained and made available for inspection at the above location upon
request.
This Permit shall not be transferred without approval of the issuing agency.
This Permit shall expire 120 days after its issuance if construction has not commenced and
a valid building permit has not been obtained. Any change in plans or specifications after
the permit has been issued invalidates the permit, unless approval is secured from the
Health Officer for such changes.
This Permit is temporary until final approval is granted by the issuing agency in writing.
Final approval cannot be granted until construction, repair and/or operation have occurred
in conformity with the conditions of this permit. This Permit is valid only for the indi-
vidual sewage disposal system and/or equipment specifically identified herein.
Before issuing final approval of this Permit, the issuing agency reserves the right to
impose conditional terms and conditions required to meet its applicable regulations on a
continuing basis. Monitoring and testing requirements may also be imposed. The issuing
officer shall be notified not less than 24 hours prior to backfilling or closing up the
work which would prevent inspection of components installed in places otherwise inaccessible
following such backfilling or closure.
This Permit may be revoked or suspended by the issuing agency for reasons set forth in the
regulations of said agency or of the State Board of Health, as applicable, including failure
to meet any term or condition imposed thereon during temporary approval or upon final approval.
Each and every condition of this Permit is a material part hereof and is not severable. Any
challenge to, or appeal of, a condition hereof shall constitute a rejection of the entire
permit and upon such occurrence this Permit shall be deemed denied ab initio.
This Permit is issued and accepted with the understanding that a fee in the amount of
$ , plus _cents for each mile traveled by a designated inspector from
the principal office of the issuing agency to the location of the system and return, may
be charged for each of no more than two annual effluent samples routinely collected and
tested from subject system as deemed necessary by the issuing agency to monitor said
system for compliance with the Provisions of Article 10, Title 25, C.R.S. 1973, as amended,
and the rules and regulations which implement said Article; and that a like fee may be
charged for each such sampling taken in conjunction with the determination of compliance
of subject system with a cease and desist order issued pursuant to C.R.S. 1973, Section
25-10-107(1)(k).
The issuance of this Permit does not imply compliance with other state or local regulatory
or building requirements, nor shall it act to certify that the subject system will operate
in compliance with applicable state and local regulations adopted pursuant to Article 10
of Title 25, C.R.S. 1973, as amended, except for the purposes of establishing final approval
of an installed system for issuance of a local occupancy permit pursuant to C.R.S. 1973,
25-10-111(2).
APPLICANT'S SIGNATURE
ul
•ASPEN*PI.TKIN •
ENVIRONMENTAL HEALTH DEPARTMENT
:I.Pi,ICATIO FOR AN INDIVIDUAL -U-MACE DISrOSI .• 1ERDiIT
Nam-- of OWNER PHONE pz'f -'3%17Z
AdOress o,_ G ER ��7 Z �ir:'sa.z �/
Maine of APPLICANT
PARK f•i YY' rot ( !Okdd Up
L7^_ATION o'r'
!/rLi DcacriVtior. _,�
( &) Ailed tot . /
( )Otmar 1 )Applicant .
S
PHONE Y:Z% 34— / -J"
( New Inmtalletto' ( Rr>afr
I MF ergency Use ( )Alteratlon NOT due to tall •re
9r-7 // l . T00 .o .A
L:t__ Dleck riling__—SeWI.Sn!or._`� ,-•_vt re of Lut —J?::o__eercx
TY�C OF STrO4fnR': ( sin•Tle Family Dwelling ( )Ot)wa:� _ _�•__^ --_ Do you plan any .'urther� -d ions to the
reeldr�cel ( )Yes Ia
.'.J. No, of Lefts ra
No. cC lbayo Llohoeala �_ Nc. OI Aatcm>Clc ✓: xl•:ra nh-_rs
of tel�oa;as -4�--
No. Of A.tOna11C Clothes Nae:..rs __ j_•___•i_
PATER. TLPPLYI ( )Private vn)1, Mnthor ( )Puhlie. Na..^..a o2 tyetem
( )SPr+aq
( )Strcam ct Crank
. rpr^ IND/VID^dL C^'.1^.E o1S]9_S%L SY:TEY PP.OPY,_T,Rr
I .S's' z;.t1e Trn`.; Ahsc.ntien Field ( )Aeration Plant/AF:nrption Field ( )Conpoetinq Toilet ( )Incineration Toilet ( 'Mound
( )RecycIing, potaLlc usn ( )Ret;¢ting, othcr use ( "-Ault Privy ( lother, _
Tht'ir;tial dte ln.e.•r. ten most are nrrenged with tho Aepen/PitkinEnvlrenment>1 Reclth Department 1925-2020. P:30 -9:3P
LefOfC t p_rmlt ran 1`e 1en9r•e. The Snd-vld Ual PQwdge di5p0e41 permit must be !?SUCd {Klore a builditg permit cw, be obtain.
