HomeMy WebLinkAboutpitkin.eh.264321302006 (1995)SEP 2
Hanle of OWNER
Mailing Address
Name of AGENT
Mailing Address'
8
'95 11:30AM. CITY.OF A' -t --'EN P. 1.2
Parcel tD # �'�y3— Zf3 _ a2- oo(o
ASPEN/PMN ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INOMDUAL SEWAGE DISPOSAL SYSTEM OSDS) PERMIT
s s. Phone
j2 Lj�tmo #
Bus. Phone # S/
`5G2> �G/ c Home Phone #
Copy of Permit to be Sent to:
Is FOR: (} NEW iNSTALLATI N, ()'Fl PAIR { ALTERA710NN. NOT DUE TO FAILURE. or EMERGENCY USE, for permit ,#'
ADDRESS of Pro ert .•
T A P y U�
E -GAL DESCRIPTION of Property: tot ,block , tiling , and s�ubdly.
ze of Lot acres Type of Structure Proposed
' BEDROOMS T, # LOFTS # GARBAGE DISPOSALS _, # DISHWASHERS _ 1
ater Supply: (). Private Wall, () Spdno, () stream, gr () Systsm (Public. or Private ams:
PROOF OF ADEQUATE WATER ATTACHED? () YES or () NO HAS THIS RO.le
pit Ad n rot an In4lv54uat We"49e dlsjwstu system perms rc,rereuy +nl
iGNATURE OF APPLICANT -C
tai application becomes invalid 120 ' -Jays from the dta s19
# CLOTHES WASHE=RS ,
:T BELN APPROVED BY PITICN COUNTY4 () YES or (} NO
.wr. t....nA.,., a.. t..rs,w, A
r m e utbon,ounomat to mann County oodcs.� No eonsLuctlod �' undarta�tan
-- date
W4 W11 ,hi 9f.,pvirib Cl liGt LAY.
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t
of Bedrooms: Percolation Rata: _ mgt, Average Daily Waste Flow: gallons. ) t
an Engineer beeigned systam needed? (} Yes or 4"No W pietas and spadr"Uons of a>o engineer awA ba Wowed. Any manges mud be approval tri writing and the engtnaar
a ceA4 me Rosi Ir%sWlaffw to the Environmental Hcoih Depttrtrswnt In vAZAO
Hifi*******es Res*►*rr:*tertrle*BB-C OR OFFICE'USE ONLY*lets�ARtre,tttttttt[ RMIYAatlri,tr;
MID': S DfUAIL. SEEVIAGE DISPOSAL SYSTEM PERMFr #
fC / y Rseelvecf B
50 tee paid {„)'Yes. Oats rscsivt:d /� ' / Q -%� Raosipt # y
ESIGN CRITERIA OF SYSTEM TO BE INSTALLED: Any changes must be aubmittod and approved in vrrhing.
inimum Septic Tank Capacity _! (D�7j gallons Absorption Area squats feet minimum
Absorption Bed, () Absorption Field in Trenches, () Gravet-leas aystom, () Pumping/Dosing Chbmber. ( );Absorption Pit
41 u n k re f bt c aeA i- due- -iv C rA died 4 x i`54)'n� �icn IC
tagas ra airing Inspection. () Before excavation, () Upon completion and prior to piacemant of grave% () Before covering distribution ayatam of absorption
old, (rior to backfill of any component and any situation deemed necsssaty by Environmental Health Department Staff,
aru and apa+Jficadon9 or the propasact lndlviduaf sewage disposal vystcrn haus been rcvIcwed AM ars wnsldeeed catlstaciwy. Pelmttakn Fs twraby grunted b the pwngr a his agent W ppdurm she wore
dicatad above Ms accordenee with V-4 PHkln County IndEvidud t 9e Otapaeat Ra9!Aatlent: in effect on the date of issue. In dMitioa W garpral pwlslons set forth In any attachments, this Penna 1- suf> s %
tl.a foitomrg eddtt;OM4 leans and oomei'me V any-.
,PPROVED FOR ISSUE BY: DATE OF ISSUE:_ /Ll - /4' q� --
,e above Indtr dual ccwagc disposal system has been Inspected for by the
�Envieo�Mel%tal (kpadmenL Ttw m"V-4 A&euMoallresgornstbllhics In case d fallule of ?jadegvacy of this
-gem. Canpicte as Wilt drawing and eft ;peciGcaiions of as-bul$ Included th
I
INAL INSPECTION BY: DATE OF FINAL INSPECTION: �0 �/a
iit�./I�13dSb
OTrtUr?4:.lrCPC:wP:PEkt.trr.&i tae aru_E" ST • n3PFrl, CDLOr?.4b'0 sta•tf • tyt40h�E �-t724�070 FAX 393,92 .0,519?
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Pwrrr�.o t?N a�YCtEt7 PaafEt .
C�Al 6:100
ti ,SEP 11 O
2$ 95 • 1AM CITY F ASPEN`
NM AL. EALTH:: E.?AR�N[i✓Ni' ;',.;.;•::,.,,.,,;
M,. ,.
NAL:'.SYSTEM DESIGN,,;
-INAC SPECIFICS-OF THE.
M INCL:UD15M UNDER THIS 'PERMM. ".
'As-Suilt' Conditions)
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•ype of Tank or Treatrrti4ht u�,It::'�
Taank'aclty: , 9auons
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Ahsevr+fiM AfAA! paugo filet''
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1/t'K.. ,•�^•�Ti �'���; ',�n•. '' 41;x''. '.
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INAL AS-BUILT PLOT PLAN;:
walters company
'
building contractors
.. '
p.o. box 2323
;,:• . glenwood springs, colorodo 81602
';..•:
(303) 945-2851
3'7q s.
dward wolte -
'WAL 1NSPEOMN BY:
,, OATE OF INSPECTION:
.
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s3o SOUTH GAL'2 NA STREET ASPEN, C LOPA30 ata! 1 PKON15 3Q9M.5070 PAX W7.=,ti tj7
ppuw M. on RCCYWO PAPER