HomeMy WebLinkAboutpitkin.eh.246734300081 (1986)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
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Engineer Design
Soil Information
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Second System on property
Third System.etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information
0
PARCEL ID:a&1-3y3-AO -Qg/
CHANGE OF OWNERSHIP/SEPTIC RECORDS
NEW OWNER: {Bram, /
ADDRESS: lq(j 5noWjk4l(SS 6.tz 1' - Ri.
LEGAL DESCRIPTION: �r� g, + g� ��. 3y i $ SQ g4 uJ
PREVIOUS OWNER: �nGra Sven
I Crc -.!
• ASPEN*PITKIN •
/-3L/3 -00-081
ENVIRONMENTAL HEALTH DEP TMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. „0
TY)?E OF PERMIT: —
/,X\'/Inl tlal Construction ( )Emergancy Use ( )Repair Mork,(Pievious Permit I..) ( )Alteration of an existing system,
or Installation (Prevloua Pe mit 1
( )Use Pcrmlt as a result of Sale ( )Othort
ISSUED (TO: I DATE OF ISSUE.
Owner J jQ/E�YM _&CkAM Rome Phone ,2 - 2 Business Phone
MailingAddress I
Agent �AD Ve Phone
Mailing
Address
Sewage Disposal System Work to be performed by Toe(G&/tJKE/3 p� QC /J p///
This permit valid only //f1at �)p{rc�m/acs location by the fColloving legal dcsedptiontA T.�e (ACT 814 Z &.34 e 1 opfl(I
LOT SILE 3, D�� !ICf��J MATER SUPPLY Aubwyistwu L(,ItLL. 1 AVERAGE PERCOLATION MTIYQ 111A/ CN
This Individual Sewage Disposal Permit is granted with regard to the following uset SILIG LE �4 111i YR&SI9 E AIC'[
L) L_. ( AIA If
Ruaber oft Bodrtwms _-/ Lofts � Garbage Disposals � Dishwashers Clothes Mashers
CALCULATED AVERAGE DAILY WASTE LOAD f�� CALLOtIS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Type of Tank or Treatment Units 1;E leC TANK
f+:thod of final Disposals {{µ�R Pr/QLfTFA)C XLC Absorptioe
Description (Including brand name, It any) of other equipment or appurtnanceat
.POS/kir, SiPioA) ay 14SS0CithTeP 1 LASTIL�Iplec,0VC -T5
Tank Capacity 4 Callon Minimum
Area I3 Square FeeprMinimum
WITH DOSING SI PNON `20r%RED(k
.Other Conditions or Speeificattones
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Before Excavation (7p Upon completion of excavation and prior to placement of gravel
Xbofore covering dlstrihutlon
system of absorption field
16(p rior to backfill of any component ( )other, Speclfyi
Plans and specifications of the proposed sewge disposal system have baro reviewed and are considered satisfactory. Permission
in htrcby granted to tl.r owner or his agent to perform the work indicated above in accordance With the Pitkin County Individual
Seva•; Disposal Rc•Inlations in effort on the date of issue. in addition to general provisions act forth on the reverse hereof,
this Permit is subject to the following additional terms and conditions:/Lk'A,
APPROVED FOR ISSUE BY / (title)
The above individual set.a.le disposal system Installed by /.�ii�/.I�L'F/ .b
has bran in:ipeetcd tar use by a rePrescatat ivc of the Aspen 1, in Cnvi ronmonta Ilea th Department. T ownur aaaumee .11
roolwnsibll tty n <s se of fail re or
"ad.,q uacy of this aewg disposal system. Complete as -built drawing attached,
fA�AG /a���6
DATE OF FINAL INSSPE TION
BY: a%iG/�/ TITLE
CCI0w �
w ,
930 South al Street / t„c Aspen, Colorado 81691 303/925-2020
Q
F-1
r • ASPEN*PITKIN •
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER 1 �^� =�i� �^ PHONE 4 ZZ - 4Z34
Address of OWNER L< ( ACS) No GL - L-
Name of APPLICANT t__ PHONE
PERMfT TO BE, ry Picked Up
I/KATION OF PROPOSED SYSTEM,
Legal Description A pn(�
( )Mailed tot TYPE OF PERMIT, New Installation
( IOwner ( )Applicant . 1 )Emergency Use
( )Repair
( )Alteration NOT due to failure
of 71-1f-
Block Filing Subdivision size of Lot
TYPE OF STRUCTURE: Single Family Dwelling l )Other, Do you plan any further additions to the
residence? ,l>q YES ( )NO
NO. of bedrooms 4-' No. of Lofts No. of Garbage Disposals No. of Automatic Dishwashers
No. of Automatic Clothes Mashers ! _
WATER SUPPLY, ( )Private Well, Depth er WFubIIr, None of SYstem
C )Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED,
kiSeptie Tank/Absorption Field I )Aeration Plant/Absorption Field
( )Recycling, potable use ( )Recycling, other use
( )Composting Toilet ( )Incineration Toilet ( 1Mound
( )Vault Privy ( )Other,
The Initial site inspection ..at be arranged with the Aspen/Pitkin Environmental Health Department (92S-1070, 8:30-9,10 a.m.)
Fc Core a permit can be Issued. The individual sewage disposal permit must be lasue,d before a building permit can be obtained.
FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITAIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION
OF THE SYSTEM.
Application for an ind
Is true and that false
signature of Applicant
NOTE:
I permit is hereby submitted. The undersigned acknowledges that the above Information
lidate the application and any subsequent Permit.
�i DATE
(This application becomes. invalid 112 no the from the above date.)
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.
4. 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 undersigns hereby a,knovledges receipt of this Individual savage disposal pe t ap//{{{{l lc tion and apo ant a In the amount
Of i_f �� Receipt Number C y `l Date Fee Recolved by �j
AdminIstrativo Officer
130 South Galena Street Aspen, Colorado 81611 303/925-2020
ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
Legal decr
Name of Ow
Address:
FIELD TEST DATA SHEET
Name of Agent:
Water Supply: Public Utility_ Subdivision Private Well X
Lot Area: Distance to Nearest Surface Water ft.
Dates Observations Made: Soil Borings: by
Percolation Tests: by
SOIL BORING TESTS
A A A A A A A AM
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Average Rate: /10 minutes/inch
Plan of�te� site on the back
Dated/d10 Signature��
7- &OB NBSON
ASPEN/PITKIN
SANITARIAN
130 S. GALENA
ASPEN, CO 81611
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SCALE: III 20' APPROVED BY: DRAWN BY
DATE: REVISED
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