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• ASPEN*PITKIN at
ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. h qD q
TYPE OF PERMIT:
'I Initial Construction ( )Emergency Use ( )Repair Work,(Piovious Permit 1 .) ( )Alteration of an existing system,
or installation (Previous Permit t .)
( )Use Permit as a result of sale - ( )Other,
ISSUED TO:
DATE OF ISSUE . —7
Owner , Ub�'l r( 11 Home Phone4Qif-877-b11`I`� Business Phone
Mailing
Address L(t�(1 l x04 �_ b1! 1 K(Am'( fL 331 31
Agent_
MaiLing
Address
Sewage Disposal System Work to be performed
Phone
This permit valid only for premises location by the following legal deoedptionsLoTb1k 1 043fWA4 ktSa hJnaSi
LOT SITE 1,01 ��1Li S WATER SUPPLY , AVERAGE PERCOLATION luTE Ems)
This Individual Sewage Disposal Permit is granted with regard to the following use: �IJQF t ikffiJ CCn •
Number oft Dodreoms _3-- Lofts_ Garbag,e/I Disposals_ Dishwashers_ Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD "l 11jJ GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Type of Tarek or Treatment Units C1bxlC111lCt --A"Jk-
rr.thod of rinal Disposal, AhSOE.`1`lUta.'I C.C1r�iS Absorptioa
...Description (including brand ease, if any) ofother equipment or appurtnancen
Tank Capacity 1GG C) _Minim,..
.Axes
Minim,.
Area 1 btiQ square Feat Minimum
Other ConditionsLL or Spccificationet I is "10 "Jc (,o N&l I top — � (�I � ) fM�A +D V
(�
-Z li1i�A)wwVLl \0�-' QCQOI QZ.,iW C�LOAJ — COtJ Lv,'f U. 1+c-^^'�'t �^ Wcpa
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
I )Before Excavation ( )Upon completion of excavation and prior to pleeemena of gravel ( )Before coverin.7 distribution
system of absorption f ,ld
•t/rl Prior to backfill of any component ( Other. Specify,
Plan's nand specifications of the proposed sewage disposal Syntex, have been reviewed and are considered satisfactory. Perninslon
is hereby grantod to the owner or his agent to perform the work indicated above in accordance with the Pitkin County Indiviival
Sewage, Disposal Rc•,alataons in etfoct on the date of issue. In addition to general provisions act forth on the reverse her.ee2,
this Permit Ja suhiect to the following additional terms and conditions,
APPROVED FOR ISSUE BYVjl`V' (title)
Tho above Individual aZw,-Io disposal system installed by
has M•en In::pccted for wse by a rcpresent.x en%1',t
ive cf the AslzR,O Lnv Th'! „VnJr .1 ., all
rvZfxinstbilaty In cdie of failure or inadequacy of th,v sewagu disposal system. Completo as -Lull[ drawing attacnod,
DATE OF FINAL INSPECTION
BY: TL'rLV
DL -'34
930 South Galena Street Aspen. Colorado 81811 30M/91110-0070
9 0
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ASPEN&PITKIN
ENVIR NMENTAL HEALTH DEPARa !i
ENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER Judy Fick PHONE Loll -877-6119
Address of OWNER L)lIO S. Bayshore, #609, Miami, Florida 33131
Name APPLICANT
Mark Regan
PHONE
927-326%
``o//f
PERMIT TO BE: (X1Picked Up
'' \\
( )Nailed to,
TYPE OF PERMIT: (New Installation (
)Repair
( )Ownar ( )Applicant
( )Emergency Use (
)Alteration NOT due to !allure
LOCATION OF PROPOSED SYSTEM:
Legal Description Gateway
of Snowmass Mega
Siihdiyiaion
Lot 6 Block
1 Filing
3 Subdivision above
sire of Lot 1.O1 acres
TYPE OF STRUCTURE: (Single Family Dwelling 1 )Other&
No, of bedrooms 3 No. of Lofts_ No. of Garbage Disposal I
No. of Automatic Clothes washers j
Do you plan any further additions to the
residence? ( )YES O
No. of Automatic Dishwasher. 7
NATER SUPPLY: ( )Private Well, Depth or (\4Publlc, Name of System Gateway Homeowners
( )Spring // \\
( )Stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED& -
( Saptie 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 (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 DACKFILLIAG ANY PORTION
OF THE SYSTEM.
Application for an individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above Information
1s true and that false information will invalidate the application and any subsequent per t.
Signature of Applicant ��='fir_- x - DATE
(This application becomes. invalid 12 mo Ahs 1rom 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.
{. 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.
The under^e�lgned h rj�y acknowledges receipt of this individual sewage disposal permit application and a permit Cee in the amount
OC S /YS Receipt Number Date Pee Received )-y(�,_�(/��/'j/ .t by %�
I/ / Administrative Officer
. /o �'_
130 South Galena Street Aspen, Colorado 81611 303/925-2020
0 0
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER V r G�� PHONE
MAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 8 hour soak
d
„,7
� L `
IN - - I
TEST HOLE No.1
TEST HOLE No. 2 TEST HOLE No. 3
Dro Time
Drop Time Drop Time
�
v
o O I 2
Percolation R ach Hole \ 5 �"5-6315 `� 3 i
Average Rat
Comments on F tJ s;wAy Q,,ay ,6LZL,
PO �,W,
Signature Q Date ( — tQ
9