Loading...
HomeMy WebLinkAboutpitkin.eh.26433430001 (1999)Aspen/Pitkin Environmental Health Department Permit for an Individual Sewage Disposal System 130 S. Galena St. Aspen, Colorado 81611 Phone 970-920-5070 / FAX 970-920-5074 Permit # 99078 Parcel ID # 2643-343-00-001 Type of permit New( ) Repair( ) Addition to House( X ) Name of Owner Luigi & Elizabeth Giordani Street Address 1038 Owl Creek Rd Property legal description Size of lot .5 acres Water source private well # of bedrooms in house Caretaker unit # of bedrooms in caretaker unit Total square footage of the house 2600 # of offices, lofts & similar sized rooms in house (2 future remodel) Total square footage of the caretaker unit # of offices; lofts & similar sized rooms in caretaker unit Designed for what # rooms (list) FOUR TOTAL 2 existing + 2 in future addition. Permit information Designed by Jerome Gamba Mailing Address Perc rate 20 Septic tank capacity PO Box 1458, Glenwood S Profile hole depth 17' 1750 minimum CO 81602 _ Depth to groundwater or bedrock +17' Absorption area 1252 Comments Septic permit approved per compliance with the engineer design and specifications dated with engineer's stamp 9/21/99 on Sheet 1 and 9/16/99 on Sheet 2. Any changes must be approved by this department and the design engineer prior to them being made. Design is for two -1,000 gallon concrete septic tanks (the first tank does not have a baffle) followed by a 1,000 gallon concrete pumping chamber. The effluent is pumped up to a drywell that shall be 19' wide by 19' wide by 12' deep. The 12 foot depth is the distance measured below the horizontal inlet pipe. Minimum horizontal distances between components of the system and physical features shall conform to the Pitkin County ISDS regulations. The ditch must be lined were the setback does not conform to the required 50 foot setback between the septic tank and the ditch. This department does not endorse any brand of products. Permit approved by: Date: /F -z 3 9 Plans and specifications of the proposed individual sewage disposal system have been reviewed and are considered satisfactory. Permission is hereby granted to the owner or the agent to perforin the work indicated in accordance with the Pitkin County ISDS Regulation in effect at the time of issue. This permit becomes invalid 6 months from the date that the permit was issued unless system construction has commenced or an extension has been approved in writing by the Department. As -built drawings must be included with this permit before the final approval will be issued. Installer: inv'T- - . j Final inspection approval Date: 0 i 0/6 I y 11 A, - A,--" ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATI . FOR INDIVIDUAL SEWAGE DISPC L SYSTEM 130 S. Galena St., Aspen Colorado 81611 Phone 970-920-5070/Fax 970-920-5039 ---------------------------- Name of OWNER n 1 Owner's Mailing Address Business Phone: qA) - -7V - / Home Phone: Primary Contact Person (all communication regarding this permit will go through this person) Name Company / U Contact Mailing Address Business Phone : q4 hu A L v r. 59CCell Phone. S uJD& SIP C o 1 d Fax: 9¢-S - 11/0 Parcel ID # (available from assessor's office) / _ 3 - 3 at 920-5160 or at www.aspen.com/assessor/ J lv �% Street address of property -10 3 F 0 f & �" S CO Legal Description: Lot :0 ,BTock`1 u'�1 4434 ,Filing Subdivision rl,Ia Size of lot: 1/ 2- acres. Type of proposed structure: wlh � Size of bldg. envelope: Total square feet of house 617 DD # of bedrooms in house 151) # of offices, lofts & similar sized rooms in house Caretaker Unit: Attached ( ) Detached ( ) Total area(sq. ft.) of caretaker unit N 1 III u ;_ --+'L-, ,nit # of offices, lofts and similar size rooms of caretaker unit Permit is for: New Home ( ) Repair due to failure ( ) Remodel/Addition (✓) Emergency use ( ) Water: Private