HomeMy WebLinkAboutpitkin.eh.264315201003 (1978)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.
CHANGE OF OWNERSHIP
PARCEL ID: a(o 14 3 - l 5� -2// L- 0�
NEW OWNER: 0-14L, ✓ C;PEPP5F-�2I..RtiO AND CFi TILE Oorh4n j
ADDRESS: lC�9a 4)000E6K �jAa 1
LEGAL DESCRIPTION: "LpsoA.) ksueply - ko-r 3
PREVIOUS OWNER: GA./ A5 T / N
14 /U
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2&V3-15-2--ol-oa
` PITKIN COUNTY HEALTH DEPARTMENT
PERMIT M ER 70070 RECEIPT NUMBER lie
Owner I %�\�P{\hone No.� �_�
Owner's Mailipg Address P J� � i 0
Contractor
Address
System'<.
Address
Legal Desc
Phone No.
Lot Size ` C -AK Type of Building by U ( e
P
Number of Bedroo � Type of Water Supply
C
Owner'sSignatur Date
4,
PLOT PLAN: ATTAC ED AS REQUIRED
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Type of Individual Sewage DisF
Type of Soil or Soil Classificati
Proximal Location of Bedrock
Proximal Location of Ground 1
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Percolation Test Date L/Qp_2L 0 Minutes Per Inch —
Minimum Recommended Absorption System Size -TUO i �D
Minimum Recommended Tank Size 7` 60 �/ zzaA/zzoo �oi%�i%PT/yIENTs
Special Coditions of Issue: NOTICE
/qWhen property signed for Issuance,valid
this year from
pplication
becomM Your permit. Application veIIE one year from
date. If an Individual sewage disposal permit Is Issued
J r n ^ Te /� leO T ,r/ / � � AA for property on which no building permit hes been
h(/U/T J/ �/• / %��V� ,I' Issued, the Individual sewage disposal permit MNI
expFpOW (AFL L /J /✓n &!�j 77 (2 -
not b c mmdaycadfter Its y Changuance If n plans or tion
has
/� /7 �V /� �'/7�� �/J , / ,�/� �{/] not been commenced. Any change in Piens or sped•
TfW,K�lsT (3E ,SD / i • /—/ 1/I/1i" r�i / the per t,aftur the permit his been Issued theInv
/� the permit, unless approval b secured from the HpIM
F/`oM vu/EL� Officer for such engp.
Approved for Issuance By Date
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FINAL INSPECTION APPROVAL Date
10Z (Drawing of System on Back)
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ASPEN4PITKIN
41ENVIR MENTAL HEALTH OEPART ENT
Date
--Bill
Inspection Requested By
Original Report To Be Sent
Copy Of Report To Be Sent To
PROPERTY 1NEQBMICK:
Pr2122rty
i
Check/Receipt Number
Parcel ID Number — /5-'2-- 0 / — 'Z
Legal 1/4, L4, Sec. T S, R W'
LotBlock, ,Filing — SUbdivj ion Gi/oLr_SO
Building Occupied_ 'Vacant Age Of
Date Septic Tank Last Pumped ofLlC'�'/✓1�GG�C ACde&
DEPARIMW REOCRDS
Permit Number Year Issued No Records Found
Septic Tank Capacity (Gallons) Septic Tank Material
Leach Field Size (Sq. Ft.) Leach Field Type
INSPECTION:
Date Of Inspection 9 Inspector r✓
Soil Conditions: Dry Saturated Snow Covered Other
Septic System: FunctionirK Satisfactoril t �}mctioning
C idents: flGmf� /.%�" .Q rlili i1.g•.n 7J-w�.
