HomeMy WebLinkAboutpitkin.eh.246717401008 (1995)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design
Soil Information
Water Permit & Information
Second System on property
Third System etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
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` ASPENwITKIN ENVIRONMENTAL HEALTH DEPARIMENT
APPLICATION FORAN INDIVIDUAL SEWAGE DISPOSAL SYSTEM OSDS) PERMIT\
Name of OWNER t*. [kiAIK 6kff Bu�s.sPhone # 9 70 19 27 --WS
Mailing Address 1.255 sgm 6 y ST 'l/611(fA Q ?4219 Home Phone # (
3P3 9�s /lp` 3
Name of AGENT BOB IVEC,SoilJ Nt WS{ LrID)Bus. Phone # X23 3289
Mailing Address P6, Spy( !0 9(,' _qAh1 IJJJJAS LAG, 41 U/iHome Phone #
,r
Copy of Permit to be Sent to: _OLIJAI aAi
PERMIT IS FOR: O NEW INSTALLATION, A REPAIR, )JO ALTERATION NOT DUE TO FAILURE, or O EMERGENCY USE. for permit #
STREET ADDRESS of Property: x.336 1k1M1JD ///I. L,5 ROA D
LEGAL DESCRIPTION of Property: I1. OT _ lot 23, block _, filing _, and subdiv. LY1AA/O/j�145
Size of Lot _ -acres Type of Structure Proposed I — PLE
# BEDROOMS ( # LOFTS Q, # GARBAGE DISPOSALS S, # DISHWASHERS �, #CLOTHES WASHERS _2
Water Supply: () Private Well, ( ) Spring, () Stream, or System (Public or Private Name: 1,I LJWD /41415 I
IS PROOF OF ADEQUATE WATER ATTACHED? () YES or k NO HAS THIS PROJECT BEEN APPROVED BY PITKIN COUNTY? k YES or () NO
Applimtlon rot an individual sewage disposal system permit is hereby submitted. `The undersigned acknowledges hat the above Information Is true and Mat false Information will Invalidate the application and
any subsequent permit Issuance of the permit does not explicitly or Implicitly Imply Me approval of any other permit reoulred for constructlon pursuant to Pitkin County codes. No construction may ba undertaken
until all approvals and permits have been obtained. The "
owner assumes all responsibilities in casesoffailure r Inadequacy of this system.
SIGNATURE OF APPLICANT �G/ `Dr / e��N,e -r7- Date
The application becomes invalid 120 days from the date signed. This Permit is valid only for the design as specified below.
•aurateeaaaauetats-aafetssaa.BELOW FOR OFFICE USE ONLW'auuaaaaaauea>.aaauaaeaae.
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT # qo5ca-1
nn l
8150 fee paid ( es. Date received o� VI Receipt # '�} Q -Z) I_ Received By �
DESIGN CRITERIA OF SYSTEM TO BE INSTALLED: Any changes must be submitted and approved in writing.
# of Bedrooms: I 7Percolation Rate: 115' mpl, Average Daily Waste Flow; 1330 gallons.
Is an Engineer Designed system needed? ( ) Yes or (fi (All plans and specircahons of Me engineer shall be followed. Any changes must be approved In wring and the engineer
shall car ity the finai Installation to the Environmental Health Department In wrding
Minimum Septic Tank Capacity at 0 0 gallons Absorption Area 10 3 D square feet minimum,,-
Absorption
inimumAbsorption Bed, ( ) Absorption Field in Trenches, () Gravel -less system, () Pumping/Dosing Chamber, (-"Absorption Pit
bite + Q -Ci+'G'1;XLrl sy5lru.. 44.3 jkJq�a fn�anircOucskd I(44> {kms a lisp cttrab lasts 4e /'�mufucl
AtJ Al 6", 0( 464'
`64 ocnerffG Xnd kifi he Vl-, file j. 1i tom
ll re O/rrn,Ier( .(&a1 ruLLl"jN
rtr
-(hfur?nafi it veittwed since if was no+ ascd A secya3c Pit��lflxX /Wx lsectp) will
Stagesrjj�99uiring inspection: () Before excavation, () Upon completion and prior to placemenr of gravel, (or Before covering distribution system of absorption
field, (+j'Prior to backfill of any component and any situation deemed necessary by Environmental Health Department Staff.
