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HomeMy WebLinkAboutpitkin.eh.246734303011 (1988)Document Layout (From Most Recent to Oldest Permit) 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. ASPEN46PITKIN ayo- ENVIR. .MENTAL HEALTH DEPAR ENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. �;C) Ur (L TYPE OF PERMIT: Ltiilnitlal Construction ( )Emergency Use ( )Repair Work,(Pi¢vious Permit 1 .) ( )Alteration of an existing syvtem, r irmtallatlon (Previous Permit I ,) ( )Use Permit as a result of Sale ( )Other. ISSUED TO: DATE OF ISSUE ' ' Owner Home Phone :;L_% - 3726(susiness Phone Agent Mailing Address Sewage Disposal System Work to be performed by D W w-� Phone This permit valid only for premises location by the following legal descrti�ptionst r 6-� q . Ff; 2; •y LOT S14D �� 1 MATER SUPPLY r ONNUflNAVERAr..E PERCOLATION RATE. This Individual Sewage Disposal Permit is granted with regard to the following usae_ �h0(ol.£ iAMt4( )i4.QNC:Q Nu.,ber Of, Dodreoms Lofts l[J_ Carbage Disposals_ Dishwashers _Y I ' �`� 1 Clot ca Washers CALCULATED AVERAGE DAILY WASTE LOAD '�j�( i GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:6i(OII.if gee DkzSIC&/J Type oC Tank or Treatment Unit - I-AIA- M.thod of Final DL s poaalr nbS�i,4 C.r 1 Absorptloo Description (including brand nada. it any) of other equipment or appurtnancen Other Condition! or Specifieatlonal .y .(_y -i _(^U5.j•*.(L AS JW^ i STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: Tank Capacity ) _Gallon Minimus Area Square Feet Minimum OPO) IOCX��al�o+l doi�n� sl��la� d2s19Ai btu i:i.In2.-rEc.N,fuc.,�� ( )Before Excavation ( (Upon completion of excavation and prior to placement of gravel ( )Before envering distribution system of absorption field Prior to backfill of any component ( ]Other, specify. Plans and apecificattons of the proposed se.wale dtspnsal system have been reviewed and are considered satisfactory. Permission in herchy granted to tl,e, owner or his agent to perfnrn the work indicated ahnve in a_cordonee with the Pitkin County Individual Sewage D"Pasdl Pe,nilatlons in effect on the date of issue. In addition to general provisions act forth on the reverse heL!ei, this Permit is sub)ect to the followtng additional terns and conditions: APPROVED FOR ISSUE BYe!L (title)[ U1JI QAC tR (7NOlT�i� �t 5-19- X13 ,i The atAe individual c,,ago disposal system installed byC 4". has hon inspected for use by a rcprescnt.K ivc of the Aspe�lt in Lnv1r*nmc-nt4I Health Orpart mcnt. Tfiuwnur As... .11 ra-=!!''��naibiiity in ca a/¢ of failure or lnad yuacy of this /Tsevago disposal system. Complete as -built drawing attached. t-1eW IJj�lct', G.3 •p� 7o -Q15 {N_IcS iut+.lea-�.—� I hANvf�vko l• ,,✓r+.¢)� DATE OF FINAL INSPECTION BY: (' �I—� TITLEIAM t zt- 130 South Galena Street i CTC C9 Aspen, Colorado 81611 303/925-2020 i 10 �J o � ory G o TANF- • "ppsi,�x� kgNly �I . ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPAROENT APPLICATION FOR ANNINDDSIIVV,IDUAA�L//SEWAGE DISPOSAL -PERMIT Name of OWNER _r / y /IeI77aU PHONE227 CJ Address of OWNER Name of APPLICANT PERMIT TO BE: (Picked Up ( )Mailed tot ( fOwner ( )Applicant . LOCATION OF PROPOSED SYSTEMt -/ L Legal Des^r1 on Wn'70f S Lot Block �t Pllinq_ U PHONE / ?—/ ` -3 1#75i�5 TYPE OF PERMIT: *lew Installation ( )Repair ( )Emergency Use ( )Alteration NOT due to failure %I of Lot e TYPE OF STRUCTURE: ngle Family Dwelling ( )Othert Do you plan/any further additions to the residence? ( )YES �!f0 We. of bedrooms - No. of loftsV No. of Garbage Disposals No. of Automatic Dishwashers No. of Autonatic Clothes washers 1 NATER SUPPLY: ( )Private well, Depth or i ubllC, Name of System 1 Q r L cya- y ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSF.Dt k S.ptic 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, 8:30-9:70 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/PITAIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BAC%FILLING ANY PORTION OF THE 5YSTEM. Application for an individual gggs$ age disposal permit 1s hereby submitted. The undersigned acknowledges that the above information Is true and that fal.. 1� on i nva lid h do nd any subsequent pc mite Signature of Applicant DATE o (This application becomes- invalid 12 month. from 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. She undersigned. hereby acknowledges receipt of this individual sewage disposal permit application and a permis,�e ip the amount It S sa Receipt Number Date Fee Recelved ^ � O e 21 ,-by Administrative officer 3 130 South Galena Street Aspen, Colorado 81611 303/S25-2020 PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER lel NO,0TAc-GA-00 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 ©%k TEST HOLE No.1 TEST TEST HOLE No. •.. Time •.. — Percolation Rate Each Hole '71 b K 5 Average Rate A // Comments on soil or site: – 4(� - `a N SrIT� CAA — 01 4)., 5fe4-)6-0n-9— Signature'�I�(.- �^ Date q E 6 U IA 7vs�e �I 0 TAX/MEMO TO: AIVIV S�lutptl4 Phone 9 2,7- 3 0 9� Fax Phone 4 z 7 - )- CC: C I Date -7 la -7 9 9 INumber of pages including cover sheet FROM: Nancy MacKenzie Aspen/Pitkin Environmental Health Dept 130 Galena Street Aspen, CO 81611 Phone 970-920-5076 Fax Phone 970-920-5074 IREMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please Comment 55/.,AOws