HomeMy WebLinkAboutpitkin.eh.264315201001 (1997)Document Layout
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Permit
Application
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Second System on property
Third System etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
ASPEW/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT
APPLIC N FOR INDIVIDUAL SEWAGt DISPOSAL&TEM
130 S. Galena SL, Aspen Colorado 61611
//'/ S
Phone 970-920-5070/Fax 970-920-5039 N�
Permit 0 7 6 if 9 g Parcel ID 0 L��t �>' �2- " 01 — co
Permit For. New Installation ( ) Repair ( ) Remodel lq Emergency Use ( )
Name of OWNER �i _ Os G.c_.
Owner's Mailing Address gq% �1 f �J Y Gam'✓ 1— GU �%� iD yl (.p
Business Phone: %2 3 J /. /3 Home Phone: G%Z 3 ' 13 3�7
Name of Agent 1LTD MEzoe*0+�
Agent's Mailing Address 72/9- /ni. 0%,f/AJ 07-
l p a �(4P/I
Business Phone: -/pr • '72//9 Cell Phone: 'j -i -9779 Fax : 606P-1-7
Copy of permit to be sent to: Owner( ) Agent( ) Both r'
Street Address
Legal Description: Lot 1? - ,Block .Subdivision
Size of lot: 4 acres Type of proposed structure: ftH. P615. Size of bldg. envelope:
Total arealliving space (sq. R): // t% do x of Bedrooms, offices and similar size :rooms:
Water( )Private well(X)Spring ( )Stream ( ) Community/Public (Name of System)
Is Proof of Adequate Water Attached? ( )Yes(X)No
Has this project been approved by Pitkin County 7 ( ) Yes (K) No
Is a copy of the Boor plan attached (required)? It) Yes( ) No
Application for an Individual sewage disposal system Is y submitted. The uncle 'lined acknowledges that Me above information is true "that false information will
invalidate Me application and any subsequent it. I arm 'does Imply Me approval of tiny other permd reqused lar mnstrudion pursuant to Pitkin County
codes. No conslruCbn may be undertaken until la Is - n obtained. The owner assumes all responsibilities in case of failure or inadequacy of this
system.
Signature of applicant W BltA'/1•� Date 7 2 7�• CICO
For department use below
s• sr s 3 - t 's 1 .
Septic tank capacity: %']3') gallons Absorption area: 73y sq. R.
k Aclzsb •4zAk- w5fs a't -RA Pror. 4 5760 9tlfat soli- uus+ be added
Clea- AA_ 17 SD JonL )n a Serfe.S . A Jraudfess Ch4"tzrs ,I.us4- be added b -
[J )sb'nI irrjleluS Gr Oe- increased Catau4'j *_ a.-- kyin (w¢SC . /} 30%
rite,41en wits alfdwed -ir gqr"�4(ts5 ek�tdRe3 wh)ch reduced ase 54K�-
rCJvlr�.uan4- -ID 317 f 0 • A '*bbrc-([s uas+ be maj,lWncd .
An Inspection Is required prior to backfill of any t:omponent of the distribution system.
Design by Engineer Required ? ( ) Yes (/) No All plans and specifications of the engineer must be followed. Any changes must be approved in
writing and the engineer must certify the
eefi IL( final install/atition to the Environmental Health Department in writing. p
Permit approval by: /.iG� 0 Dale 8 ,
Plans and specifications of the proposed Ind' ewage dis I system have been reviewed and are considered satisfactory. Permission k hereby granteli to the owner or
the agent to perform Me work indicated ir aceta with ' rn County ISDS Regulation in effect at the time of issue. This Ferns becomes invalid 6 momns from the date
that the permit was 5 `issued unless system construction has mm
renced or an extension has been approved in writing by Me Department
Installer. ls yQ,, - Geeki. 2-
As -Built drawings must be Included with this permit before the final approval will be Issued.
Final Inspection Approval: _lit.=•Trt.. Kyifo Dale: y- /tf - G % Date requested: rf -//- 5/ %
Date Pd.'. l-31-q(o Receipt 2J16 Received by: 6q Information complete
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