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Please See Building and Land Use Approvals Files for additional information.
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• ASPEN*PITKIN
ENVIRONMENTAL HEALTH DE ARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. 50
TYPE OF PERMIT: `,
( )Initial Construction { )Emergency Use (7 Repair Nork,(Piovlous Permit 1"�,_.) 1 )Alteration of an existing system,
or Inatallation ^ (Previous Permit 1 .)
( )Use Permit as a result of Sale ( )Other, ,
ISSUED TO: ,, // DATE OF ISSUE�—�4r�a j/
Owller�ftEN W ER Home PPhone 92s-Nlusiness Phone
Mailing
Address
szO SrPs... 1A�NT D w _— T( 74-i
N
AgentLAEL/lcws R Tye • - Phone
Address nFnnQPP
TW0fil t%�II /__ T RAM
G
Sewage Disposal System Work to be performed by 64- „WrlffS \n
This permit vvIaa��llIi��d only
sa ACR FS
premises location by the following legal deucription,�dro 7-49 J 1 A)
LOT SIZE fJ,= ACRFS NATER SUPPLY Qwtx AVERAC..E PERCOLATION RATE. AdA
This Individual Sewage Disposal Permit is granted with regardtoto the following user
Ntr.,bcr oft Dodreoms � Lofts* Garbage Di 1. Dishwashers / Clothes Wa s hors
CALCULATED AVERAGE DAILY WASTE LOAD GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Typo of Tank or Treatment Unl G, xPrIt f;�AJAC
Rethod of Final Dis posalr A* ExIST-Absorptiod
Description (including brand name, if any) of other equipment or appurtnanceet
�OrJE
.Other Conditions or Spcciflca t Sons# FAA• E k
CRUSHED ANO E t ark
gQEA HAD NENEX 8
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTPE-NT:
Tank Capacity_12sO _Gallon Hln ln.c�
Area 4m� Square feutUllllllllM
vdye S r
ov, �� ,vE �oiu
{ )Deforc Excavation ( )Upon Completion of excavation and prior to plepement of gravel ( efore coverinq distribution
1, stem of absorption field
Prior to backfill of any component 1 )Other, Specify, _#ope y--
Plans anti specifications of the proposed sewage disposal syntem have been reviewed and are considered satisfactory. Permission
is hereby granted to tLe, owner or his agent to perform the work indicated above In accordance with the Pitkin County Individual
Sew ,e Disposal Rmtr,lntions in effect on the date of issue. In addition t qen el provisions eat forth on the reverse hereof,
this Permit is sub)ect to the following additional` terms and conditions, ��N r(,i -�,%�'�`''•
APPROVED FOR ISSUE BY '• (title) �M4��LiA►wn
The alxtvc lnAivldual sevm)o disposal system Installed by
has bent ln:tpected (or use by a reproscntaaive of the A,Pen 1'It in EnVlre n:r�wto Ilea t. ncpa rtment. The uvnar aan u+wa aiI�
rceponsiblitty in case of failure or lnad yuacy of thaw ucwage d"Poul system. Completo as -built drawing attached.
DATE OF FINAL IAV-22
TI N 0
I C 3 BY:�� TITLE
130 South Galena Street Aspen, Colorado 81611 303/925-2020
• ASPEN46PITKIN •
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER N 1QG-r'ei� I-- G ll� PHONE
Address of OWNER
Name of APPLICANT
PERMIT TO BE; 0Picked Up
'Plea%-- PA"e_
LOCA?ION OP PROPOSED SYSTENt
Legal Description I
Block J"04"Or, y"9 -
TYPE OF STRUCTURE:
( )Nailed tot
( )owner ( )APPlieast .
9a3 -3x 6 3
y v f N c --ba (✓o / g e r PHONE %„2 Y 2 H3'
TPPr OF PERMIT: ( )New Installation ( )Repair
( )Emergency use (I)Alteration NOT due to failure
('-)Single Family Dwelling ( )other:
Subdivision Site of Lot O • 2 1 acres
No. of bedrooms No. of Lofts No. of cartage Disposals
No. of Autonatic Clothes Washers /
NATER SUPPLY: ( )Private Well, Depth or ( )Public
( )Spring
(yStrcam or Creek
on. you plan any further additions to the
residence? ( )YES I )NO
No. of Automatic Dishwashers
Name of System
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED.
(1VI'Septie Tank/Absorption Field I )Aeration Plant/Absorption Field ( )Composting Toilet ( Ilncineratlon Toilet ( )!bund
( )Recycling, potable use 1 )Recycling, other use ( )Vault Privy ( )Other,
The initial site inspection must be arranged with the Aspen/Pitkin Environmental Health Department (925-2020. 9:30-9:10 a.m.)
before s 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/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION
OF THE SYSTEM.
Application for an individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false information will inva date/�rha application and any subsequent permit.
Signature of APpllcanE�f�i��L-�.i -El�d-c DATE
(This application becomes. invalid 12 months 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.
The undersSgne9 hereby acknowledges receipt of hl Snd�lyvidual sewage disposal persit • pliutio and a permit fee in the amount
of S /�'E l _ Receipt Number ) - /: , Date Fee Received / .by ' -
54W67. . Administrative officer
I=� '130 South' Galena Street Aspen, Colorado 89811 303/925-2020
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