HomeMy WebLinkAboutpitkin.eh.247318100039 (1972)Document Layout
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Permit
Application
Log Sheet/Notes & Photos
Communications.
As -built Design
Engineer Design
Soil Information
Water Permit & Information
Second System on property
Third System.etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information
0
-00-039
PITKIN COUTPY DFP.-'iiPMT OF ?}7T_R0NI'4Ei3^AL HEALTH
Box V Aspen City :fall
Aspen, Colorado ,
r
9z5-zoz.�
7ry� p�
720019
System Location '27z,.L44Z L i /Q • �.--------__- __—..
Contractor
1. Construction approval:
Plans and location are hereby approved.__�
Pere. rate inches it, feet of
absorption area per bedroom.
feet_ _&q, feet m_n .orum require --
Ment /iJDO 'e � [a s 1"J^
..
Date- ya _ Inspect or�}0_��lfQ,,��
2. Final approval of system:
No system shall be deami d to be in compliance with the
Sewa-e Disposal Lau:s un"31.1 the asscabled sysLem is a??roved
urlor Lo cove,in.7 any part. _
8" septic tank cleanout with gas seal
1 N� �_..-._._._._ —. _ ._� .i_.
V� Proper materials ani assembly
ate absorpt?.Ori area
ate concr2te Cover (dry urolls only)
Date Inspoctol'_�� _
-'-}retain ;: th pnr;iit record -c at construction site.
COLORADO DEPARTMENT OF HEALTH
Water Pollution Control Division
4210 East llth Avenue
Denver, Colorado 80220
APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS
Applicant (Owner):
Mail Address:
,City: u, Phone: 2 Z 2.r/
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of area, habitable buildings, location of potable water wells,
soil percolation test holes, soil profiles in test holes.
1. Location of Facility: County City or Town�/Lo7,t,cc�r�ec�
Legal Description Lot Size:
2. Type of area and facility - Number of persons served:
Subdivision ,&/ Motel ". Restaurant 11FATrailer Court ;V4 .
Other:
3. Source of domestic water: Pu61ic (name): Yin
Private: Well �� Depth dl Other j Depth to first ground water table f714
4. Is facility within boundaries of City or Sanitation District:
If so name:
5. Distance to nearest sewer system: / /_�yyr�
Have negotiations been attempted with owner to connect:
If rejected, give reason: n/1+7-
6. Rate of absorption in test holes in minutes per inch of drop in water level after
holes have been soaked for 24 hours: / '%:.. K—� .__
7. Name, address and telephone of
person who made soil absorption tests:
8. Name, address and telephone of person responsible for design of the system:
9. Est. bid opening date: Est. Completion Date: Est. Project Cost:
Date: _ ,.7 72 o
Signature of Owder
Ci
a
. r
B. SIGNATURES FOR LOCAL OVERNMENT OFFICIALS: The undersigned have reviewed the
proposal for the location of the above-described septic tank system and
RECOMMEND APPROVAL or DISAPPROVAL in the space provided below:
DATE APPROVAL DISAPPROVAL
Comments:
/__7 /__7
Signature for Local Health Department
/ / F-7
Signature for Mayor or City Manager
/— _
Signature for County Commissioners
Signature and Title
Note: The applicant must obtain the comments and signature of at least one of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
I WP -10 (Rev. 5-70-100)