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HomeMy WebLinkAboutpitkin.eh.264328205002 (1983)ASPEN*PITKIN.j( ENVIRONMENTAL HEALTHQARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. `)U TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit 1 or installation ( )Use Permit as a result of Sale ISSUED TO: Owner 19M Mailing - Address ►` TTL D ( )Othort DATE OF 1 .) ( )Alteration of an existing system, (Previous Permit 1 ) ISSUE -1d � — E9� Business Phone 1 Agent W i MJ, ► )in IJALI Phone q4s"--_?IR"71 H) 1�yglq�2� Mailing Address / 11 Sewage Disposal System Work to be performed by &AUlWD — JQQ LAC,Doc ✓A-T/Qcl This permit valid only for premises )ocation by the following legal dencription sbT-J0 &Kt L& 16,04 l,ere-a<-I�011,1146j;_ LOT SIZE / � A C-` A�S r WATER SUPPLY LiJE � AVERAGE PERCOLATION RATF. ' DQ A This individual Sewage Disposal Permit is granted with regard to the following uses st t C Number oft Dodicoms _ Lofts Garbage Disposals I Dishwashers_ Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD `/mss C L GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: Type of +lank or Treatment Units S6-r—FIC_ [ Rdv- Tank.Capacity L/ _Callon Minimum Method of Final Disposals Tj� Absorption .Area-2,5120Square Feet Minimum Z� i r� r� Description (including bran name, if any) of other equipment or appurtnancess i �F e �Cl3ni5 CHANGED -'DUE To-511i4Lr P,,eOCK ©;j U )e E4 NIDCIAuo A Other Conditio ! or Specifications: �f / rf t) jV0 Me, (�� �tUcSr,2� 4 s, , .SN/+cam ,6, j tel_ coZV 4f=D. !ki.-a to 415 ICi / Q J/ PS A -DAY S NAL M?hM - STAGES REQUIRING IN`SP'ECTION BY THE HEALTH DEPARTMENT: ' ( )Before Excavation ()()Upon completion of excavation and prior to pJACement of gravel XBefore covering distribution ,` system of absorption field 'KP to backfill of any component ( )Other, Specifyt _ AJ nJC_ Plans and specifications of the proposed sewage disposal system have been reviewed andare considered satisfactory. Perminsion is hereby granted to thr, owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewage Disposal Rcuulations in effect on the date of issue. In addition to general provisions act forth on the reverse hereof, this Permit is subject to the following additional terms and conditions:�('}� r APPROVED FOR ISSUE BY f (title) (/�UN'7-Y &A)1-rA01A1) i The above individual scwago disposal system installed by i has txcn ln:1Pccted (or use by a rcprescntative of the Aspe 'it in L'nvironrr�nta lies t. nepartinent. zfie ow•nur as!rumos a re pwnsibility in case of failure or Inadequacy of his se ago isposal system. Complete as -built drawing attachod. j DATE OF FINAL INSPECTIONS ' BY: tJ c � TITLE 130 South Galena Street Aspen, Colorado 81611 303/925-2020 off-Larr, -- Q ASPENObPITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER PHONE a f_- Address of Or' `1ER F0,U&)( `°t 45-- q + Wa K ?lame of rtUPLICANT �^� ��'nn�,/� 6Af9n+Post i'��r.er� ) PHONE 0 g� ►-1�rn� PERMIT TO BE: ( )Picked Up ( )Maile-1 to: TYPE OF PERMIT: New Installation ( )Repair ( fowner ( )Applicant ( )Emergency use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEMt Legal Description to I k 11/� Lot I Block Filing I Subdivision-6pau"I 1 &tz_.r _ Sire of Lot acres TYPE OF STRUCTURE: ingle Family Dwelling ( )Others Do you plan any further additions to the residence? ( )YES Y-41TO Wo. of bedrooms /*_ No. of Lofts ` __ No. of Garbage Disposals No: of Automatic Dishwashers No. of Automatic Clothes Washers HATER SUPPLY: U.41rivate Well, Depth or ( )Public, Name of System ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSEDt ' (.)Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet Mound ( )Recycling, potable use ( )Recycling, other use ( )Vault Privy (.)Others _ The initial site inspection must be arranged with the Aspen/Pitkin Envirornental Health Department (925-2020, 3:30-9:30 a.m.) t-efoce a permit can be issued. The individual sewage disposal permit must be issued before a building permit can be obtairud. FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PEXIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION OF THE SYSTEM. Application for an individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information is true and that false i. rmatio will nvaiid application and any subsequent permit. e-3 a Signature of Applicant DATE /�' Z%' o J (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. 4. Pr000sed and existing buildings, driveways, and other structures. 5. Streams, lakes, ponds, irrigation ditches, and other water courses. S. proposed and existing individual sewage systems on subject ,property. , SUBMIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTALLATION IS TO BE CHFNGED FROM ORIGINAL PLAN.' The undersigned hereby acknowledges receipt of th s i vidual sewage disposal pereit appliM�- nd a pe f % in the amount of s , Receipt Numbs[ ( r Data Feo Received" by d/�/. jam'-- -- Adminlatr%tivo O:flcor T 600-7;4 . 130 South Galena Street Aspen, .Colorado 81611 303/925-2020 .