well ( ) Spring ( ) Stream ( ) Community/Public Water System ( ) If community system: Name of The fee for a ISDS application is $330 for a permit that takes 6 hours or less for the department to approve. If approval takes longer than 6 hours, a rate of $55 per hour will be charged. The maximum fee is 51000. The basic fee of $330 is due at the time of application. The remainder, if any, will be due in two stages: first, at the time of issuance of the ISDS permit: second, before final approval of the ISDS permit. Application for an individual sewage disposal system is hereby submitted. I hereby certify that the above information is true and accurate and that I have provided true and accurate information on locations of all existing and proposed wells, contour intervals, buildings, property lines, ditches, slopes, waterlines, springs, suction or irrigation lines, drinking water cisterns, drain tiles, irrigation ditches, lakes, water courses, streams, floodplains, dry gulches, and existing septic systems. I hereby certify of that any such features not shown on attached site map are not present. Issuance of the permit does not imply the app any other permit required for construction pursuant to Pitkin County codes. No construction may be undertaken until all approvals and permits have been obtained. The Aspen/Pitkin Environmental Health Department, Pitkin County and employees of these agencies will be held harmless should the individual sewage disposal systerjjfaA or malfunction. The permit to construct is issued on information submitted by the applicant or his/her representatives. er assumes full responsibility in case of failure of the system. Date Signature of applicant Received b Receipt # 311/Date y ,iE If I ASPEN/PIN ENVIRONMENTAL HEALTH*-eEPARTMENT SEPTIC SYSTEM APPLICATION CHECKLIST NOTE: SEPTIC PERMIT APPLICATIONS CANNOT BE ACCEPTED UNTIL ALL OF THE INFORMATION BELOW IS INCLUDED. The soils test and system design must be done by a Registered Professional Engineer. You should plan to meet with the RPE at your site to discuss where the soils tests should be done to meet all of the County regulations and where you want to put your house. The RPE will be your contact for issues you want to discuss about your system's size and location. The RPE should check each box to indicate the following have been submitted before the application can be accepted. Completed application form �w Engineer design by a RPE registered in the state of Colorado. Site map showing locations of, or stating that the following do not exist: all existing and proposed wells within setback distances (including on surrounding properties), contour intervals, all proposed and existing buildings, property lines, ditches, slopes of greater than 15%, water lines, sprinkler systems, springs, suction (irrigation) lines, drinking water cisterns, drain tiles, irrigation ditches, lakes, ponds, water courses, streams, floodplains, floodways, dry gulches, or existing septic systems. This must include all such features on neighboring properties within setbacks. Complete building floor plans. Floor plans should be 11x17. Proof of adequate water supply: for private wells, recent well driller's pump test showing gpm actually produced, well permit showing legal supply, and test showing good quality; for community systems, proof there is adequate water for all houses served by the system; for other systems, proof of adequate quality and number of gallons/minute. Well must be drilled before septic permit can be issued. sb Env. Health has been called to look at profile hole Percolation tests (make sure to do lesser of 3 holes or one/ 1200 sq. ft. of field Per it fee Copy of county approval (1041 approval, subdivision approval, etc.) Check if your septic system is within the building envelope and no part of the system is