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Home My WebLink Aboutpitkin.eh.264321307004 (1992)a(ag3-a13-0-7-cX� � CASPEN*PITKIN ' f ENVIRONMENTAL HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PER11IT NO.�� TyjYPE OF PERMIT: 061nitial Construction ( )Emergency Use ( )Repair Work,(Piovious Permit ! .) ( )Alteration of an existing system, or installation i ( )Use Permit as a result of Sale ( )Others ISSUED TO: (Previous Perm DATE OF ISSUE . �— OwnePti"Js a (%N�� Home Phone /G --3 Business Mailing Address�_`� Agent Phone Mailing Address Phone Sewage Disposal System Work to be performed by 171��A/GP This permit valid only for premises location by tho following legal descriptions Jyrl LOT SIZE 2 %� t ✓ , WATER SUPPLY -S"WA/45S VIfl LA_! I . AVERAGE PERRC•OL�B -AATIOO4 RATF. 1-3 MAIIIMNI This Individual Sewage Disposal Permit is granted with regard to the following use1 ,SJAk-LZ= 1Z Number of: Dodicoms _ Lofts C.` Garbage Disposals Dishwashers ^ Clothes Washers . CALCULATED AVERAGE DAILY WASTE LOAD 'V -S-40 GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: ype of Tank or Treatment Units/ _shod of Final Disposals ,N �1�(�Absorptiop zscription (including brand name, if any) of other equipment or appurtnaneess Tank. Capacity_/zyo Callon Minimus Area Square Feet Minimum BELvcv l -i aves AkD OF TMr- AAtfD V eYu064L i OX WAaHE,41-1 :then Condition! or Specifications, A cxey w,4-T&,e- `=YsrEM oj'- "?s0 E�,�►�[�n/ 71-fi✓< /9NQ �Xyw6z— AL b' 1 . �f'TH �4�tiE® r1n1 D STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: fore ( )Defore Excavation 50 Upon completion of excavation and prior to placement of gravel system ofverinabsorpdtionrfiold ution ('=,Prior to backfill of any component ( )Other, Specify, /tJL'7tX Plans and specifications of the proposed sewage disposal system have been reviewed and are ecnsidcred satisfactory. Permission is hereby granted to the owrer or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewa,c Disposal Re-julations in effect on the date of issue. In addition to general provisions act forth on the reverse her_of, this Permit ie subject to the following additional terns and conditions. �J _ k4a 6661ei-O- APPROVED FOR ISSUE. BY // (title) � f�'�� {yr� She• alxivc in4ividual sc�ra.lo disposal syitca installed by 1,✓4e t- __ has been for use by a representative cf the Aspen Pit- lin-Cnvlronr-�nta t(calt.. Department. reaponsibillty in case of failure or inadequacy of thio scwage /disposal system. Complete as-•Luilt drawing attachod. DATE O1 NAL IN'nFC 1, 11 Aspen/Pitkin Environmew l Health Officer BY: TITLE _ 130 South Galena Street Aspen, Colorado 81611 303/520-5070 ' ASPEN+PITKIN ENVIRONMENTAL HEALTH DEPARTMENT r APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT II'PHONE 7,;13 ^--3 S Name of OWNER I" �^I�-x-15 5FO L� �y C'r�s Address of OWNER �Gk 2! 0 Y2. -� Name of APPLICANT PRONE a�3 sa :RMI? TO BEs ( )Picked Up ( )Nailed to: TYPE OF PERMIT: ( )New Installation ( )Repair (jOvner ( )Applicant . 1 )Emergency use ( )Alteration NOT due to failure --ATIOtt OF PROPOSED SYSTEMSQ yal Description CD 2 Filing Subdivision L � 7 size of Lot C7� acres ..t ./ Block iYPE'or STRUCTURE: Siegle Family Dwelling (!Other: Do you Plan any further additions to the residence? ( )YES ( )NO / -. et bedrooms �' No. of Lofts 0 No. of Garbage Disposals No: of Automatic Dishwashers of Automatic Clothes washers [iiTER SUPPLY: ( )Private wall, Depth Or Public, Name of System- '-- ( )Spring ( )Stream or Creek IrPES INDIVIDDAL SENAGE DISPOSAL SYSTEM PROPOSED: 7 stip Toilet ( )Incineration Toilet ( )hound :t Septic Tank/Absorption Field ( )Aar+tion plant/Absorption Field ()Compo q E )Recycling, potable use ( 1Reeycliny, other use ( )Vault Privy ( )Others -he'initial site inspection must be arranged with the Aspen/Pitkin' Environmental Health Department (925-2020. 