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HomeMy WebLinkAboutpitkin.eh.264335203001 (1988)eX13-3sZ'o -oo) ASPEN*PITKIN ENVIRuNMENTAL HEALTH DEPART AAENT INDIVIDUAL SEWAGE DISPOSAL PEFl-1IT NO. �(i<X 7 TYPE OF PERMIT: r ( )Initial Construction ( )Emergency Usegepair Work,(Pievious Permit i (� Ni= .) ( )Alteration of an existing system, or installation / ` (Previous Pernit i ) ( )use Permit as a result of Sale ( )Others ISSUED TO: DATE OF ISSUE.12-5A O Owner WILL Home Phone ''0 Business Phone MailinAddress P 0. Ra,'37 %� A'Onj -00 12 Agent Phone Mailing Address CoA) Sewage Disposal System Work to be performed by ,Qna STP-DC's/('r� This permit valid only for premises location by the following legal description: /C - � T LOT Size rl C , WATER SUPPLY ��}80V J Sj0Al AVERAr.r PERCOLATION RATE Ivry N -ca. This Individual Sewage Disposal Permit is granted with regard to the following use: 2W -AM f Mr.sbcr ofs Dedicoms _ Lofts Garbage Disposals Dishwashers Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD fpaoGALLONS. THE NATUP.E OF THE SYSTEI.:�r1- INCCLLU,DJED UNDER THIS PERMIT: Type of Tank or Treatment Unitx SeP' 1 ffi- I AAi4 (fX1S�1 NC-) AEthos of Final Disposal:�.PAG6- 7;FEA � ES Abeorptiop ODescription (including brand name, if any) of other equipment or appurtnances: Tank Capacity, t1400- _Callon Area � Square Feet minimum .Other Conditions or Specifications: p� e.E `-o / ?F� vQ. FT. t.�df•Tl 7-60o C �^66T 4FC % 1SE�B�� S STAGES QUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Before Excavation ( )Upon completion of excavation and prior to placement of gravel ( )system covering cistributi n of asoou field ( )Prior to backfill of any component ( )Other, Specifys _ --- Plans and specifications of the proposed sewage disposal system have been reviewed and art, considered satisfactory. Pernission in hereby granted to thn owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewa,e Disposal Revelations in effect on the date of issue. In addition to genera) provisions set forth on the reverse Iver^or, this Permit is subject to the following additional terns and conditions: r APPROVED FOR ISSUE BY-49(title)1// The above individual sc%rago disposal system installed by /t/Y/�'(_ l.y�L/C�t% has been innpectcd for use by a representative of the Asl:cn Pit in lnvironm�nt.3 reoponsibility in case of failure or inadequacy of this sewage disposal system. Health Dep.:rtmrust. Tn.! uwnur asuunx» a Complete as -built drawing attached. DATE OF INAL NS E ION --lid- _ ' f BZ: TITLE _ 130 South Galena StreetAspen, Colorado 81611 303/925-2020 a�y3-3sa-®�`©oi ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL• PERMIT Name o f OWNER y/ f11 l �'� K�� ✓� PHONE S� Address of OWNER f -Ir J-0H/VL(0/V Name of APPLICANT /*rri'/�'� PHONE PERMIT TO BE: ( )Picked Up ( )Mailed tot TYPE OF PERMIT: ( )New Installation ( )Repair ( )Owner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEMt ,/ Legal Description y CI Lot _ Block_ riling Subdivision ,r o o (D size of Lot /¢ acres TYPE OF STRUCTURE: (>(single Family Dwelling ( )Others Do you plan any further additions to the residence? ( )YES (>C) NO No. of bedrooms_ No. of Lofts_ No. of Garbage Disposals 2.. No: of Automatic Dishwashers �. No. of Automatic Clothes Washers C _ WATER SUPPLY: ( )Private Well, Depth or X'Pub11e, Name of System ( )Spring , i C— . ( )Stream or Creek TYPES OF INDIVIDUAL SEWACE 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, 8:30-9:30 a.m.) tefore 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.invSlUate the application and any subsequent pgrmit. f Signature of Applicant DATE DATE 2 lid �2 (This application becomes. invntno the 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. 5. 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 undersi ne//dh�ereby acknowledges receipt of this individual sewage disposal permit application and a ermit fe in the amount of i d. � VU , Receipt Number Date Fee Received r �� .by Administrt tivo Officer 130 South Galena Street Aspen, Colorado 81611 303/525-2020 ASPEN♦PITKIN ENVIRI .MENTAL HEALTH OEPART ENT IaI2UFST FCR WMM AND SEMC SYSTEM INSPE(TMM USE PERMW APPLICATION Date Requested _.!! � Check/Receipt Number I1z1 � tY OC`OO S Bill Th -..RWZAWWi2YWM1 7 Inspecti•n Requested L Phonei Original Report To Be Sent To ♦ i i Copy Of Report To Be Sent To Property• I Parcel ID Number Legal 1/4, Lot Block_ V1, Sec.. T S, R W; Filing Subdivision .5Ti4.C'uJ,6o� Building Occupied--,K/--Vacant Age Of Building J Date Septic Tank Last Pumped -t" �2- Yc�92S a PA..r cc'v, s .� DEPAI�ENT Permit Number >VON E Year Issued % Cl 724- No Records Found Septic Tank Capacity. 12,!5-0 (Gallons)A0bdVSeptic Tank Material 6"E Leach Field Size Ft.) Leach Field Type QEFboTE-0 '10 RIF -RED IPISPECTION: Date Of Inspectio Inspector t Soil Conditions: D Saturated Snow Covered Other Septic System: Functioning S�atisforily Not Functioning Can-nents : - _ / '1-0r , Water Supply: Public: Name r?10 t.cyGC)� Private: Well , Spring , Cistern , Surface -r Other Well Construction And Location: Approved X Unapproved Because Bacteriological Water Test: Lab Number Date Acceptable Other A.P.E. H.D.: VP7 130 South Galena Street Aspen, Colorado 81611 303/925-2020 DIsrAlacrnotJ BOX MAAI0 I -C AISEAS TV SWAFAer-. F—X I STI nJ 6r Cood e4F-TE sEP�rtC -arAAIK --- - (lo' DIAMET L-4 &" UVI o DEPTH) REFITTED Wrr i4 /tJtEr AND ©lfrLt r Tee3" A Six--/ oo '-nA/cH 5' w i-rm Q .2' OF GAAVEt_ SEZVW L/A16-,S IL V ae-