more than 30 above grade. If both of these conditions are not met, you must obtain written approval from Community Development before submitting this application. ASPEN/PITJUN ENVIRONMENTAL HEALTH DEPAUMENT ISDS DESIGN CALCULATIONS � Owner's Name Parcel ID # House Size (sq. ft.) 45M (75 gpd, 100 gpd, or 130 gpd) 100 Number of Bedrooms in Main House Number of Offices, Libraries, Studies, Similar -sized Rooms in Main House Number of Bedrooms in Detached Caretaker unit Number of Offices, Studies, Similar -sized Rooms in Caretaker Unit (If the caretaker unit is ATTACHED, treat as if part of main house.) verage Daily Waste Flow: 800 State Review Required?: no Perc Rate (t) _ Design Flow (Q) _ # potential bedrooms X 2 people/bedroom X gpd X 1.75 Q = 1400 Absorption Area = A = Q x11 L 5 A = 1252.20 sq. ft. of absorption area required 81 infiltrator units without reduction A maximum 30% reduction is allowed for use of deep gravel or gravelless chambered system, only if the lot size and soil conditions are optimal. If a reduction is being proposed, describe why lot size and soil conditions are optimal: A = 876.54 sq.ft. with reduction 57 infiltrator units with reduction Type of system: DAbsorption trenches nAbsorption bed n Gravelless chambers GDry well OSeepage Pit 00ther (hype) Minimum tank capacity: 1750 gallons SETBACK FROM WELL # of feet = 132 SETBACK FROM POND, STREAM OR IRRIGATION DITCH # of feet = 82 SETBACK FROM DRY GULCH # of feet = 57 FINAL INSPECTION BY: Page 1 of 1 DATE: PERCOLATION TEST RESULTS FORM MEASURE DROP in WATER MENT LEVEL PERCOLATION RATE REMARKS HOLE DEPTH OF No. TEST HOLE TIME INTERVAL TME (min) 0:15 (inches) (inches) (min/in) (in) (min.)—r-- # 13'-2" 19:30 9:45 12 3/8 15 1/4 2.875 5 17 3/4 2.500 6 10:00 0:15 20 1/8 2.375 6 10:15 0:15 21 7/8 1.750 9 10:30 0:15 0 refill test hole 10:35 10:40 0:05 13 1/4 15 1.750 5 10:49 0:09 19 3/4 4.750 6 #2 8' #3 5'-7" 11:19 11:34 9:27 9:29 9:46 10:01 10:16 10:31 10:35 10:41 10:48 11:18 11:33 9:29 9:32 9:47 0:30 0:1521 0:02 0:17 0:15 0:15 0:15 0:06 0:07 0:30 1/2 1.750 9 12 3/8 16 1/8 3.750 5 18 1/4 2.125 7 19 1/2 1.250 12 20 3/4 1.250 12 refill test hole 13 5/8 14 7/8 1.250 6 18 1/2 3.625 8 - 0:15 19 1/2 1.000 15 0:03 0:15 9 1/16 - 11 1/4 2.188 7 12 1/2 13 1/2 14 1/4 15 1/8 16 16 7/16 1.250 1.000 0.750 0.875 0.875 0.438 12 15 20 17 34 34 - - 10:02 10:17 10:32 10:47 11:17 11:32 0:15 0:15 0:15 0:15 030 0:15 ASPEN/PITKiN ENVIRONMENTAL HEALTH DEPARTMt-,,IT ISDS DESIGN REQUIREMENTS -DEPARTMENT USE ONLY Name elizabeth & Luigi 4,500 (75 gpd, 100 gpd, or 130 gpd) 100 House Size 4 #of Bedrooms, Similar Rooms accessible to baths in Main Residence # of Bedrooms, similar rooms w/ access to bath in ATTACHED caretaker # of Bedrooms & Similar Rooms w/ access to baths in DETTACHED caretaker Average Daily Waste Flow 600 # bedrooms X 2 people/br X 75 State Review Required? no Perc Rate 20 (T) 3 equals # of Perc Holes Required Design Flo w (Q) = # bedrooms X 2 people/bedroom X gpd X 1.75 Q= 1400 Minimum tank capacity 1750 gallons Absorption Area (A= Q/5 X SQRT) A = 1252 sq. ft. of absorption area required 81 infiltrator units without reduction A maximum 30% reduRtion is allowed for use of deep gravel or gravelless chambered system. 877 sq ftv0 duction 57 infilt tori with reduction AREA NEEDED FOR STANDARD ABSORPTION TRENCHES 417 1252 Total sq ft /3 =lineal ft of trench needed 7 417 lineal ft/assumed trench length of 60ft = # of 60ft trenches needed 6 # trenches minus 1 = rows of 6ft wide undisturbed soil between trenches 21 7 times 3 = total width of of 60" long field needed for just the trenches 36 6 times 6' = total width of 60' long field needed just for undisturbed soil 57 width of trench +width of undisturbed soil = total width needed 57 by 60 ft is the area needed for a standard absorption field in a trench configuration with no reductions taken and ASSUMING AN AVERAGE PERCOLATION RATE OF 20 SLOWER PERCOLATING SOILS WOULD REQUIRE MORE AREA. SETBACK FROM WELL SETBACK FROM POND, STREAM OR IRRIGATION DITCH # of feet = 132 # of feet = 82 SETBACK FROM DRY GULCH # of feet = 57 Remember: 8 feet of additional distance for each 100 gallons/day of design flow over 1,000 gallons/day should be added unless an RPE can verify that it is not necessary to prevent contamination. 