HomeMy WebLinkAboutpitkin.eh.264327400003 (1980)i
ASPEN*PITKIN
�U4�5 — ag4l —CO -CGS
ENVIRONMENTAL HEALTH DEPART ENT
PEP?d `JiJ1. 'UB � 0 ! �— RECEIPT NUXIBER
Phone No .
Dwn^ r ��--��'� /�
Own et'' s _Ma.i i ilio Address/f�li� T L L C�Ii:� /z-T�
a a a
Contra:_tor /�--DL'i� L��
System's Contractor"s Name
Andress
Phone No. �;
Leg;a l De ,cri,
)ti..�r, E �TT�G_NE� T - C61 PT -
Lot Size 2 i'�� � ��-� Type of Build.in. by Use,���i
Nwmbei cl Bedrooms Type of Pater Supply
C°;rncr' J Signature _ -- Date
FLOT FLAN: A'17AC..HED AS RE'QUiREI7
*�^?c ,i * # ix ##** c% 1ck-k�ctic+ �:•x k� k*tc�c*jc kkM. K,F#* Yl kksk c:k� *Ai; -41-
I
Type of Individual Sewage Disposa? Sysi em
'Type of S( -)-4'L or Soil C1«saif i cat i.or, ILTY
Proxim�1 Location of Bedrock -�T
Proximal Location of Grcund Water Twble
Percolatic,n Test Date
X,irimnm Recommended Abso 'pticn System Size_l 0� —_--
�t_�nilrs�.rtA R::commer.dod Tank Size 1.7V0-
Special Conditions of Issue:
A�"m —
NOTICc
WO -.en proper+ � signed for 1- jenav this arn'icntin•,
bene nc* Your dn
parrnit. App!iclon VTOr, ce vaa: from
date. If un h.d!viduai st'v.zgc d1sPc9a: per-nIt :: iss..cy
for prooertY on whir_h nn ou+l,finQ nor'�.t his aeon
issua,i, t!+c indrvrd a 1 sawagectsr;^sni pur - i+ sF -ai
expira i20 days af.er ;sr.y:Inc6 ;t cUnst::.c'..+on nes
not. be.+n cor-.manced. An'+ c'1eno in irons ,r srtci-
ficat!G +s r?fte.
r xil4 p . mit has -a-sln 10-ruao invalid-rrt
the aarn.;t, unloss -"provAl is sect red from [h? �2-afrt+
officer for such cnar,p_e.
Approveld for Issua.nc . B^ Wit e
rMAL I`'QPP"Date-
(I i
ace_(Ii awing of Sys Yetrort Bac..:) A/P-EE-si.D. 6/80
130 South Galena Street Aspen, Colorado 91611 303/925-2020
W
7K
Z
n
O
c
Z
D
N
C
0
v
C
O
m
_mZ
m c
n m
A_ N
W
m
0
m
O (�
A
Z
V
D
rn
Z
1
O
T
O
r
Z
m
CD t7 3mt7�CAD
Ornocornrn
xCl) RIZZ xi
m a o O D r -
w I-+ O co -n t") 0
-4n
►+ -t c to D
•-�rnrrna�
ornxr-r) 0
G Z CO) a -c
2► U! f Z
mrn OMvZ-,
rn z to 1 n -4
cy-QxDm 1 ICAO
mn ZUDUl-4 m
CM
ZO D"'I
r -t 13 r 1
f" UJ • Tn
MN- v
OD -4 . ► o,
0 M 3C -1 + +
O w !>> X c
A ++ =# •
-i m -4
covz
D . rn
C-)
rn�
co
O 2.>
�
'
r
m
W
7K
Z
n
O
c
Z
D
N
C
0
v
C
O
m
_mZ
m c
n m
A_ N
W
m
0
m
O (�
A
Z
V
D
rn
Z
1
O
T
O
r
Z
m
CD t7 3mt7�CAD
Ornocornrn
xCl) RIZZ xi
m a o O D r -
w I-+ O co -n t") 0
-4n
►+ -t c to D
•-�rnrrna�
ornxr-r) 0
G Z CO) a -c
2► U! f Z
mrn OMvZ-,
rn z to 1 n -4
cy-QxDm 1 ICAO
mn ZUDUl-4 m
CM
ZO D"'I
r -t 13 r 1
f" UJ • Tn
MN- v
OD -4 . ► o,
0 M 3C -1 + +
O w !>> X c
A ++ =# •
-i m -4
covz
D . rn
C-)
rn�
co
O 2.>
Z�
c=
m
m
D
•• m
x
p
n P
--1
g0>
� m m
Po
cs LP -:c
CA0C)
V
• PZ
<CZ
-1 G)
C') 01
` -1
�
v
r Gr
m
D X
G 0
N _�5
Z �
D
?ZOrn
v r
n cn
c .
0 n Z M
A
Z
G
c
O D T
co000
O
m � �
-1
2
y
O .p
N V
m '0
0
y
c?`
N
N
tsn r
N
N m
m
H m
C")
<
D
D
r
C
m
n
O
Z
-i
n
D
x
LA
c
D
D
-e
<
ZC)��,
Dm
Z
r
Q
A
rn-�
Z_�
A
Nm
V' n
>m
x<
D
m
i
v
m
NAD
rn
TP
Z
--1
Z r
v,A
O
r A
N
m
O
N
D
m
Z
Cn
�i
c
b7.tt'tb7 NrMs:inNOIIV-)IW1WWC)7
C=
W m
m n
m
n
OZ
T_ C7
Z�
DA
r D
O �^
n A
�D
Om
V
m
0
Z�
c=
m
m
D
•• m
x
D
--1
Po
cs LP -:c
CA0C)
V
• PZ
-1 G)
C') 01
` -1
�
v
r Gr
m
D X
G 0
N _�5
Z �
D
?ZOrn
v r
n cn
c .
0 n Z M
A
Z
G
c
O D T
co000
O
P c m
-1
2
y
O .p
N V
m '0
t7D
c?`
N
C=
W m
m n
m
n
OZ
T_ C7
Z�
DA
r D
O �^
n A
�D
Om
V
m
0
I:
I
Z�
c=
m
m
•• m
D
--1
m
V
Z m
cn
CD m7
A
F`J
I:
I
PROPERTY OWNER
MAILING ADDRESS
I
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 8 hour soak
PHONE
TEST HOLE No.1
TEST HOLE No. 2
TEST HOLE No. 3
DropTime
Drop Time
Drop Time
all
4S
y �tpn,-"Q
6�
LIL
Percolation Rate Each Hole y
Average Rate 40V
Comments on soil or site:
(-I-,-." i . A/
Signature
Date _ z3 fig"'"