!';PAL lmSPFCT1ON APPRUVAL NWT Si SIV" hY TY.E ASPEN/PITx1N ENV3A0)InLNTA. HEALTH DCPAF:7JLKT PRIOR TO BACKFILLING MY POAT:OI•
07 TI:E SYSTM. -
Appllc-tion for in 1r.LlvI U. !wage die .aI crit is horehy suxmltted. The vndcrrlgned ecknow!edgca tnat the above Snfa,mation
-t 119. ani that tale. lui at r. ull ova dctt the pglicatlon aad any o••_ml.ene permit.
Yl9..at.we of Applicant _ DATE/%'�� '� SL -'Q
/_. __�'
(Tl. application bo comes. Invalid 32 rwnt:.c 's= G.c abu•+e datoJ
NOSE: r/ PLOT PLAN mtt.st be filed with this application.
Pease locatc the following items by measurect distances:
1. Property lines and dimension.;.
i. Proposed and existing water wells on subject proerty and
adjacent property.
3. N�mestic water service lines.
1. 3roposed and existing buildings, driveways, and other
structures.
S. Streams, lakes, ponds, irrigation ditches, and other water
courses.
S. Proposed a,Jd existing individual sewage systems ort subject
property.
l
SUBVIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTALLATION IS TO
BE CHANGED FROM ORIGINAL PLAN.
,h. andersignecreby acknowledges receipt cCtthi� ladividual 3ewagc disposal permit Ppl ®&tion and a penam
't fee the aouPt
ut' $- ��Q , Recelpt Number 77�9� rate Fee Ae:eivcd _ Y3 _t•:+y ��
AdmtniPLrcalvo O!L1 ccr
130 South Galena Street Aspen, Colorado 131611 303/826-BOWO
CITY O�SPEN
FINANCED RTMENT
CASHIER'S RECEIPT
LICENSES
& PERMITS
❑
GENERAL OCCUPATION BUSINESS LIC.
00111-61000
❑
LIQUOR OCCUPATION LICENSES
00107-60900
❑
BEER, WINE, LIQUOR
00107-61030
❑
LIQUOR LICENSE RENEWAL FEE
00107-61031
❑
LIQUOR LICENSE APPLICATION
00107-61039
❑
EXCAVATION PERMITS
00115-61211
❑
SEPTIC TANK PERMITS
00125-61213
❑
NON -COURT DOG LICENSES
00135-61100
❑
COLORADO FOOD SERVICE LICENSES
00125-61001
FINES & FORFEITS
❑
CITY SHARE-DUI'S
00131-64002
❑
COURT TRAFFIC FINES
00132-64003
❑
TOWING FEE -CITY
00132-64011
❑
PENALTY ASSMTS. ON TOWS
00132-64013
❑
STORAGE FEES
00132-64014
❑
NON -TOW PENALTY ASSMTS.
00132-64014
❑
TRAFFIC FINES
00132-64020
❑
NON -COURT DOG FINES
00135.64040
❑
NON -COURT IMPOUND FEES
00135-64041
❑
NON -COURT VET OR R.V.
