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Permit
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Please See Building and Land Use Approvals Files for additional information.
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7- 33-0 5
• ► ASPETKIN 3
N PI
qP
Er" NMENTAL HEALTH HEPAR ENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT N0. %,—USD
TYPE OF PERMIT:
Mnitial Construction ( )Emergoney Use ( )Repair Work,(Pievious Permit 1 .) ( )Alteration of an existing system.
t Installation (Previous Permit 1 .)
( )Use Permit as a result of Sale ( )Others
ISSUED TO:
Mailing
DATE OF ISSUEEi'ZS
Phone_127_14e Business Phone
Phone
Mailing
Address
Sewage Disposal System Work to be performed
This permitvalid only for premises location by tho following legal�/dose iptiens��/ L [ /4/i_X-f'/ i/ '+G /I Cir
LOT SILE, 7 /!GM' . MATER SUPPLY QN L<LL. 11VEEM:C PERCOUITION MTE IN c/TES /MCF
This Individual Sewage Disposal Permit is granted with regard to the following uses_ - 1- P Ne., .
Rauber oft bedrooms 3 Lofts Garbage Dispo��ssajal Ts Dishwashers_ clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD .�.3 C GALLONS. -
THE NATURE OF THE SYSTEM INCLUDED tiUNDER THIS PERMIT:
ypo of Tank or Treatment Units( /'� tv� Tank. capacity Gallon M1nlmtes
:thud of Final Disposal&/��tL1�}a,��Vp t�'y/�/O� I Ie�C..J�� Absorptlo0 .y^Ajr'�e../71 Square Faet Nlalmw '
ascription (including brand name, 11 any) /off other equipment or appurtnaneest 1�" 'O� G �JE L a f-D1-f%� L
Cs7s64 L LOAJ -f>C)MP1X1l9 almmge� ,ecqulr- p>Mo- Zr/
Jthor Conditions or Speciflcationes
sET
STAGES REQUIRING INSPECTION BY THE HE PA DfENT: /
( )Mfore Excavation ryUpon completion of excavation and prior to placement of gravel ♦�(i eefore covering distribution
I u / ` rystem of absorption field
( Prior to backfill of any component I !Ocher. Speeifys _ --
Plc s and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Permission
im hereby granted to the, wrcr or his agent to perform the work indicated above in accordance with the Pitkin County Individual
Sewage Di'PCBal RC•IHlationa in effect on the date of issue. In addition to general provision% act forth on the re arse heb!ef,
this Permit is subject to the following additional terms and conditional
_ I AsPen/PWn Environmental
APPROVED FOR ISSUE BY CHied) Officer
_ (title)
The above individual seva*Io disposal system Installed by
has been in for use by a reproscnt.ative of the As
rvcponsibility in case of failure Snad yuac f hill
DATE
In4sfa'T'/OAS ' X
TE OF FINAL INSPECTION Q
BY
/O� IQ 930 South Galena Street
pen/Pitkin Cnvironthntal Health Department. Tn.! 'nor a••w..o
sewage disposal system. Complete *%-hdk1L dra ng ttachod.
C4 tj
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L L9L8 00'N3dSV
TITLE VN31VO *S 0£L
IViNNYWHIAN3 NI)UJd/N3dSV
Aspen, Colorado 81611 303/X0CM@)I1MHVW
• ASPEN*PITKIN .
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER S NACD i1 ' PHONE ` 20-23 33
Address of OWNER
Name of APPLICANT// ��A u� 1 ��<� • 1C • // PHONE �12o-Z 3 3 3
►ERM2T TO Ott ( )Picked Up (61/ulled too TYPE or PERNrTs (•')Mer installation ( )Repair
( )owner ( )Applicant . ( )Oaergeacy use ( )Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEMS
Legal Description
C
Lot Block Filing Subdivision I Site of Lot acre
TYPE OF STRUCTURES R.I5ingle Family Dwelling ( )Others Do yon plan any further additions to the
reside s,ee7 ( )YES 04NO
No. of bedrooms'_ No. of Lofts�No. of Garbage Disposals No. of Automatic Dishwashers
Ne. of Autonatle Clothes Washers
NATER SUPPLY. ( )Private well, Depth or �Pabllc, Name of System
( )Spring
( )Stream or Creek
TYFES Or INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSERS
D�smptie Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound
1 lRecyeling, potable use ( )Recycling, other use ( )Vault Privy ( )Others
The initial site inspection mutt be arranged with the Aspen/Pitkin Environmental Health Department (925-2020. 6:10-9570 a.m.)
before • 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 SY THE ASP /PI IN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR 9'O IfACRFIL:.ING ANY PORTION
or THE SYSTEM.