Water Supply: Public: Name
Private: Well_;, Spring , Cistern , Surface ,
Other
Well Construction And Location: Approved_
(hlapproved Because
Bacteriological Water Test: Lab Numbe
Acceptabl
A.P.E.H.D.:4/87
130 South Galena Street Aspen, Colorado 81611 303/925-2020
PROPERTY OWNER
MAILING ADDR
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
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LEGAL
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES Z57jP 4P
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 8 hour soak
TEST HOLE No.1 TEST HOLE Q. 2 V TEST HOLE No. 3
3� !. L 37�
Drop37 Time Dro Time Drop Time
34 S / u
4
Percolation Rate Each Hole
Average Rate Is
Comments on soil or . e:
Signature
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' COLORADO STATE DEPARTMENT OF PUBLIC HEALTH
Water Pollution Control Commission
4210 East Ilth Avenue
Denver, Colorado 80220
TION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS
Applicant (Owner) : 7 a„
Mail Address:�o,< -71> weco`C _ crz_r_+F_I City
.f4oAj E
Phone:
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 P.Tr _ _City or Townworp`r cjcww.kZ__
Legal Description [dam g d� � Sew -n s o .• Lot size: 4 pcw6F S
2. Type of area and facility - Number of persons to be served:
Subdivision rc —Z Motel Restaurant Trailer Court
Other:
3• Source of domestic water: Public(name):
Private: Well x Depth 7 Fr Other Depth to First Ground Water Table
4. Is facility within boundaries of City or Sanitation District: .N o
If so, name:
5• Distance to nearest sewer system:
Have negotiations been attempted with owner to connect:
If rejected, give reason:
6. Rate of absorption in test holes in minutes per inch of drop in water level after
holes have been soaked for 24 hours:
7. Name, address E telephone of person who made soil absorption tests:
8. Name, address b telephone of person responsible for design of the system:
9. Est. bid opening date
Date:
N
Est. Completion date: Est. Project Cost:
Signature of Owner
II
Page 2
B. COMMENTS OF LOCAL GOVERNMENT AND SIGNATURES:
Check one: F1 Mayor or City Manager
County) 0 County Commissioners
Comments:
Health Department (City or
Signature b Title
Note: The applicant must obtain the comments and signature of at least one
of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE:
D. ACTION BY COLORADO WATER POLLUTION CONTROL COMMISSION:
WP-1D(Rev.l1-68-100)
Name of
Address
ASP
aGy3 -i5�-sal-oU�
EN*PITKIN
ENVI&MENTAL HEALTH 13EPA&ENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL- PERMIT
4 _Culoew)er Land . Cattle PHONE•Ace
a • 11 ' as ( i 1 ( (-( a16141VINa
Name of APPLICANT Bob Nelson PHONE g2j_j?RQ
PERMIT TO BE: (X)Picked Up ( )Mailed to, TYPE OF PERMI7I ( )New Installation ( )Repair
( )Owner 1 )Applicant 1 )Emergency use ( )Alteration NOT dun to tailor,
LOCATION OF PROPOSED SYSTEM,
Legal Description
In. #3
TYPE OF STRUCTURE:
Black Filing subdivision Wolfson size of Lot
! )Single Family Dwelling ( )Others Do you plan any further additions to the
residence? ( )YES f )NO
No. of bedrooms 1 No. of Lofts No. of Garbage Disposals 1 No. of Automatic Dishwashers
No, of Automatic Clothes Washers 1
WATER SUPPLY: (x)Private Nall, Depth or ( )Public, Name of System
( )Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SENACE DISPOSAL SYSTEM PROPOSED:
(.)Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound
( )Recycling, potable use ( )Rerycllnq, other use ( )Vault Privy ( )Other:
The initial site inspection rust be arranged with the Aspen/Pitkin-Envlronnental Health Department (92S-2020, 6:30-9:30 a.m.)
before a permit can be issued. The individual sewage disposal permit rust be issued before a building permit can be obtained.
FINAL INSPECTION APPROVAL MUST BE GIVE By THE ASPEN/PITRIN 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 invalidate the application and any subsequent permit.
signature of Applicant DATE
(This application beeeses. 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.
4. 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 undersigned hereby acknowledges receipt of this individual sewage disposal permit application and a permit fee in the amoun
of d 1 Receipt Number Date Fee Received ,.by
Administrative Offlcor
LG n d (,tie., c, -K (GUQI &Cc 93 - /9U
/U 130 South Galena Street Aspen, Colorado 61611 303/920-IS070