HomeMy WebLinkAboutpitkin.eh.264316200001 (1982)_PERMIT NOT ISSUEDDocument Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design
Soil Information
Floor Plans
Water Permit & Information
Land Use Approvals
Second System on property
Third System etc
(All relevant older documents in the same order as above)
(A red sticker will be placed on both sides of the file tab when doc. is scanned)
G
W (1.3-l(a-00-�0/
.; ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APFLICATIGN "OR M INDIVICU L 3L,4 i.r DIS?OSr,L• SRMIT
wzt'i"• 01' 0`,,NZR
Address of OWL
FTarp cf A PLIC
( )PI')md up
I[ral Dsecript ion
( !Mailed
to, TM
Of PLA.MITI
104tiew Installatlgn
( )Rapa:r
( i0wear
! IAPPlleact ,
Ipeeageney use
4cT due to failure
<—, ,
�/
/' Ous-J
/ �oAltaration
Z V
art 41xk filln9 ___ Sub.. i
"Ingle family prelling
S. -le of Lot J a -res
TysE C- $TP.Ut-:DFr• to yea plan any further addltionr to theresiden-e? ).NO
ba. of bedrorrms / NO. of Latta—[�_ 40. of Garb"" ^Isposs:s We. of Automatic Dishwashers
:L- of a nwAt:e CloTTTthes,,,�//wasnera
e, y'}frivaca wrll, Depth or ( 1p'lblic, Name of System
( )spring
( )Stream or Creek
T9iES Jf IAD:CI DV �1. aE.4Nnz 01SPCENL aYSV. M -enres F.D•
a.l Sepcie Tank/AbsOrPticn Field i )Aoratlan Plant/Absorption Field
lfecycling, potable use ( 1Accyclinq, other use
l )Omar.
( )Comoostil.q Toi:et < )Incineration Toilet ( )Mound
( )4sult Privy ( )Other: __
:Ye Initial si.e lnspectien must be arranacd with Ins Aspen/Pitkin tn••:rodmon :al oral:h Jc par cmcrc (925-2520, er)0-ii 7C a.m.;
tefere a per�it can be Saaued. Thu lndiv.dcal ac�aga ei_Paaal peret: r,,It ve cssned before a bull•ling permit can Dc caalnaC.
'd1MAL :4sr.Z=1 4 APPFC'!AL MUST BE CIYE4 ry THE
Ot THE 517 --TEM.
:tpplleatlon for an
it true and that t
T: -Awtore of
in
di
HEfSTH DEPARTME4T PRIOR TO BACXFILL:NC, A9': POP -:0-4
submitted. The mwerslgred acknowledges that the above lnlormacion
,tion and any subeeyucntPC It.
DATE O
ation bcrnaes. lows L'd 2 —7
)% from the above date.)
?TOTE: PLOT PLAN wast be piled with this application.
Please lccate the following items by measured distances:
1. Property lines and dimensions.
2. Proposed and existin; water wells on subject property and
adjacent preparty.
3. Domestic water service lines.
{. Proposed and existing buildings, driveways, and other
structure_.
S.
Stream, lakes, 1� nds, irrigation ditches, and other water
courses.
6. Propo E•nd and existing individual sewage systems nn subject
property. •
SUBMIT A REVISED PLOT PLAN PRIOR. TO CONSTRUCTION I: INSTALLATION IS TO
BE CHANGED FRGM ORIGINAL PLAN.
Tha ardecsigned herrby scknowtedges rete Lpt of this evage disposal permit apollcatian and a permit fee Jr. the aaocr.c
Aaceipt iNv�mxr Date rca 7cec l/v^ad by
ot3
lL"C1� /SSvri7 '-
���1 SY TC/
130 South Ga Str
set Aspen, Colorado 61611 3113/925-2020
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