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ASPEN♦PITKIN 2Vi7-3#- -
ENWOMMENTAL HEALTH OEPAF'J#/IENT
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INDIVIDUAL SEWAGE DISPOSAL PERMIT 140. Ior Loo
TYPE OF PERMIT:
( )Initial Construction ( )Emergancy Use
of installation
( )Use Permit as a result of Sala
ISSUED TO:
Mailing
Address
MaiLing
Address
IpO Repair Mork, (Piovlous Peralt 1)Alteration Permit
an exlalSnq system.
9 (Previous permit 1 .)
( )Others
DATE OF ISSUE.
Home Phone Business Phone
Phone
Sewage Disposal System Work to be performed bq JCE 1J/Fi)/✓jeC-IJ
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This permit valid only for promises location by the following legal descriptions / Y o. FV�tt,—t 1 �}
LOT SIZE 6^t l /tC MATER SUPPLY , AVERAGE MKOLATIOH {RATE
This Individual Sewaga Disposal Permit is granted with regard to the following user U LC / IJM� L /DE/IL
Muober oft Dodreoms _ Lofts E Carbage Disposal* C' Dishwasher Clothes Mashers
CALCULATf'.0 AVERAGE DAILY WASTE LOAD
THE NATURE OF THE SYSTEM INCLUDEDD UNDER THIS PERMIT:
ype of Tank or Treatment UnLts SC- P1T'IG 1 14 Tank Capacity O&D Callon Minimum
.shad of Final Disposals Cr/�n f_ .D/r Absorption Ares 1 Square Fee! Minimun
asarlption (including brand Cn Car, lIf say) of other equipment or appurtnancess
Rher Conditions or Spetificationst
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
1 )Rofore Excavation ( )Upon completion of excavation and prior to placement of gravel O(Defore covering distribution,
system of absorption field
(/q Prior to backfill of any component ( )Other, Specify,
Plans and specifications or the proposed Sewage disposal system have been reviewed and are considered sattsfactory. Pernl ssion
is hereby granted to the owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual
Sewa;c Disposal Re•nilations in effect on the date of issue. In additlon to general provisions act forth on the reverse hereof,
this Permit is subject to the following additional terms and conditional
!)�/ )G� Aspen/Pitkin tfficer ental
APPROVED FOR ISSUE BY (title) Health Officer
Tho aVx vc individual sewage disposal systca Installed by
has been InIpeeted sur use by a representative of the Aspen PK in Covlronm,•n to Hca t.. Ocparuncnt. The owner assunwa a 1
rt-:p,nsibillly in case of [allure or lnad quacy of this sewage disposal system. Complete as -built drawing attached.
DATE OFI'AL IISPE TIO
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BY: �. TITLE _ Health officer
/� 3 130 South Galena Street Aspen, Colorado 81611 303/920-5070
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