1/20/99 Printed on Recycled Paper Aspe""` P;tkin Environmental Health Department Contact Log Sheet ame: arcel I D#: Address: Date Person Socken To 1 Comments / Action to be Taken pis Time i 'tir' `rrf JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS 113 9TH STREET, SUITE 214 P.O. BOX 1458 GLENWOOD SPRINGS, COLORADO 81602-1458 PHONE: (970) 945.2550 FAX: (970) 945-1410 Monday, January 17, 2000 Nancy McKenzie Pitkin County Environmental Health 130 South Galena Aspen, CO 81611 Re: Giordani Residence I.S.D.S. Dear Nancy: On October 4, 1999 Jerome Gamba & Associates, Inc performed a final inspection of the Giordani Residence ISDS. The system as observed by Jerome Gamba & Associates, Inc., was found to be in substantial conformance to the plans and specifications signed and dated September 21, 1999. If you have any questions or comments, please call me. Sincerely, JEROME GAMBA & ASSOCIATES, INC. r Chris Strouse Robert W. Pennington, P.E. 293 Cc: Luigi Giordani Page 1 of 1 G:\99845-GIORDANITI N_LETTER.DOC JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS 113 9TH STREET, SUITE 214 P.O. BOX 1458 GLENWOOD SPRINGS, COLORADO 81602-1458 PHONE: (970) 945-2550 FAX: (970) 945-1410 Thursday, September 16, 1999 Luigi Giordani P.O. Box 2616 1038 Owl Creek Road Aspen, CO 81612 RE: Percolation testing and Soil Profile results. Dear Luigi; As per your request Jerome Gamba & Associates, Inc. performed Pecolation testing at the site as described above. The testing was performed on August 19, 1999. The Percolation testing was performed for a Dry Well System design. Therefore the percolation tests were performed at three different depths and in each different soil strata encountered in the excavation. The test holes were pre-soaked the night before testing. The results of the percolation testing are presented on the attached table. The average percolation rate is 20 min/in. The soil profile as observed by Jerome Gamba & Associates, Inc., is as follows: DEPTH (IN) SOIL DESCRIPTION 12 to 14 Dark brown organic top soils 14 to 44 Dark brownish red soil with cobbles up to 6" dia. 44 to 96 Light brown sandy soils, river alluvium material 96 to 152 Sandy clay with large cobbles up to 12" to 18" dia. Giordani Soil Investigation G: W845-GIORDANPGEO_TECH. doc Page 1 of 2 0 • On September 1, 1999, the profile hole was extended down four (4) feet for further soil investigation as per our August 26, 1999 meeting. The soil was uniform with the lower soil description mentioned above and no ground water was encountered. This report has been conducted in accordance with generally accepted engineering principles and practices. The recommendation in this report is based upon the data obtained from the percolation testing. If conditions encountered during construction appear to differ from those described in this report, we should be notified at one to evaluate these soil conditions. If you have any further questions regarding the percolation testing, please contact us. Sincerely, Jerome Gamba & Associates, Inc. wP_2erQ0 Chris Strouse Robert W. Pennington, P - V/ G:19984i GIOR ANIIGEO— JEROME GAMBA & ASSOCIATES, INC. G:199845-GIORDANIIGEO TECH.doc Page 2 of 2 CONSULTING ENGINEERS & LAND SURVEYORS JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS 113 9TH STREET, SUITE 214 P.O. BOX 1458 GLENWOOD SPRINGS, COLORADO 81602-1458 PHONE: (970) 945-2550 FAX: (970) 945-1410 August 30, 