Application for an Individual sewage dl aposa1 1t hereby submitted. The undersign sckawledgee that the above Information
IIs true and that false information rill,inv date /tj(e ppliutlon and any subscqucnt rdt
Signature of Applicant L / DATE (/
(TRIS application becomes. invalid 92 monolks 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.
1. 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.
SUBMIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTALLATION IS TO
BE CHANGED FROM ORIGINAL PLAN.
Ths undersigned he eby acknowledges receipt of this individual sevaga dispouI pore! pp Psion and a gerwit fee in the amount
of S O b Receipt Number �`{ p Date res Received G�
Administrative Officer
00130 South Galena Street Aspen, Colorado 81611 303,/820-5070
ENVIRONMENTAL HEALTH DEPARTENT a t)(G 7 _ j t{ 3 _0 ? _ Q1
• INDIVIDUAL SEWAGE DISPOSAL PERMIT NO.
TYPE OF PERMIT:
kf]n In itlat Construction ( )Emergancy Use ( )Repair work,(Pievious Permit 1 .) f )Alteration of an existing syrtem,
of installation (Previous Permit 1 .)
( )Use Permit as • result of Sale i )Other, q
ISSUED TO: DATE OF ISSUE S`� / �✓
Ownerx, Home Phone 2730Business Phone
Mailing 12_ , I /�/1 O 1/ /-.,
Agent_
MaiLin€
Address
M
Sewage Disposal System Work to be performed
This permitvalidonly for premises location by the following legal dog* iptions 4.0 / G I /L
LOT SILE� J /(CWATER SUPPLY1RlXIlISJQn� U/�LL, AVERAGE PERCOLATION
This Individual Sewage Disposal Parrott is granted with regard to the following usesy IOJ& LL" f'1)/pl! L7
Nuiber of, Dodccoms 3 rafts V Garbage Disposals
T
ss''al s_ Dishwashers-� Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD 3 J V GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
pa of Tank or Treatment Units ( /"l� A) Tank.Capaeity _Gallon Minimum
thod of Final Disposals %ENCHE� Absorptioy . Are Square Feat Minimum '
f gs %lt�pp��r_�NGNES (iJ/
scrlption (including brand name, if any) of other equipment or appurUaaccsa DF C,;eAJE L, i3c LAL.L) L(N Si
zr�
thcr Conditions or Spccificationas 7
Cf1T1oy�"--a,f ,//1
STAGES REQUIRING I14SPECTION BY THE HEAL DEPA MENT: tit ��`
1 )Before Excavation rpon completion of excavation and prior to placement of gravel tyl acfore covering distribution
U 1 ` ryslen of absorption field
x3andrior to backfill of any component ( )Other, Specify.Pis specifications of the proposed sewage disposal system have been reviewed and are considered satis(Actory. Permission
ix hereby qranted to tlm owr<r or his agent to Prrforn the work indicated above in accordance with the Pitkin County Individual
Scwa;e Disposal Re-,alations in effect on the date of insue. In addition to general provisions set forth an the reverse Recce!,
this Permit 1s subject to the following additional terns and conditions.
Aspen/Pitkin Environmental
C- Health Officer
APPROVED FOR ISSUE BY /� CJ title )
Tho a`,,ve individual scwaga disposal vyn:em installed by f./ /VG
hoe two•<n la Ix ReJ lar use by a rope<acn tet ive of the Aspen Pat in twM-anuta Ilea t.. Department. TA.e or
aenumoa a
.vo(,ensibllaty in <cse of failure r lnad q.Ac f hoe sewaga disposal system. Complete as -t It draw ng ttaehod.
