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HomeMy WebLinkAboutpitkin.eh.273503300044 (1984)ASPEN*PITKIN �2 7.3G -- D -3 3 �` ENVIRONMENTAL HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT N0. JI 02 7 TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use ( )Repair work,(Piovious Permit i .) KAlteration of an existing sy tea, or installation (previous Permit 1 C J` ) ( )Use Permit as a result of Sale ( )Othors (f ISSUED TO: DATE OF ISSUE -.7-234 Owller 14LI-Az}g f COOS Home Phone d19V Business Phone Mailing D L Address pQ9f� r, p Q fi l� 0)( X31 b2 14 Al�� 'e Agent '�,�� ! `��L�,�� C70 -1 -el Phone q -27-:5V72 Address g _01�l �k� c V f�.PR©�r/li�fl T Sewage Disposal System Work to be performed by 1—% " L t y��ez �Q/V57' UST/U� This permit valid only for premises location by tho following legal detictiptions Z SSC T-ICN,3TI 0 J LOT SIZE �(' �'C�r NATER SUPPLY AVERAGE PERCOLATION RATE_ / ll _ This Individual Sewage Disposal Permit is granted with regard to the following use:.�/1%�_Ft''fi/F1/L%/ti��/��ft�l Nkralh r of: Dodreoms _ J Lofts_ Garbage Disposals_ Dishwashers Clothes Washors CALCULATiX) AVERAGE DAILY WASTE LOAD GALLONS. THE NATURE OF THE SYSTEM I—N�C-LUDED UNDER THIS PERMLIT: :} q•= .:f Tank or Treatment Units Tank Capaeity ,zLCi' _Gallon Hinla:u ,Mctnod of Final Disposals ����� CJ�� Absorptlop Area klclo Square Feet _ Oeacription (including brand name, if any) of other equipment or appurtnancess ..Other Conditions or Specifications ' STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Before Excavation { )Upon completion of excavation and prior to placement of gravel { )Before covering distriF.utica system of absorption field 01) Prior to backfill of any component ( )Other, Specify:./Vo/,JF _ --- Plans and specifications of the proposed sewage disposal- system have been reviewed and are considered satisfactory. Pernissi.on is hareby grained to tl:o or+ner or his agent to perform the work, indicated above in accordance with the Pitkin County IndiviJual Sewa;e Disposal Rc,nilations in effect on the date of issue. In addition to general provisions act forth on the reverse hercoi, this Permit is subject to t:he following additional terms and conditionsi14161NE r � � APPROVED FOR ISSUE BY �� ��Z� - (title) The aboive individual sc•.:a,)o disposal system installed by Akwy (?^67ef1 _ w 0. _ i has been impacted for use by a representative of the Aipen I':t in Cn nvironciwttakliea t. oepartnant. The uwner asci—' u:'os ail rvnpons1biI1Ly in cdse of failure or inadequacy of thio sewage disposal system. Complete as -built drawing attached. c DATE- 0 FINAL I SP CT_ON'��� BY: - TITLE bM 130 South -Galena Street Aspen, Colorado 9'16'11 303/925-2020 ASPEI\I�RITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT Name of OWNER Allan B. Iargolis PHONE 920-1194 Address of OWNER 0860 Buttermilk Weat - P .•0. Box 3102 - Aspen, Colorado ' Name of APPLICANT Meckley Company -James P�eckley PHONE 927-3477 P£RMM/T TO BE: 'Xr—'cked Up ( ):Tailed toe . TYPE v:- PERMIT: i )New installation ( )Repair ( )Owner ( )Applicant j )Emergency use Z)Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM: Legal Description g Lot Block Pilin Subdivision Size of Lot acres TYPE OF STRUCTURE: W Singh: Family Dwelling ( )Other: Do you plan any further additions to the residence? ( )YES "=N0 'Co. of bedrooms_ No. 01` Lofts No, of Garbage Disposals No: of Automatic Dishwashers No. of Automatic Clothes Washers 1 WATER SUPPLY: (XPrivate Well, Depth or ( )Public, Name of System ( )Spring ( )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. 9:30-9:30 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. ptrueand thatfalse taindividual informationsewage willdisposal invalidatepermit thesapplicationsubmitted. any subsequentundersigned permiacknowledges that the above information is t. Signature of Applicant DATE 7-26-84 (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. Proposed and existing buildings, driveways, and other structures. S. Strears, 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. The undersigned hereby acknowledges receipt of this individual sewage disposal perrmi.t application and a permit feee0/ in the amount Receipt Number , Date Fee Received / '� / y by of S. /r•7`•- Administrative officer 130 South *Galena Street 'Aspen, Colorado +91611 303/925-2020 4OU5E �Deyr7M�� 3�GIP t- 67 cA 4` A ICA P QETVAI IIrG' ( CD1AAMMM ADPYt�fi.t vJ IJS 111o, it . _ o SCA LX I DrVEWAY MT)