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Home My WebLink Aboutpitkin.eh.264335200006 (1991)ASPEN*PITKIN ENVIP40NMENTAL HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use i Repair Work,(Piovious Permit 1(JC- .) ( )Alteration of an existing system, or installation (Previous Permit 1 ) ( )Use Permit as a result of Sale ( )Others ISSUED TO: DATE OF ISSUE Owner lC Mo L'l-sk Rome Phone -E�'V3 Business Phone Mailing Address PS p Agent /�{,�Phone Ma ilin g Address Sewage Disposal System Work to be performed by AC Ale r rc This permit Valid only for premises location by the fol owing 1 gal de ription: RL' �- L y� / LOT SIZE 7'' ��' � , WATER SUPPLYR Htrc/k r/t'; NVf AVERAGE PERCOLATION RATE + M /Y This Individual sewage Disposal Permit is granted with regard Co the following uses •_7//�^ F Iti// L / FC, ✓� �� 4 Nurabor of: DodreomsLofts �' Garbage DisposalsDishwashers �_ Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: A ype of lank or Treatment Units cthod of Final Di3p033l1A0W0_1& 1 - Absorption escription (including brand name, if any) of other equipment or appurtnaneest Aher Condition! or Specifications) i J �o F/ -r5 AT- l5`x E,XIST0X11 12s -D 614u6j Tank (s cit C'� Gallon Minimtsa Area �rQ/i o square Feet minimum To'n1 L STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ion )Before Excavation (VUpon completion of excavation and prior to placement of gravel Asysten ofBefore vabsorption fr4i141 ((`gPrior to backfill of any component ( )Other, Specify( Plans \\\and specifications of the proposed sewage disposal system have been reviewed and r.re considered satisfactory. Perniesion is hereby granted to thr, owner or his agent to perform the work indicated above in accordance with the Pitkin County lndivi ual Scwa;c Disposal Revelations in effect on the date of issue. In addition to general provisions set forth on the reverse het'±of, this Permit is suthject to the following additional terms and conditions: - Aspen/Pitkin Environmental yk Health Officer APPROVED FOR ISSUEBY z Gr` (title) ` �---- The abxivc inlividual sc�ja,jo disposal system inatallcd by ��•+—lY- ��_ has been in:!j,cctcd for use by a representative of the Ashen PitinL'.nvironm�rnt recamonsibiltty in case of failure or inadequacy ofmin sewage dispora system DATE OF F 'AL INSPECTION 14Alr4% V�AYL a Hcalt., Deparcmcnt. The uwnur aauurnoa a . Complete as -built drawing attached. TITLE 130 Soutt Galena Street Aspen, Colorado 81611 An/PiWo bwirm"ental He,Wt t O fiver 3031920-5070 t+. - ASPEN*PITKIN ENVIRLoNMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNERf6z'i�X f rl&__ PHONE Address of OWNER Name of APPLICANT _, PHONE 7 PER.yITTO BE: ( )Picked Up ( )'tailed tos _ TYPE OF PERMIT: ( )New Installation (yl Repair ( }Owner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure (ACA?IGN OF PROPOSED SYSTEM: Legal Description Block Tiling Subdivision Size of Lot acres Lot - [j Do you plan any further dditions to the TYPE OF STRUCTURE: (()Single Family Dwelling ( )Others residence? ( )YES i )NO No. of bedrooms No. of Lofts No. of Garbage Disposals �_ No. of Automatic Dishwashers --Z— So. of Automatic Clothes Washers J/ WATER SUPPLY: ( )Private Well, Depth Or (vPublic, Name of System 1 fY a✓ `�s'' �d�' e G ( )Spring ( )Stream or Creek TYP OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSF.D9 (Vi Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound ( other use ( )vault Privy ( )Other: )Recycling, potable use ( )Recycling, The initial site inspection must be arranged with the Aspen/Pitkin Environmental Health Department (925-2020, 8:J0 -9:J0 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.ion and he un uentipermiacknovledges that the above information is true and that false information will invalidate the app Signature of App licant DATE l 7 S� (This ap ation becomes. invalii 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. 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. g Permit pplica ion and a permit fee i the amount She underr7s�lgtsld hereby acknowledges receipt �� this individual sewage disposal Pe Z / by of S�/=� , Receipt Number , Date Fee Received Ayainistrativo Officer 130 South (3alena Street Aspen, Colorado 81611 303/920-8070 ASPEN*PITKIN 0 ENVIRONMENTAL HEALTH DEPARTMENT FIELD TEST DATA SHEET ON PERCOLATION TEST Legal description: � I g& 2 Address of Property: Name of Owner: Address: (# & St. p.o. box) (city) (state) (zip) Name of Agent: Lot Area: -7 Water Supply:Public Utility Subdivision_ _ Private W611 Other Distance to Nearest Surface WaterT p Dates Observations Made: Soil Borings: ! by Percolation Tests%-Vjjft by SOIL -BORING TESTS PERCOLATION TESTS Total -Depth Observed Depth to Groundwater Estimated Depth to Groundwater Character of Soils t, 41A Depth of Water " PERCOLATION TESTS Rate P-1 /(0 Rate P-2 Rate P-3 AVERAGE RATE: I.& minutes/inch Plan of the site and location of test holes on the back Comments on Soil or S'te: Date Signature 130 south Galena Street Aspen, Colorado 81611 303/920-5070 P- P-2 P-3 Depth Diameter r, Depth of Water (left after 8 hr. presoak) Rate P-1 /(0 Rate P-2 Rate P-3 AVERAGE RATE: I.& minutes/inch Plan of the site and location of test holes on the back Comments on Soil or S'te: Date Signature 130 south Galena Street Aspen, Colorado 81611 303/920-5070 Drop Tim, - Rate P-1 /(0 Rate P-2 Rate P-3 AVERAGE RATE: I.& minutes/inch Plan of the site and location of test holes on the back Comments on Soil or S'te: Date Signature 130 south Galena Street Aspen, Colorado 81611 303/920-5070 SEEPAGE ITS VV w. ry EACH PIT �F�r iN�ecf Dug ouy .... , .. k �Il 11-. �ooc� GAtt a A ° "VCP" r � C?a? 177 OK J o—rAuA1J META 4156 i A.AJQ y 1 uu 1 N j: /