1999 Luigi Giordani P.O. Box 2616 Aspen, CO 81612 Re: I.S.D.S. Application Dear Luigi; This information was sent back to me reguarding your I.S.D.S. Design for your existing residence and the proposed additions. I was not aware that you had not submitted the application for this I.S.D.S. I have checked off the information Jerome Gamba & Associates, Inc. has provided to you. Also, Pitkin County and Jerome Gamba & Associates, Inc. must perform 'final' inspections of the system prior to the covering of the final system construction. If you have any further questions please contact us. Sincerely, Jerome Gamba & Associates, Inc. f Chris Strouse JEROME GAMBA & ASSOCIATES, INC. CONSULTING ENGINEERS & LAND SURVEYORS J o oG POST OFFICE BOX 1458 113 NINTH STREET - SUITE 214 GLENWOOD SPRINGS, COLORADO 81602 (970) 945-2550 1 I °�- -TRANSMITTAL a 0 �{ 3 Date Aust 26, 1999 1 Time: 2.51 PM ,, Project Name: Giordani ISDS, 1038 Owl Creek Road Project Number. 99845 To: Nancy McKenzie Company: Pitkin County Department of Environmental Health Address: 130 S. GALENA Street Aspen, CO 81615 Phone: (970) 920-5070 From: Chris Strouse{ ' Re: ISDS Design CC: We herewith transmit the following: Fax: x Drawings ❑ Contract Documents ❑ Bid Documents ❑ Specifications ❑ Product Literature ❑ Change Order ❑ Other For your: x Approval ❑ Review & Comment ❑ Distribution to Parties ❑ Record ❑ Info • Comments: Please find enclosed: 2 sheets – Original Stamped ISDS design 3 sheets - Soils information 1 Pitkin County Design for the Giordani Reside 9- -. AtY Use /fl— ' m rn rn 0 Ln O m 0 co r, C=L a) cn F- CD 0 cn J H 4 W U H n D - Lu cf) H Z Q O H LC7 co rn m APPROX EDGE OF DRY—WELL EXCAVATION 1 1/2" Sch. 40 F FROM PUMP ( 1-1 19.00' DRY -WELL PLAN VIEW N.T.S. 19.00' FINISH WOVEN GE PLACED ON TOP 1 1/2" Sch. 40 PVC PIPE FROM PUMP CHAMBER 4" PVC RI;ER W/ CAP 19 mm. DRY -WELL CROSS SECTION N.T.S. 1/4-- HOLE IN CAP. 3' i.vrvirr�. i JVO—O/"JG TO 987o STANDARD PROCTOR CROSS SECTION OF PUMP CHAMBER NOT TO SCALE DISCHARGE TO DRY WELL JC PIPE 1) dlons 4 lATIONS OF TOP OF LEACH FIELD DISTRIBUTION LINE AND PUMP CHAMBER SHALL BE PROVIDED TO THE DESIGN ENGINEER TO VERIFY THE PUMP SPECIFICATIONS. l 1 INV 1 I 0 1 1 01 1 01 1 1 _.._ 1 1 1 -- - -- -- 1 ■ rn Cn Cn 2 M m Ri N v N a CU Cn CD 3 II Cu W H Cni d CD 7 H Z d CD H CD "T co Cn C3� 50' SETBACK FROM SEPTIC TANK MIN. LIMITS OF DITCH LINING FOUND REBAR & CAP L.S. NO. 18478 z 0 0 m 0 C. £ SHED CARPORT ACCESS DRIVE FROM OWL CREEK RD. OVERHEAD POWER LIP'S` PROPERTY BOUNDARY N 90.00'00' E,,442.18' 102.84' NEW 1000 gal. SEPTIC TANK W/0 INTERIOR BAFFLE. NEW 1000 gal. SEPTIC TANK PROPOSED DRY -WELL W/, ,!,VM-RIOR BAFFLE LOCATION 1000 gal. CONC. PUMP CHAMBER 1 1/2" Sch. 40 PVC PIPE. (5 ft. min cover) FOUND REBAR & CAP L.S. NO. 18478 Z C S 90.00'00' V 164.46' -19.00' *-I EK ROAD f� 10 0 10 20 30 GRAPHIC SCALE IN FEET 1 INCH = 10 FEET NOTE: EXISTING STRUCTURES, UTILITY LOCATIONS AND PROPERTY BOUNDARY INFORMATION PROVIDED BY SCARROW AND WALKER, INCORPORATED, Glenwood Springs, Colorado. oI I CALCULATIONS FOR LEACH FIELD SIZE c I ( DESIGNED FOR A FOUR BEDROOM SINGLE FAMILY RESIDENCE. 7; FOUND REBAR & CAP L.S. NO. 18478 ASSUME 2 PEOPLE PER BEDROOM AND AN AVERAGE DAILY SEWAGE FLOW OF 100 GALLONS PER PERSON PER DAY ACCORDING TO THE PITKIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT REGULATIONS. THEREFORE: (4 BEDROOMS) X (2 PEOPLE/BEDROOM) = 8 PEOPLE (8 PEOPLE) X (100 GPD/PERSON) = 800 GALLONS PER DAY (AVERAGE DAILY FLOW) MAXIMUM DAILY FLOW = 175% OF AVERAGE DAILY FLOW, THEREFORE: MAXIMUM DAILY FLOW = (1.75) X (800 GPD) = 1400 GALLONS PER DAY MINIMUM LEACH AREA SHALL BE CALCULATED PER PITKIN COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH DESIGN CRITERIA USING THE FOLLOWING FORMULA. THE ABSORPTION AREA FOR A NORMAL GRAVEL -TYPE LEACH FIELD IS CALCULATED USING THE FOLLOWING