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HomeMy WebLinkAboutpitkin.eh.264328205001 (1990)a043 -- )8a --C)5 -o0I 0 ASPENobPITKIN ENVIRONMENTAL HEALTH DEPARTMENT -� 2 INDIVIDUAL SEWAGE DISPOSAL PEMIT NO. C?003 VT'l: E OF PERi1IT: )Initial Construction ( )Emergency Use ( )Repair work,(Pievious Permit t ) I )Alteration of an existing system, or i natallation ( )Use Permit as A result of Sale ( )Othori ISSUED TO: OwnerV1 D ' 9SQQ Home Mailing o0q� &cy,_,v_t4f_9=. j�Address Agent, Ma i l.in g Address DATE (Previous Perpitt �! — •) OF ISSUE v _Business Phone Phone Sewage Disposal System Work to be performed by t�1TyTSti(ItN}"(_��PfQ�4Z — This permit valid only for premises Location by the following legal deacriptiont T -( �t)sU&5a�. f L, st2E 3t At.�1�-�-.,(�- � NATER SUPPLY LISH E/� AVERAGE PERCOI_'1TIO. 41� -4 RATE ,�/II _. This Individual Sewage Disposal Permit is granted with regard to the following uso: �i- Peie 14C N%r.lbcr of: Dedreom%_ lofts_ D Garbage Disposals_ Dishwashers �� Clothes washers CALCULATi.D AVERAGE DAILY WASTE LOAD _ff5�)CALLO,IS. THF NP"T'URE OF THE SYSTENf INCLUDED UNDER THIS PER11IT: Tyaa of Tank or Treatment Units iPTtc iUK- Tank Capacity//1000Callon Minion a r:t..*.od of Final C•ispo3alsfl /r1L-r, ..r��11`��GN Absorption Area 1>�_./ASquare rent Hintrrun�7q;� Dcacrlp_ion (including brand name, if any) of other equipment or appurtnancess .2&4 1-1 MCA L_ 0600- OF (Rip, � Other Cond1tion.1 or Spccificationst P4©AJ t.— STAGES REQUIRING I_v'SPECTION BY THE HEALTH DEPARTr1ENT: ( )Before Excavation ( )Upon completion of excavation and prior to pineement of gravel i)Before covering distribution system of absorpt_l fi.'ld 7rior to backfill of any component t )Other, Specifyr Plans and specifications of the proposed sewagc disposal system have barn reviewed and arc ecnsi,lcrcd saCisfaCCOCy. Pr_rnlss i.on irr hereby granted to tl:c owrer or lit a ayenr. to n•,rfnrm the .nl% indicated above in a.:c.•ordance with tho Pitkin C.>unty :ndivi.',val Se::a,;e Uispcsal Re--l in etf,r:t on the d.,to of issue. In addition to general prwtslons set :ort: on the r•eve, !!et!ce, this Ptrmit i,a sut•je�ct to tac :ollcwiny additionaL tcrr,:3 and condition3: _ A . APPROVED FOR ISSUE BY (titl_e)—,---- Th.• *•._cvc it fividaal sr••a-le :i+ponal eymto:m In.:t.:llcd by V_ IC), "�•/��vv�'(/�I�' _. .-. t- ---'- -- - -- _ - r 11—'s1 cn in acted for u•..• ty a rcpc.•a•=ntat.vc -t rbc .t�;: ir:t:in u..... a+i •.c i:' -f cn �_ of f.,>.iur_ w of t!0 -lc--j- di.ry .-Al .:yiacm.I - WC, 90 +:r r•, 1.,.:. ..111: .:r::vin� e_tac:,ad. �t! TiT LF 0z U 130 Sou,ii L.alene, Street Asptln, Coloracio 8161-1 303/9L�G-ts07G ASPEN40PITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER LA7 V/ p PHONE Address of OWNER 9-7 CA65 Z'EMN45 '57- 0921 t1��GE Go ^1623 Name of APPLICANT L7*y1;P // otil PHONE PERMIT TO BE: ( )Picked Up p4 Mailed tot TYPE OF PERMIT: XNew Installation ( )Repair D40wner ( )Applicant ( )Emergency use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM: •� f� cin - Legal Description d / %3 � //KINE w �� �/�� CP_ Lot / Block_ Filing Subdivision 5_9U SN CR _ Size of Lot 3, 9 acres TYPE OF STRUCTURE: Single Family Dwelling ( )Other: Do you plan an further additions to the 2 residence? YES ( )NO No. of bedrooms i No. of Lofts No. of Garbage Disposals �_ No. of Automatic Dishwashers No, of Automatic Clothes washers MATER SUPPLY: ( )Private well, Depth or OQPublic, Name of System 0RUS/_I C'2EE14_, C�/.4TER- ( )Spring PS%*>/G%" ( )Stream or Creek TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound ( )Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Other: The initial site inspection must be arranged with the Aspen/Pitkin Environmental health Department (925-2020, 6:30-9:30 a.m.) before a permit can be issued. The individual sewage disposal permit must be issued before a building permit can be obtained. FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION OF THE SYSTEM. Application for an individuaVseage dispo el mit is hereby submitted. The undersigned acknowledges that the above information is true and that false info*Oat n wiil/in dte_the application and any subsequent permit. Signature of Applicant�// " '" — DATE (This application becomes. invalid 12 months 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. {. Proposed and existing buildings, driveways, and other • structures. 5. 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. 1 The undersigned h eby acknowledges receipt of this individual sewage disposal permi appplicat�on and a permit fee i the amount of S ���• Receipt Number 0 6 -3 �/ . Date Fee Received 3 - -by —' A lnistrativo Officer 130 South Galena Street Aspen, Colorado 81611 303/920-5070 W' Ra4-p&jSC A40 CAW i /tjK i yt✓ivTS (1N5P6-C-'Ti40AI /_&7M) LT•YPI tea✓) 17,74 IIAI&AL re -e-7- ��►FI c.-rieR-Tbi2��/�ES /