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Please See Building and Land Use Approvals Files for additional information.
0 ASPEN*PITKIN .6
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ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT N0. Q
TYPE OF PERMIT:
( )Initial Construction ( )Emergency Use ((1 Repair Work,(Proviou• Permit 1) ( )Alteration of an existing system,
or Installation '/\� (Previous Permit 1 .)
( )Use Permit as a roanit of tale f Intbn..
ISSUED TO:
Mailing
Address
DATE OF ISSUE. �'a 1p
Home Phonelz7-7501 Business
Agent dIAiX CftfA, &I A Phone Z%- `%5Fj
Mailing p p,, A
Address _L172 /6RJ Ay $2 nlsw � gggo /Jalb �•
Sewage Disposal System Work to be performed by 6D Z,gMD A -=4'OWAleRS
This permit valid only
for premises
premises location by the following legal deseriptioniA OF 1AA10 id N/fid
LOT SIZE t 6 AceEs NATER SUPPLY O)EL.L- , AVERAGE PERCOLATION RATE 2-0 A41sJ jAJCq
This Individual Sewage Disposal Permit is granted with regard to the following user 5IAIGL—g- rH ILY 4SI DEAe g
Mira'acr of Dodreoms Lofts 6 Garbage Disposals_ / Dishwashers Clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD oUl) GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
of Tank or Treatment Uniti SEPTICTRA r— Tank Capacity / (] _Gallon Mlnim=
64.f final DlspoaaliSEE-PAG Ir BED Absorptioe Area Sgoarc Feat Minimum
crlption (including brand name, if any) of other equipment or appurtnancest
Ala AIC
Conditions or Specifieationsl
f YGA✓r
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
l )before Excavation Upon completion of excavation and prior to placement of gravel ( )Before covering distribution
system of absorption field
XP rlor to backfill of any component ( )Other, Specify,
Plans and specifications of the proposed srwago disposal system have born reviewed and are considered satisfactory. Permission
In hereby granted to tl,e owrer or his anent to perform the work irlicated shove in accordance with the Pitkin County Individual
5euage Uispesal Re,inlations in effect 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 conditions&
APPROVED FOR ISSUE BY _ /� (title). --
The above individual senega disposal aystem Installed by /goAA - �WNE2_
has ba•en ln:�pe aced Wr use by a rcprr aentative u( the As Pit in lnviron manta Ilea t. Orpar unont. TFu ,want anaumoa .11
re_ponsibllily in ease of failure or lnadq vary of thl ac w. to disposal aystem. Complete as -built drawing attached.
DATE OF INAL INS; ECTION ae
NY: �� -
130
I
O�t
I GARAGC
10
Dovt-
H ICH WAY 82
1
I I IL
£V£R6�'EIJ
'FREES �—
=AkA
20'
o GAu,on1 "VCP "
0►JaRETE SePr)C. TAKW EAcH.
w irN Two RI SERB co
POF-tH
1
2 ST0P y
y
TO RIV(!RL
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&A t E i of _ �0
*ASPEN*PITKIN •
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Mame of OWNER PHONE Pj7- yS8/
Address of OWNER ea gel /G 7o
Name of APPLICANT s��r��a rr ._ PHONE 9a —YSB/
I PERMIT TO BE: VIPicked Up ( )Mailed to: TYPE OF PERMIT: ( )New Installation ( )Repair
( jOwner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure
Id'ATIOV OF PROPOSED SYSTEM:
Legal Description (_ 97a /Vy U)ay 's
Lot Block Filing Subdivision Size of Lot acres
TYPE CF STRUCTURE: OSingle Family Dwelling 1 )Other: 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 I
No, of Autonatic Clothes Mashers ( -
MATER SUPPLY: ()()Private well, Depth or ( )Public, Name of System
( )Spring
1 )Stream or Creek
TYPES OF INDIVIDUAL SE AnE DISP05AL SYSTEM PROPOSED:
MSeptie Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound
( )Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Other:
The initial site inspection must be arranged with the Aspen/Pitkin Environmental Health Department 1925-2020, 8:10-9:30 a.m.)
before a permit can be issued. The individual sewage disposal permit must be lasucd before a building permit can be obtained.
FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTIO`!
OF THE SYSTEM.
Application for an Individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above Information
is true and that false information will invalidate the application and any subsequent permit.
Signature of Applicant �g,,.,GQIo� __ DATE�986
(This application becomes. inv ld 12 eronths from the above data.)
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.
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 7 individual sewage disposal permit application and a permit ;cc in the amount
2
of S�////• !/tom Receipt Number GI UO Date Fee Received I - - O by KFfVI
Administrative Officcr
91
130 South Galena Street Aspen, Colorado 51611 303/S25-2020
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