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HomeMy WebLinkAboutpitkin.eh.264335401002 (1987)R� q3-3s4-oI-©oa ASPEN*PITKIN /I ENVIRuNMENTAL HEALTH DEPARTMENT hQ1t w Dr INDIVIDUAL SEWAGE DISPOSAL PERMIT 140. / `TY/PE OF PERMIT: nitial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit I.} t )Alteration of an existing system, r installation (Previous Permit 1 ) ( )Use Permit as a result of Sale ( )Others ISSUED TO: DATE OF ISSUE - 4A Owner � it l�i�J('�'i Home Phone!222--b/ �j Business Phone . Mail_iag Address SP{/l� (1itK1/ki (�E Agent inf-—Atil►J z 1Si f��i od Phone Ma i l.in g � Address 17�30 _W10SK1IAlrnli ,40 i.�,f6 x -Q-0 A170 � l� Sewage Disposal System Work to be performed by This permit valid /�o/nlyy for premises location by the following legal descriptions /P �(p �BPLC�i�C Q LOT S I IE � �C 'FS WATER SUPPLY S ~ Rb/(//-/© AVERAGE PERCOLATIONRATE This Individual Sewage Disposal Permit is granted with regard to the following use: -rVA1 L- //`411-y '&- 519 tJI-C- Nue.iber oft IIodreoms _ Lofts Garbage Disposals_ ( Dishwashers ' Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD `%5 O GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: Type of Tank or Treatment Units .� a / IQ -TA/ k Tank Capacity�L' (.�� Callon Minimu:a Pirthod of Final Disposals �CP�E�C/VL%fFS(3 FTWfDO Absorptiop Area � ;�(� Square Feet Minimum Description (including brand name, if any) of other equipment orlappurtnances: Other Condition! or Specificationes ' )/2EN(.rfe`s T3F 6W C_40AJ7,00e STAGES REQUIRING I_1SPECTION BY THE HEALTH DEPARTMENT: ( )Peforc Excavation )Vpon completion of excavation and prior to placement of gravel Before Covering distribution K). \ system of absorption fi..ld Prior to backfill of any component ( )Other, Specify% Plans and specifications of the proposed sewage disposal system have boon reviewed and P.re ccnsidered satisfactory. PC rmi sa to n is hereby granted to tic owner or his agent to perform the work indicated above in accordance with the Pitkin County Indivi sal Snwa;c aispcsal Re•mlations in effect on the d.,tc of issue. In addition to general provisions act forth on tic reverse hercei, this Permit is subject to the following additional terns and conditions: BY (title)% APPROVED FOR ISSUE B _ The alxivc individual No%%ago disposal system installed by U�NI/ has been in:hccted (ur use by a represcnt.it lvc of tho Asl:en tin in nvironm.•nta rcoponsibility in case of failure or inad,-quacy of this %ew..ge disposal system. DATE O1 N I 'nE TI 130 South Galena Street Aspen, Colorado 81611 MTN t{caft �[)cp•%rtmtnt. The ownar a3!1wn03 a Complete as -Guilt drawing attached. TITLE CSL LL 303/925-2020 " I v ASPEN*PITKIN • ' ENV MENTAL HEALTH DEPARTMENT f - I APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER PHONE q ZS - Address of OWNER c)Zar, qs?e�-, O-z\A — Name of APPLICANT .� C� c ��� �� ��+�� `f ��-�' o"� PHONE q'Z o - b-1 1 PERMIT TO BE: (o)Picked Up ( )Mailed tot TYPE OF PERMIT: pV New Installation ( )Repair ( iowner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEMt Legal Description II Lot --k- -% (_ Block riling Subdivisions vwor cl Sw�J . Size of Lot Z.y� 1 acres TYPE OF STRUCTURE: Oq Single Family Dwelling ( )Othert Do you plan any further additions to the residence? ( )YES ( )NO No. of bedrooms No. of Lofts b No. of Garbage Disposals No: of Automatic Dishwashers No, of Automatic Clothes Washers ^� MATER SUPPLY: ( )Private Well, Depth or "Public, Name of System ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAC:E DISPOSAL SYSTEM PROPOSED: - 60 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 individu ag epos 1 permit is hereby submitted. The undersigned acknowledges that the above information is true and that false inf matin will in lidate the application and any subsequent permit. Signature of Applicant DATE -Or-3Q— 61 (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. 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 u e igned hereby acknowledges receipt of this individual sewage disposal pe i app 'lcation and a per(ni ea in the amount o! $250. Receipt Number Date Fee Received by 1sCC�%! - Administrative Officer 130 South Galena Street Aspen, Colorado 81611 303/925-2020 IDA., V 46 1250 -GA U-04 '120Pktmo,,O-O , K S" rA DISTP-l6uno,j BA 3 AS�JS r— — —.. — — — — -- — — — — — — s, -r PIPE (-"rICAl) TWO FLIXIr OF LJA/E:S (EFFCLvr,iVCA&64 -401. /,59-7 Ch) << -r° SouA L Dmmle s-vo 'Pahl- 0 •