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Please See Building and Land Use Approvals Files for additional information.
• SPEN40PITKIN •
ENVIRONMENTAL HEALTHP RTMENT
INDISt_rD:!AL Sr -WAGE DISPOSAL PERMIT ::0.
TYPE OF rFRMIT: .'llL
( )Initial Cm,strectLen ( )`-mccqur.cy Use xRopalr work':Prevlcue Perr:e 1.) 1 )Altcret ion of an existing s+a:e m,
or lnatallation tPrew:ous Pormlt / .j
( ;Use :•crmir as A result of Sa.e ( )Olhor,
TSSunD TO:
DATE OF ISSUE 7'L 4,-j
Owner L pill/1 /4. SAekCX Rome Phone -27-141..Business Phone
Mailia �. ��r r,� _�a+r►v /12EeEDii�l _ G ,,II
Anti r,±Ss iOaPADO SILO,
Agent Mom Phone
Mail -'ng
Address Msoi
Sewage Disposal System :fork to be performed
/1 ? cT of to
This permit valid only for premises location by tho fol.r:o"nng`�/legal deseript'_ont IOPd
1/yt SIZE • O \ 3 A C en WATER SUPPLY W L y. AVERAGE PCRCOL%TICN
This IndivLdu.il Sewage Dispoenl Pe mit is granted with regard to the following use, ,411CLt %M1/L7 Nt11uCA/CC
htnber of, Dodreoms 'L :,efts_ Garbage Dlaposals_10. DSsnvashers�_ Clothes Wasnar,
CALCVLAri.D AVMA CC =ALLY WASTE LOAD —3" .ALL7N3.
THE NATURE CF THE SYSTEM I::(.LTUDED UNDER THIS PER -MIT:
F7 of Tank or TreatmentUnits ��9'�s^�K Tank Capacity __ alion Nlalm•:.•s
comGE �(/�. llbsorptln0 Arca Sguarc F¢a MSn Lvem
thoG of anal Disposal:-&-
scnptlon iincluding brand name, it any) of other equipment or appurtnancesr
NONE
Other Conditions or Spceificational
NONE
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )"for. Excavation ( )Upon eorplotlon of excevat Ln and prior to p}sttment of gravel Wsystem of absog distribution
`� syattm of abcc rption C4,11
l?rlor to Lcckfl_1 of any co„porent ( ;Other. Specify, _p ay%E --
Plans and speclfleatlon: of the preposed sewage disposal syntem have bran rev !ewed and Cr- considered sat!sfaetnrv. permly+ion
is heresy qrc:Red :.) tl,. owr ^ or his anent to perform the work imiicated shove in accordance vita the ?ttkin Cuenty Indivi..usl
Sewage UinpesaL Re.u,:at.ons in atfcct on the date of issue. In addit,on to general provrs,ons act forth on the reverse hereof,
this Permit is subject to the follovcDg addrt!onaL terms
and
� condatlonli
APPROVED FOR ISSUE EY /1�// ' +yZ%'001111M.- (titIe)
the above ln.lividunl ac,,a,lo disposal system installed by
h.,a Dern in:;rcctcd (or u.nn by a representattvc at the Anuen+1'1 ,nmant4l Iles 1r.. De par Unto L. Tia• owner as,wren a,a
reoponsabiilty in Casa of failure or Lnadequacy of ttn,/s sewpyj drapuaal system. CcmplaLe as -built drawing attacn0d.
DATE OFFo�I`�AI. I_1SP JTkP 0 x!/43
TITLE
13 South Galena Street Aspen, Colorado 6161'1 303/925-2020
f c��l�
0
0
GENERAL PROVISIONS OF AN
INDIVIDUAL SEWh3c DISPOSAL PE!).MIT
This Permit must be retained and made available for inspection at the above location upon
request.
This Permit shall not be transferred without approval of the issuing agency.
T' is Permit shall expire L20 days after its issuance if construction has not commenced and
a valid building permit has not been obtained. Any change in plans or specifications after
the permit has been issued invalidates the permit, unless approval is secured from the
Health Officer for such changes.
