HomeMy WebLinkAboutpitkin.eh.264326300002 (1972)COLORADO DEPARTMENT OF . .,ALTH
Water Pollution Control Division
4210 East llth Avenue
Denver, Colorado 80220
APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS
Applicant (Owner):
-PJAJA, 'B/,- �-> i A
Mail Address: �� �Y�J? / Ci t 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, soli profiles in test holes.
1. Location of Facility: County 24rL/ City or Towne
_ �Legal Description Ct%SA'
Lot Size: /G�
2. Type of area and facility - Number of persons served:
Subdivision _ Motel 4J#_ Restaurant _ -_Trailer Court
Other: , mac,
3. Source of domestic water: Public (name):.
Private: Well Depth eL Other Depth to first ground water table_
4. Is facility within boundaries of City or Sanitation District: 41/0
If so name:_
5. Distance to nearest sewer system: !/_�_
Have negotiations been attempted with owner to connect: s!
If rejected, give reason: /z/#-
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 and telephone of person who made soil absorption tests:
8. Name, address and telephone of person responsible for design of the system:
I
9. Est. bid opening date: Est. Completion Date: Est. Project Cost:
Date:
Signature of Owner
COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
ACT I V I T Y RE PORT Code_
Section County
FILE REFERENCE '���j�✓
INDIVIDUAL OR
ESTABLISHMENT: �./�l�r��•/
ADDRESS:
NARRATIVE:
LETTER TO FOLLOW: ( ) OTHER RECOMMENDA,TIONS:
DATE:
ES: 7 (Rev. 6-70-100)
REPRESENTATIVE: rC��
a
PITKIN COUNTY DEP A'IZTILENT OF HEALTH
Box V Aspen City Hall
Aspen, Colorado
925-2020
PER14TT 11 , _ 720018
System Location
Contractor
1. Construction approval:
Plans and location are hereby approved.___w__.
Perc. rate inches in minutes=�'Q �- sq. feet of
- - absorption area per bedroom.
X sq. feet: =-1 � o,. feet mi require -
mint ._.._I Suget
I'll I-001 1160e 1411
Dat e=--7Inspector,-�-�
2. Final approval. of system:
No system. shall be deemed to be in coraoli_:nce it th tt e
Sewa-e Disposal Lars until the asse.!b'ed syste:-n is an roved
nr�-or to co�✓er _n7 any part.
81, �y
septic WLank cleanout i.. -h gas seal
Proper materials and assembly
Adequate absorption area
Adequate concrete cover (dry wells only)
i
Date .:�-�2 __— 7nsPect'or-- ---- `��-----
*NRetain •,-A th p:irmit record:: at, con: truction site.
PITYIN COUNTY DETA 7"'E IT OF IWVI'Iz.O,'R4V ;IAL "E- AL'TH
Box V Aspen City Hall
Aspen, Colorado
925-2020
PER�MIIT '` 720018
System L o c a t i o n��i__lc/
Coritra,ctc)-r '11622_� 0A
1. Construction apo.oval:
Plar:s and location are hereby approved.___
Perc. rate inches a.n__/ minutes= __ sq. feet of
absorption area per bedroo:�.
X
sq. feet-=�/o,. feet `_nimu n reyuire-
ment.
Date MSS- 7-2 Inspector
2. Final approval of system:
No system shall. be dee: ed to be i.n co;12pl fiance wil th t}:e
Sewage Disno al La. s unti1 the assu:;b'_ed systei;l is aporoved
-ior to coverir � any part
J4se'p
v1C tc T:l:� CZ`ei_I1o.�5�. 1i1�v'fl c�a5 Ses?lr____-__
roper materials and assembly r
decuate absorption area
[--�4dequate
concr-;,e cover (dry wells only)
Da t e�Y_--
x''i:cta'i.n ',•.7 fl h p '.r mil rocorii:". al. can:;truction site.