fi �L INs n�ioni f nlcci lc�i-r�r�mVC L� ��(,�qz
TE OF FINAL INSPECTION
L L9 L8 03'N3dSV
gy • TITLE VN31VD *S OEL
-- o3rit3@Htltl3aY—
IV1N3WNOWAN3 NDWd/N3dSV
130 South Galena Street'. Auspen, Colorado 814311 303/IjG*"j6AUVW
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ASPEN+PITKIN
ENVIRAMENTAL HEALTH DEPARANT
FIELD TEST DATA SHEET ON PERCOLATION TEST
Legal descripti
Address of Prop
Name of Owner:
Address:
(# & st. / p.o. box) (city) (state) (zip)
Name of Agent:
Lot Area: c -Water Supply:Public UtilitySubdivision
Private Well_ Other
Distance to Nearest Surface Water Type
Dates Observations Made: Soil Borings: by
Percolation Tests: by M Z
SOIL.BORING TESTS
PERCOLATION TESTS
P-1
Total
Depth
Observed Depth
to Groundwater
Estimated Depth
to Groundwater
Character
of Soils
B-1
r
�—
� ••
Depth of Water
(left after 8 hr. presoak)
PERCOLATION TESTS
P-1
P-
P-3
Depth
�I
Diameter
� •• n -I
� ••
Depth of Water
(left after 8 hr. presoak)
•• n-I�
••
73�lIkdmm ®1
���
�I
� •• u -I
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u-I�
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••
a -I
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o -
`v -67d"
IPM
Ii -M
MIM-
�M,
I
MOMIM-
Rate P-1 lio Rate P-2 10 Rate P-3
AVERAGE RATE: --)"+�minutes/inch
Plan of the site and location of test holes on the back
Comments on Soil or Site:
Date
���
23a Q 130 South Galena Street
Signature
Aspen, Colorado 81611 303/920-6070
r 0
0 �� P-/ -
tv
e
2
ASPEN+PITKIN
ENVIRCOMENTAL HEALTH DEPARANT
FIELD TEST DATA SHEET ON PERCOLATION TEST
Legal description: _
Address of Property:
Name of Owner:
Address:
(# & st. / p.o. box)
Name of Agent:
(city) (state) (zip)
Lot Area: Water Supply:Public Utility -.Subdivision
Private WAll_ Other
Distance to Nearest Surface Water.
Dates Observations Made: Soil Borings:_ by
Percolation Tes Zby
SOIL BORING TESTS
PERCOLATION TESTS
Total
Depth
Observed Depth
to Groundwater
Estimated Depth
to Groundwater
Character
of Soils
B-1
Diameter
PERCOLATION TESTS
^r_
v; L_
Q %.L
Rate P-1 Rate P-2 Rate P-3
AVERAGE RATE: r? minutes�ch
Plan of the site and location of est holeson the back
Comments on Soil or Site:/`Q
Date Signature���n`��
130 South Galena Street Aspen. Colorado 81611 303/S20-6070
P-
P-2
P-3
Depth
Diameter
Depth of Water
(left after 8 hr. presoak)
0
^r_
v; L_
Q %.L
Rate P-1 Rate P-2 Rate P-3
AVERAGE RATE: r? minutes�ch
Plan of the site and location of est holeson the back
Comments on Soil or Site:/`Q
Date Signature���n`��
130 South Galena Street Aspen. Colorado 81611 303/S20-6070
f
v )I
`� -- 9;--X 70 3
• ASPEN*PITKIN 0
ENVIRONMENTAL HEALTH DEPARTMENT
FIELD TEST DATA SHEET ON PERCOLATION TEST
Legal descripti
Address of Prop
Name of Owner:
Address:
(# & st. / p.o. box)
Name of Agent:
(city) (state) (zip)
Lot Area: Water Supply:Public Utility—.Subdivision
Private WAll Other
Distance to Nearest Surface Water Type
Dates Observations Made: Soil Borings: by
Percolation Tests: by
SOIL BORING TESTS .
n,
PERCOLATION TESTS
Total
Depth
Observed Depth
to Groundwater
Estimated Depth
to Groundwater
Character
of Soils
B-1
Drop Time
Drop Time
Diameter
Time
n,
PERCOLATION TESTS
I. L_
I
-,Vi—
P-1
P-1
P-2
P-3
Depth
P-3
Drop Time
Drop Time
Diameter
Time
Drop
Time
Depth of Water
(left after 8 hr. presoak)
Time
Drop
Time
I. L_
I
-,Vi—
P-1
P-1
P-2 I
P-2
P-3
P-3
Drop Time
Drop Time
Drop
Time
Drop
Time
Drop
Time
Drop
Time
1
7`
`ll <
L33
Z Il' ,
Rate P-1 �"�v Rate P-2' Rate P-3
AVERAGE RATE: minute/inch
Plan of the site and location of test holes on the back
Comments on Soil or Site:
Date-
930 South Galenas Street
7 V
Signature /
Aspen, Colorado 81611
303/920-6070
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11-vool,
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