HomeMy WebLinkAboutpitkin.eh.264315301002 (1996)Document Layout
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Permit
Application
Log Sheet/Notes & Photos
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As -built Design
Engineer Design
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Second System on property
Third System etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
ram Pam # 2&113 — 15_ 3—o
ASPEN/P17F4N ENVIRONMENTAL HEALTH DEPAR MaNT 1 ^ ODy
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM QSDS) PERMIT
Name of OWNER /�. GC g aki rrX. Fa t- Bus. Phone #
Mailing Address //iX 2''//� l✓�ad�/ ���n/� a Home Phone # �G/2S — 7741y
Name of AGENT /;1e C�G� — �OrY/S -� %7 e(!lal/e�5 Bus. Phone #
wi lm tff x1la-,Q ee
Mailing Address ,9DX X75 � Si Home Pfhonel# 963 l 8��9
(�/Copy of Permit
,t`o be Sent to: 4aw 2 ,% G VA.r 1 S 9 2 3 p y Z
PERMIT IS FOR: yp NEW INSTALLATION, () REPAIR () ALTERATION /NOT DUE TO FAILURE, or () EMERGENCY USE. for permit # (�r�� r }��}�
STREET ADDRESS of Property: 1I7 N1eaa'�W1.4AE L-�
LEGAL DESCRIPTION of Property: lot Z, block _, filing _, and subdiv.%l[�% ,/e S/w%�GNey
7
Sae of Lot � acres Type of Structure Proposed ern
# BEDROOMS 0 # LOFTS C) , IF GARBAGE DISPOSALS # DISHWASHERS Q. # CLOTHES WASHERS 0.
Water Supply: O Private Well, O Spring, OStream, or �yjfSystem (Public. or Private Name: 1li1l ie Sf tr Pam4 .1110 rf
IS PROOF OF ADEQUATE WATER ATTACHED? () YES or () NO HAS THIS PROJECT BEEN APPROVED BY PITKIN COUtJTY't () YES or () NO
Apperadon fav an hdMdual aawaQ* dlspoaal Mt«n permat b bweby wfinJmd no atlaraignad aalxwbdpes 4ttl ew above Nwmaeen It bum and sat W" edwmulon M Nvalleate the &WICadon and
any subsequent permit ksusnca of me penx does M eopbcldy w bmpkidy, Booty she appavw of any dAes pwmtt uquimd fav con Umtion puauard b Piston Courtly codes. No corawction may be undertsk n
uNA a0 app nnals and parole Nva been obtained. The ovmw asnerrs as wpwaDaties In case of factum w bbdequacy d this system
—7) J/ �•
SIGNATURE OF APPLICANT l ( G / L "t' Date -7 /5
The application becomes invalid 120 days from the aale signed. This Permit Is valid only for the design as specified below.
«eaeau......aaeeaa........ BELOW FOR OFFICE USE ONLY a.... .aau......auam..a...
INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT # ` �V
$150 fee paid (-) Yes. Date received S Receipt # 60„?.? 3 w Received By �K
DESIGN CRITERIA OF SYSTEM TO BE INSTALLED: Any changes must be submitted and approved in writing.
Fzl r,I !_ X i -v -C.
#-oFBedrovma:(�. Percolation Rate:-?_� mpi, Average Daily Waste Flow: / 3:,2 gallons.
Is an Engineer Designed system needed? ()Yes or M, No W ptw and aperdradwr d aw engllww abaB b klwsed Any da^gaa aawt be appsowd N wddrp and the angi,.ear
stus Addy the foul Inswiaton to ane Envn nmenW Heam Oepwbmwa In wmno-)
Minimum Septic Tank Capacity � gallons Absorption Area a 30 square feet minimum
O Absorpdon Bed, (t]' Absorption Field In Trenches, (Gravel -less system, O PumpNpfDosing Chamber, O Absorption Pit .
o� &6sow-F-h a•% Area_ /is r-egLarcd- -!:,C in5•f4.11cd in ItandX,5 44f Wo�fd rtQIJJ«-
.� 'lreockml of 7 unrfS Cach 1G- a 4afetJ ar 14 u4if5b4' gr&velle55,r5. 7/tc �albyn of
Steges "wing Inspection: () Before excavation,() Upon completion and prior to placement of gravel, (�"BNoro Bowring distribution system of absorption
held, (4 Prior to backfill of any component and arty situation deemed necessary by Environmental Health Department Staff.
Ptwa am speexica[bm of the poPosed WMdual seeage disposal aIsta^r leave bean revlsvwd " en considered "Waciory. IMrissbn is hereby gunUd to she owner w his ager! to perform she wdM
ink vd above In accordance with the PNdn County WMdual So age t]aposal RepMdons In effect on dor dab of leave. „addI§w b general poNalons let tont N any anacnnw dk Iris P*nm4 is wbieet
n aw baonmg addaiwW bnms"cnndidwa Is arty:
APPROVED FOR ISSUE BY: /+.1_n/J DATE OF ISSUE:
The above in&Mual s 9e disposal system ham bean Inapeoted lar use the E -*---W HWM Oepanmwa The ovwwr assumes aY respmYWales N casa d Iailwl w W.Wawacy d mrc
system. Complete ash Ah drawnp and all specifications of asbuift ane kjdtKW vssh M pent
I L 1' � `
RNALINSPECTIO14 BY: /�GLr ,, DATE OF FINAL INSPECTION:
IOn4WWJICIaCM JoUwn.es / ipWT - ABPEK COLCfaW Bielt - PNONE 3o3,*M5070 • FAX 30lafda197
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ASPEN/PITO ENVIRONMENTAL HEALTH DEPARTIVI
FINAL SYSTEM DESIGN
,L SPECIFICS OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
3uilt Conditions) //�L
of Tank or TroetmentUnIL• &IlVf f Tank Capaotly: /000 gallons
of Absorption Field:6r"-, .I Absorption Area: square feet
,RIPTION, CONDITIONS, AND SPEGFICATIONS OF SYSTEM DESIGN:
AS -BUILT PLOT PLAN:
3(kr n
a\ .
BOO. O'er -
kdt
yr
t
it
7-Clac�QeA 9-• IS- 4S � Lua-C cuu,Plc4�d
. GlCunaU-� mush- % .0.ddc� otc-Isrcic �c :xu-n .
An Inlet fir- 4 T uiQ Fk &,wej .-AD 4 --6nt.
inyc4irn p;les WCrc rCquu.S#ed 24- JdA,- Pntl.
pF G¢ch
�nSia.t✓r..�ia'T dal(, by �ie.lar� .�'rns�-,Lc�ia.�
�Ndrw �achtidori
INSPECTION BY: DATE OF INSPECTION: 7- 7- y�
?0:RCPC.WPi'ERM/rA1
130 SOUTH GALENA SWEET • ASPEN, COLORADO 61011 - PHONE =L=.3070 • PAX 30. 9=51el
PRWEO ON RECYCLED PAPER