HomeMy WebLinkAboutpitkin.eh.264335107005 (1989)2&q-3-351 —07-0pT
t �Iw ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT!�t/'
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. OI
TYPE OF PERMIT:
( )Initial Construction ( )Emergency Use ( )Repair Work,(Pcoviou■ Permit i .) XAlterationcof anexistinor installation Previous Prmit ! )
( )Use Permit as a result of Sala ( )Others / �%
ISSUED TO: DATE OF ISSUE . "1 -� V ✓0 9
Owner60p2T0l Al Q �16-FdX1,4L)8C,-eC Home Phone-�060Business Phone
Mailing .
Address lI
Agent U A1ST�&)OTI DA Phone -z2-90
adr ss 0
Sewage Disposal System Work to be performed by j1 DD n
This permit valid only four premises )ocation by the following legal/d criptions L_f)T R— b�jq ( �AgWto !�06DIVISlod.
LOT SIZE �2+ 41M 7 , WATER SUPPLY AVERAGE PERCOLATION RATE. &J 11AIG hill
This Individual Sewage Disposal Permit is granted with regard to the following
Nteaber oft Bedrooms _!�z Loft$ 0 Caritage Disposals_/ Dishwashers �� Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD L GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS P_ER;iIT:
Typ.2 of Tank or Treatment Units C)EpT FA M Tank Capacity /'�oy Callon minimuraC
t".tthod of Final Disposals Ep�GL l�'S Absorptiop Area �9p Square Feet Minimum
Dc.^crlption (including brand name, if any) of other equipment or appurtnancess —r&TAi"
Other Conditions or Specifications;
Ad AD017-10 IAL � EP��F Pi ` - �F ,500 �f /F��ylJ/AFD /�O /��MQpEG i'
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: '
{ )Before Excavation { )Upon completion of excavation and prior to placement of gravel( Before covering distribution
system of absorption field
( Prior to backfill of any component ( )other, Specifyt
Pla s and specifications of the proposed sewage disposal system have been reviewed end are considered satisfactory. Pcrninsi.on
i:a hereby granted to t1a, owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual
Sewa,e Disposal Re-iralations in effect on the date of issue. In addition to general provisions set forth on the reverse heraof,
this Permit is subject to the following additional terns and conditions;
Aspen/Pitkin Environmental
Health Officer
APPROVED FOR ISSUE BY (title)
Thv a calve ir.:iivtdual ncwayo disposal system installed by
has hxcn 0::pected for use by a rcprescntativc cf the Asy:cn ,•itk.in L'nviron.�vrta ptca t.. Dep.trt+ncnt. Th.! uunur aasu.�.s aTl
renlwnsibilt!y in case of f 1 re or inad,-guacy of tfatu sews a disposal ay+tem. Complete as -built drawing attached.
ll:',TE GF FINAZ. I�� 'PF ION �®
Aspen/Pitkin Environmental
�'t: TT'TLL i _ Health Officer
L
�C,
130B na Street Aspen, Colorado 81691 303/920-6070
ASPEN40PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER Burton and Vi ---ia Goldberg PHONE 925-4060 _
Address of OWNER 0156 Epply Drive
Name of APPLICANT B.U. Const.
PHONE 963-1290
PERMIT TO BE: j )Picked Up ( )Mailed tot TYPE OF PERMIT: ( )New Installation (j�)Repair
( jOvner ( )Applicant ( )Emergency Use (')Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEM: -
Legal Description R-89 Starwood, Pitkin County
Lot R-89 Block 16 Filing Subdivision Starwood Size of Lot acres
TYPE of STRUCTURE: X )Single Family Dwelling ( )Other:
Do you plan any further additions to the
residence? ( )YES 0C)NO
No. of bedrooms No, of Lofts No. of Garbage Disposals No. of Automatic Dishwashers
No. of Automatic Clothes washers
WATER SUPPLY: ( )Private Well, Depth or ( )Public, Name of System
( )Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSF.Dt
(.)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, 8:30-9:30 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 individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false information will invalidate 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.
S. 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.
The undersigned hereby acknowledges receipt of this individual sewage disposal permit ap 1 n(ion and a permit fee in the amount
of S �dd� Receipt Number Date Fee Received . by
Administrativo officer
130 South Galena Street Aspen, Colorado 81611 303/920-5070
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ASPEN*PITKIN
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ENVIRONMENTAL HEALTH DEPARTMENT
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s= 130 South Galena Street 'Aspen, Colorado 89611 303/926-2020