Plans and spetlhcations of Me proposed Individual sewage disposal system have been reviewed and are considered satisfactory. Permission is hereby granted to Me owner or his agent to perform he work
Indicated above In accordance with the Pitkin County Individual Sewage Disposal Regulations In efisct on the date of issue. In addition to general provisions set forth In any attachments, this Permit is subject
to the following additional terms and conditions it any:
APPROVED FOR ISSUE BY: 4!!'� y�) DATE OF ISSUE: �-O-45
The above individual sewage disposal system has been In"Cilid for u,fffiybas AspenrPitkin Environmental Health Department. The owner assumes all responsibilities In case of failure or hadaquocy, of Mis
I_systteem. Complete as -built drawing and all specifications of as built are Included with this Permit. AL INSPECTION BY: %�i.c t,_ DATE OF FINAL INSPECTION:
FIN
:eOTH:UDD:JrCPC:WP:PERMIT
1109OUTHIUNASTPEET • ASPEN, COLOPADO 616111 • PHONE 90 rias 5p]e - FAX 0aa.610.5161
A/PEHD 1194 PRINTED ON RECYCLED PAPER
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ASPEITKIN ENVIRONMENTAL HEALTH DEPA*ENT !
FINAL SYSTEM DESIGN
FINAL SPECIFICS OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
(As -Built Conditions) ,
1
rie".%r
Type of Tank or Treatment Unit: /,ZSR Tank Capacity: aSoO gallons (1—XfSflirlG P"1 �ro{�rry
Typo of Absorption Field: r!e ne a, D, Absorption Area: 1060 square feet ✓ I ,
DESCRIPTION, CONDRIONS, AND SPECIFICATIONS OF SYSTEM DESIGN:
IN- +ants ar-�C-u cd a `" Co,d;l;rns wcrc ;ns fcc,�cd by .6
'ihc. noniunr m;nq Chlor,fAJ - wo-s rtmooed. -17k_GlCisfi'aJt StcD¢yc P!f was �uurccl .�
Oil Ctrl+a ntAa4etd 9rauLl 4 soil releollej . �% p;f wre5 Gxfa.u(c+ed �a a dcP
of 1R ' . No 9ro-idwa ee- .or hedr-odL was obstraed .
FINAL ASHUILT PLOT PLAN:
of/40(rjh 464- sy s}ems was S; ud / 8'x 18 x l5 r ,t M cal u,.Talct�
a�;l,� JGraLxl /rtded % it reuooed dat b 4kt sys*cm's
` f,/ /h u3 � �;{. was tnl�ptcl as shor..n ba /ow
IYI P�CY�
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125,0 tAertlur
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IZSO 6c•4+ar
-5rIeA. inslalftd by tj &keyti f17- 3y31
31,
IS' deep
FINAL INSPECTION BY: &0 DATE OF INSPECTION: %—(j
130 SOUTH GALENA STREET • ASPEN, COLORADO Start • PHONE 303.920.5070 • FAX303.92D.5197
PRINTED ON RECYCLED PAPER
J
Owner
Address
PITKIN C01NTY HEALTH DEPARTMENT
PERMIT NUMBER
RECEIPT NUMBER /j qq
Phone q`d S - 4-3,/Ar;,
Contractor � _ IA &A� Phone
Address
Location of system
Legal description )i,1,(
Date 3/0 O /7 3 Siganture of owner
Lot Size
Percolation test data — JS � 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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9
ASPEN • PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
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