This Permit is temporary until final approval is granted by the issuing agency in writing.
Final approval cannot be granted until construction, repair and/or operation have occurred
in conformity with the conditions of this permit. This Permit is valid only for the indi-
vidual sewage disposal system and/or equipment specifically identified herein.
Before issuing final approval of this Permit, the issuing agency reserves the right to
impose conditional terms and conditions required to meet its applicable regulations on a
continuing basis. Monitoring and testing requirements may also be imposed. The issuing
officer shall be notified not less than 24 hours prior to bncKfilling or closing up the
work which would prevent inspection of components installed in places otherwise inaccessible
following such backfilling or closure.
This Permit may be revoked or suspended by the issuing agency for reasons set forth in the
regulations of said agency or of the State Board of Health, as applicable, including failure
to meet any term or condition imposed thereon during temporary approval or upon final approval.)
Each and every condi-tion of this Permit is a material part hereof and is not severable. Any
challenge to, or appeal of, a condition hereof shall constitute a rejection of the entire
permit and upon such occurrence this Permit shall be deemed denied ab initio.
This Permit is issued and accepted with the understanding that a fee in the amounc of
$ , plus _ cents for each mile traveled by a designated inspector from
the principal office of the issuing agency to the location of the system and return, may
be charged for each of no more than two annual effluent samples routinely collected and
tested from subject system as deemed necessary by the issuing agency to monitor said
system for compliance with the Provisions of Article 10, Title 25, C.R.S. 1971., as amended_
and the rules and regulations which implement said Article; and that a like fee may be
charged for each such sampling taken in conjunction with the determination of compliance
of subject system with a cease and desist order issued pursuant to C.R.S. 1973, Section
25-10-107(1)(k).
The issuance of this Permit does not imply compliance with other state or local regulatory
or building requirements, nor shall it act to certify that the subject system will operate
in compliance with applicable state and local regulations adoptad pursuant to Article 10
of Title 25, C.R.S. 1973, as amended, except for the purposes of establishing final approval
of an installed system for issuance of a local occupancy permit pursuant to C.R.S. 1973,
25=10-111(2).
APPLICANT'S SIGNATURE
J
• 8PEN*PITKIN •
ENVIRONMENTAL HEALTH DEPARTMENT
APPLIChTION FOR AN INDIVID[1AL SEWAGP. DISPOSAL•PBRMiT
Kline of OWNER Z��,' �n 2t'�jp _ YIiOi:E(3o3� 9 -Z7 -,9S69
.Addrtss of. OWINER X4711 -r FR,i.,VC,PN tnn_ 142-CR.-Dr—I'll Co. 8/E �/A—�__�__
1
27a=C cf. APPLICAAT 3,9 M g FSiOi7L __S.�.CLr ,�
t•ERw1T To Pee ( yrlekxd Up lVj Sled tot TYPE Of- PERy[Tf ( )New T.,; Lel lattoe ( tltepetr
vtficr ( )Applicant ( yEx.Frye.,cy ore ( )Aluration NeR den to Callurt
T!YJ1?203 O£ PRO?OSED SYSTEM,
Irgal Iuscr:Ptfoa �Q',rtnCN tD _� ^`_•_�,��__R_._ _.._
Iot alvck�� rlllbq Sebdlvl att:•� ite o! Lot .42,0 ,__titre;
TSPt_O£ tT77VCTURE: ;4single rtwn-ly Dwo)linq ( )Otnert___ _ Do you Piet ary ftrtler addltiona to the
resiJee.ce2 (-)YZS 00e0
No. of tcdrooea_ % _ No, of LPfra _ y Nm. of Chrbngo Disposal, _ bso: of 4etanntie
_—
40. 4C aY iMeaL (C (;lu [hal Waal,[, O�Y� �
MISS P: 06Privato Nell, Dept n_,__ 'Q
SUPLY_^�_.._. er ( )Public. Nome of Syat<m ___• .�`_ _ .._
( )Stream or Creek
TT£ES o1' -INDIVIDUAL SC!a.^.0 Dls£OShL s_y'TEy pro!'OsrDs '
9gSeutic Fank/Ahso-ption rield ( )).oration r•lant/ahavrptlon Field ( )Covpu..tinv Toilet ( IIe:ulnuetSnn To13et ! )Ncrri
t )hrcycling, potable u:o ( )a+aryc:l.o„ othur tat ( y7ault Privy ( tether,, __
Snitinlsite S::apoetioa m:!. -t to err•nreJ with the r -n/P1 ti 1n rnvironmentol health DepIrt..n;.t (973-2D2D. C130-9130 ..m.)