00135-64042
❑
NON -COURT ADOPTION FEES
00135.64045
❑
CITY COURT DOG FEES
00135-64043
❑
COURT BOND FORFEITS
00131-64101
❑
COURT COSTS
00131-64201
❑
ACCIDENT REPORTS/XEROX
00131-63420
❑
GENERAL ACCT. NO.
DESCRIPTION: (NAME, NUMBER, ETC.)
RECEIVED FROM
DATE:
�� RECEIPT
6
T TEM�RD.
11' DEEP ORYUJELL
19' �JAr�
125a sni
L�CA1, E 1 � r = ZO i
TO WtIL
t 5-" Fr -r.
ome SToiey
Cob C.ABI J
(�oaerl
v�l.msim PUM
F
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LArwt
MAKE -rieze
• ay65-13�-
•
cy*a PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER ` 2 0 3� Z RECEIPT NUMBER Z d
Owner A. �, +m p�L_�//1 Pu ZEE- kj t Phone #
Owner's Mailing Address df," A',
Contractor
Systems Contractor's
Legal Description 13 T D S „ ?7 (A)
Phone #
Lot Size =/L Q [/u -2i Type of Building by Use
Number of Bedrooms 3 Type of Water Supply
Type of Individual Sewage Disposal System
Type of Soil or Soil Classification
1V0 ',0'07/v/ -)Y
L
Proximal Location of Bedrock
Nt
7
Proximal Location of Ground Water Table
6T VEjayAllAicpS
C(iE
/`IT d
Owner's Signature � � -
d �,
Date—
ate
PLOT PLAN:
PLOT
0
r
######################################################################################################
Percolation Test Data M uut/es%gyp r inch
Minimum Recommended Absorption System Size 2i5?0,.4j2 y/ l /� 3� /lYI4/Yi9
Min' Re mmended Tank Size rLj � (%U
Pe t Rye
valid one year fr Date. Application to beco re it an final only
after lower portion is completed and signed by the Sanitarian. RE AIN THIS FORM AT THE
CONSTRUCITO�N S
I
��
Date // Sanitarian
awing of system on back
.� I
Nk
Ll
9
T
TZ) 9
poor To le"I < CeNc�
Ik_AHove GRACE
PITKIN COUNTY ENVIRONMENTAL HEALTH
0
Field Test Data Sheet on Percolation Test
PROPERTY OWNER PHONE
FLAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY SEc-T/Di✓ / 3 T g S P �S cJ
LOCATION OF TEST HOLES
Three (3) test holes required
per system
Test Hole Depths (24" minimum)
�O
3
Diameter of Test Holes
_f 2
12
Water Remaining after 24 hour
soak 0
D
Percolation Rate Each hole
Average Rate,
NAME OF RES
SIGNATURE
M"
Time
TEST
PHONE
PHONE
COUNTYJ / REQUEST FOR SERVICE
r _
PROGRAM RECEIVED BY .i e) DATESy7t;
LOCATI
REPORTED BY
SERVICE REQUESTE
i r �
TELEPHONE 9a7- -?47i -
i
9 Ar Wo ffollogo
sRI�y, . iJM.7�'T.��,///�
SH -M -7a (4-71-50
OLORADO DEPARTMENT OF HEALTH 0
DIVISION OF ENGINEERING AND SANITATION
A C T I V I T Y R E P O R T
Section
FILE REFERENCE: Private Sewaee Disposal
INDIVIDUAL OR
ESTABLISHMENT: Meekly/Ringsby
ADDRESS:
Code 12
County
NARRATIVE: I did a site location for Jim Meckley on a property
owned by Mrs. Ringsby, across from the old Emma store. There are some
definite location problems on this particular site, but I think,
depending on the percolation rate we can fit a leach field in somewhere
in the orchard area and maintain the 100' from the well, 25' from
the water line, and get the cesspool out of there.
A perc test will be run next Monday.
LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:
DATE: 4/10
LIQ ES: 7 (Rev. 6-70-100)
19 75 REPRESENTATIVE:
Bob Nelson