FORMULA. A = (0)X 5 WHERE: Q = MAXIMUM DAILY SEWAGE FLOW = 1400 GALLONS PER DAY t = PERCOLATION RATE = 20 MINUTES PER INCH THEREFORE: A = 140 X 20 = 1252.20 SQUARE FEET L 5 DRY -WELL SHALL BE 19' WIDE by 19' WIDE AND 12' DEEP. TOTAL AREA INCLUDING BOTTOM AREA = 1273 s.f. MINIMUM SEPTIC TANK VOLUME = 1750 gallons, use 2000 gallon tank. MINIMUM HORIZONTAL DISTANCES BETWEEN SEPTIC SYSTEM COMPONENTS: ABSORPTION BED TO ANY DRY GULLY: 57 Ft. ABSORPTION BED TO ANY DITCHES OR WATER COURSES: 82 Ft. ABSORPTION BED TO POTABLE WATER SUPPLY OR SUPPLY LINE: 25 Ft. ABSORPTION BED TO PROPERTY LINES: 10 Ft. ABSORPTION BED TO SEPTIC TANK: 6 Ft. ABSORPTION BED TO RESIDENCE: 20 Ft. ABSORPTION BED TO SPRING OR WELL: 132 Ft. ALL COMPONENTS OF THE SEPTIC SYSTEM SHALL BE INSTALLED ACCORDING TO PITKIN COUNTY ENVIRONMENTAL HEALTH REGULATIONS AND ACCORDING TO MANUFACTURERS SPECIFICATIONS. B r a. s S c-c)� 4--u f A , P. N ca . 1-4 !Di 7y -.r—+ r -r. Z 5, , . $,3 r7 W -i-�, C! G -U P. M . z W 1U �n a Q0 N V1 S C_ a 4--Cq�a.k Q Lot 2 A tract of land situated in Tract 72, Section 23, Township 8 South. Range 87 West of the 6th Principal Meridian. Pitkin County, Colorado, lying northerly of and adjacent to the centerline of a 30 fool: wide County Road right-of-way as built and in place, said tract of land being more particularly described ,os follows: Beginning at Angle Point NO. 4 of said Tract 72: thence E((ist 313.06 feet along the North- erly houndary line ,:r said Traci. 72; thence S 15002153" E 1204.40 feet to the centerline of said County Road right-of-way; thence S 59°12'50" W 285.05 feet along saia centerline; thence N 25002'53" W 1365.45 feet to the point of beginning, containing 8.37 acres more )r less. Lot 3 tract of land situated in Tract 72, Section 23, Township 8 South, Range 87 West of the fth Principal. Meridian, Pitkin County, Colorado, lying northerly of and adjacent to the centerline of a 30 font wide County Road right-of-way as built and in dace, said tract of land being more, particularly described as fellows: leginning at Angle Point No. 4 of said Traci: 72: thence East. 313.06 feet to the True Point Beginning; thence East 332.86 feet; thence S 2.5002153" E 942.64 feet, to the centerline cf said County Road right-nf-way: thence S 43°06150" 14 324.87 feet along said centerline; Thence N 25002'53" W 1204.40 feet to the True Point of Beginning, containing 7.43 acres ^1'e ;lr less. aiy(2~r' -- - Applicant acknowledges that he/she has been informed by Pitkin County of the existence of t "1041 Hazard Areas" that might affect the property, any improvements and the use and occu- pancy thereof. ZI- Approved 1041 Hazard Review by: Date: Pitkin oun y Planning Director f t APPLICANT'S NAME: Albert Mosc2So Im 66, M f � n O i U)' G); f! r"t\/ Q O p ca S too 1 7 M1� 1 V>'- G1 -'`j" 25,05 011 Surveyor's Certificate I, Sydney Lincicome, do hereby certify that I am a registered land surveyor licensed under the laws of the State of Colorado, that this Site Plan is a true, correct and complete plat of a 1041 Hazard Review as shown hereon, that said Site Plan was made from an accurate survey of the real property described hereon by me and under my di- rect supervision and correctly shows the location and dimensions of the property and of the building envelope. This survey is true and correct to the best of my knowledge and belief. k 9 In witness whereof I have set my hand and seal this Nday of SCog efn by � A.D. 19 ��!u�ltpr�i�ii By ��- yd n y i come oo mom<a=; 14111 m° ACCEPTANCE FOR RECORDING This 1041 map has been accepted for filing i°ff ; Cte of the Clerk and Recorder of Pitkin County, Coloardo on this day of ,�i,,� A.D. 19 in Plat Book at Page asTeception No. r � � A, i! �� ,,�.,� d ,.�� �� •,- � �a � m � �- k � �� c..._ � � H 111 �f r Clerk an ecor er Prepared by.* LINES iN SPACE Carbon dale, Colorado