8:30-9:30 a.m.) *-fore a permit can be issued. The individual sewage disposal permit Aust be issued before a building permit can be obtained. P1KAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIH ENVIRONMENTAL HEALTH DEPARTMENT PRIOR To BACKFILLING ANY PORTION o2 THE SYSTEM. application for an individual ewage disposal permit is hereby submitted. The undersigned acknowledges that the above information is true and that false info 'i n will invaliodCe—,khe application and any subsequent rmlt. Signature of Applicant DATE 7/r (This application becomes. invali 12 mo the 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.- r lice ion and a permit fee in the amour. The undersigned hereby acknowledges receipt of this individual sewage disposal Pe PP /—f`f%-��-`-/� of S �h d G . Receipt Number , Date Fee Received -�_/rL by Adminlstrativo officer 130 South Galena Street Aspen, Colorado 81611 303/980-6070 r' ASPEN#PITKIN 1 ENVIRONMENTAL HEALTH OEPAR'k .JIENT FIELD TEST DATA SHEET ON PERCOLATION TEST Legal description: Address of Property: Name of Owner: Address: (# & st. / p.o. box) Name of Agent: )'6t�r 1 4--7 (city) (state) (zip) Lot Area:,-t/3C Water Su 1 :Public Utilit Subdivision X _ PP Y Y Private W611 Other Distance to Nearest Surface Water T e Dates Observations Made: Soil Borings: 25 4 by ifFnI Percolation Tests: -25 y gr SOIL .BORING TESTS �i'r✓-?c�k: PERCOLATION TESTS Total •Dept.hJ Observed Depth to Groundwater Estimated Deipth to Groundwater Character of Soils P -t' Depth of Water (left after 8 hr. presoak) Drop Time Drop Time PERCOLATION TESTS i-7� P- P-1 P-2 P-3 Depth P - i' Diameter P -t' Depth of Water (left after 8 hr. presoak) Drop Time i-7� P- P4 P4- P - i' P- P -t' Drop Time! Drop Time Drop Time Drop Time Drop Time Drop Time 3 f 3 \ �z b ��5 �� i �� 4 pr's .- Rate P-1 Rate P-2 Rate P-3 AVERAGE RATE: ''/ minutes/inch Plan of the site and location of test holes on the back Comments on Soil or Site: �./ �✓ Date 130 South Galena Street Signature /-�W- 4�� Aspen, Colorado 81611 303/920-5070 ASPEN+PITKIN ENVIRL.NMENTAL HEALTH HEPAR', TIENT FIELD TEST DATA SHEET ON PERCOLATION TEST Legal description: Address of Property: Name of Owner: 'L1 Address: (# & st. / p.o. box) Name of Agent: (city) (state) (zip) Lot Area: Water Supply:Public Utility Subdivision Private W611 Other Distance to Nearest Surface Water Type Dates Observations.Made: Soil Borings: by Percolation Tests: by SOIL -BORING TESTS PERCOLATION TESTS �6-`/ Total .Depth Observed Depth to Groundwater Estimated Depth to Groundwater Character of Soils P-3 Diameter Drop Time Drop Depth of Water (left after 8 hr. presoak) PERCOLATION TESTS �6-`/ L IF, L P-1 P-1 P-2 P-3 Depth s P-3 Diameter Drop Time Drop Depth of Water (left after 8 hr. presoak) Drop Time L IF, L P-1 P-1 P-2 P-2 P-3 P-3 Drop Time Drop Time Drop Time Drop Time Drop Time Drop Time Rv Rate P-1 1_ Rate P-2 Rate P-3 AVERAGE RATE: minutes/inch Plan of the site and location of gest holes on the back Comments on Soil or Site: Date .� � Signature 130 South Galena Street Aspen, Colorado 81611 303/920-5070 I r COLORADO DEP4R�MENT 0 F H TH Water Quality Control Di _ion 4210 East Eleventh Avenue Denver, Colorado 80220 1W - 4 SPILL REPORT FORM Reported by: Location and Time of Spill:_ Time: Substance Spilled: Quantity: Name bf Stream: Description of Spill Events: Clean-up Action: Notification to: Downstream Dater Users: EPA, Denver:_ Fish and Game: Others: Is On -Site Inspection Necessary? Comments: Report Received By: Date: Has Spill Entered Stream? Time 0 H r1 v -77