f:[m'e porxlt can Se :asaeC. The inclvicue: cevage m i I -sal pe:r.iT meat Lw :oaued.bcforn n. bulidInq po.mi: con ba obt::nnd.
71NAL 1N6PCC^I04 APPRMAL NOST BC CIUM nY Tim A?PEF/P1TK2N CNYIRONNFI$AL NWLTH DCFAATNENT PR:Ok TL DACArI —nrr. ANY f-crooN
C£ 7Hr. 1-YST 4.
Ajplicetio.e far an :n9i v: dvd sewage Jlspaoal Perm 1.s "a Toby submitted. The un,:0r4ignvd a,krn+ledg.:a teat th- above infor,natlon
!s true and ghat !alae information wil vel! t- the p,Plliiaatlon and any subnogvont peermit.p
signature of Arplleant DAYt_t��/-
(this apP:icattoa lvtcomes. lnvat(o 12 mortis trom the ah>ve dace.)
NOTE: PLCT PLXvr must bo filed :with tilis applic:atiorl.
Ylease locdte-the fallowing items by'meaaured distances:
1. proparty lines a-nd dime:=ions.
2. Proposed a,.d existing water welly un subect: property and
adjacent proc�:ty.
1 Daalentic wit --r s_rvice lines. '
0. Proposed and esisti.ug buildings, driveways, and ether
atrubt'uve3. -
S. Streams, lakes, ponds, irrigation ditches, and other water
eoursee.
c, rvlposad and existing individual sewage systems on subject
pro; crty.
1
SUBMIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTP-LIIN.'2 (%id IS TO
BE CHIWGF,D FROM ORIGIN%L PLAN.'
Tha uaderslge hereby acknowledges receipt e1 thla Sndlvideal ,swage dlapoael Perm it appllegption and a Form.tl tee tin the amnVnt
of i v , Recblpt tlx w, �f93�2- . Date ru Roccivad
• Addnistrn•!vo Officer
3
130 South Galena Street Aspen, Colorado 81611 303/925-2020
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test �}
PROPERTY OWNER 710AM 64.4 IC F k PHONE
MAILING ADDRESS 25-1$5 F/ly//VC Anl PD
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 8 hour soak
.33 PO
36rr 36n 36�
1,9 f/ / 2 // l //
TEST HOLE No.1
TEST HOLE No. 2 TEST HOLE No. 3
`l3 L
Drop Time
�,-7 L, 3 r L
Drop Time Drop Time
<q 511L OSo
% D
V7 '11
53'
59719 it
JQ i lQ 112.
5116o
Y/a
Percolation Rate Each Hole
Average Rate /0
Comments on soil or site:5" ) ?V� ^ _ ,� Q' /
w v `tel U
Data
'j-1.2-83
RAJlKER,. ZONA 9
y 2syss FRYING PAN 4 RoAl)
MEREDITH, COLORADO
A,'IRACT 8EIN6-PA4FT OF LUT 12,
TN SE4NE4 Of Sf$TI0A1 18-8-83,
L7 N6 SETWEEN,'$T, HNY, 4104 AND
1 fRYIN6 PAN RIVER, MEIN& OESCj SY
Mt AND.pOUNDS, AND CONTAINING
re'KSeA4 'PAGE 276
9U X ?34 PAGE 427 0,43 OF AN ACRE
SE'800K 359 PAGES 967-968