HomeMy WebLinkAboutpitkin.eh.265435402005 (1989)ASPEN#PITKIN
... ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERi•1IT 140. l
TYPE OF PERMIT: y%
( )Tnttial Construction ( )Emergency Use ( )Repair work,(Pcevious Permit I .) (J Alteration o£ an exlstin�], sy•te:a,
or 4natall1tion r Previous Pernit i 1 (J(J,`� .)
( )Use Permit as a result of Sale ( )Other:
ISSUED TO: DATE OF ISSUE .3Z /12
O:.mer D_L{N1�02iS /�-/1 % Gil K Home Phone 312 / Business Phone
Mailing
Address ��j� //�l•eL/�N ��i�/✓IE(rC% /�„��07
�A Phone 9 -��
Agent ��l'l��f !R'TN1S ��2413
Ma i l.in g
Address/0`1
Sewage Disposal System Work to be performed by APE,6VIA16
This permit valid only
/for premises )o cation by tho following legal descriptions I -o R— 6 SI
LtTr s I2E 2, ,Z / /'fly/=0C� MATER SUPPLY (;;4 P/V'j jC4 . AVERAGE PERCOLATION RATE. IoM 111 A��!_
This Individual Sewage Disposal Permit is granted with regard to the following use: 91AIC UE509/11 /iy Y��--S/;04FA&— .
Nur.tL>cr oft Dedreoms _7_ Lofts 1_ Garbage Disposals_ 0 Dishwashersy Clothes Washors �.
CALCULATED AVERAGE DAILY WASTE LOAD Q GALLONS.
THF NATURE OF THE SYSTE:�f INCLUDED UNDER THIS PER11IT:
Typo of T.rk or Treatment Units �ir %/�j !� Tank Capacity_0-0 Callon Hinimu:a L
Mcthod of Final oiaposals �Ec Pft6 E /CN Absorption Area _ (� n Square Feat Minimum �1E
li Description (including brand name., if any) of other equipment or urtnancest
13 3 FT o F /eco/ L) •T�EAfC- H �M/:-J/All 0M of `TC,l O) QP—
AQ
Other Condition! or Spccificationes
_!5Ced2 f+0D/T
71--1o.J QF dZ aE�.�ooM s Z 13r%THS S711 -)D/0
SV57- M TO
FAI'VA-X knoll a'
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )hcfore Excavation ( )Upon completion of excavation and prior to pincement of gravel Before covering distribution
ystem of absorption field
(jO Prior to backfill of any component ( )Other, Specify:
Plans and specifications of the proposed sewage disposal system have been reviewed and are cc
nsidcred satisfactory. Perr�issi.on
i4 hcrc)rf gra;:ted to tt:c owner or his agent to perform the work, indicated above in accordance with the Pitkin County Indivi ,:at
Sewa,;e Disposal Regulations in effect on the date of issue. In addition to general provisions set forth on the reverse hereei,
this Permit ie sui•ject to the following additional terns and conditions: tjA
r�
��p/
Aspen/Pitkin Environmental
APPROVED FOR ISSUE BY (/Lli� (title)Health' irpr
Tho a`Kive in:Sividual sc sago disposal system installed by^PGNerr/'`�//VC
I has been in,:ported for use by a represcntative of the Aspen/Pitkin Lnvlronr,,rIntal Ifealth Department. The uwn(jr asau.:.os a
ll
re::j)onstbiltty in ca3<: of failure or inadequacy of thio sewage disposal system, mpleto As -built drawing attached.
• D.;TE OT' FINAL INSPECT ON 3 "
Aspen/Pitkin Environmental
EY:_ TITLE Hgalth Officer
�z L/
C C 14M% t� r
"11)v130 So/uth Galena reet Aspen, Colorado 81611 303/925-2020
ASPEN*PITKIN 0 } lo� \
r ,N
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
:iC�`F:.�`> LfAt i1�PHONE �-q14�-chi iName of OWNER c 3I Z -
Address of OWNER 736-.�����Vie��'���e�G
Name of APPLICANT AM EkA'we_5 PHONE
PERMIT TO BE: (APicked Up ( )Mailed to: TYPE OF PERMIT: (/1? New Installation ( )Repair
'` ( (Owner ( )Applicant . .( )Emergency Use ( )Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEM -
Legal Description
Lot -70 Block
Filing Subdivisionq�r_Size of Lot acres
�
TYPE OF STRUCTURE: ( )Single Family Dwelling (Other: �l`L� ��,� Do yo plan any further additions to the
�a+vS residence? ( )YES NO
No. of bedrooms - No. of Z No. of Garbage Disposals No. of Automatic Dishwashers
No. of Automatic Clothes Washers
WATER SUPPLY: ( )Private well, Depth or (YPublic, 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.
Application for an individ' 1 sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false inf c ation i 1 invalidate the application and any subsequent (pe miiit-
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.
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.
'Pheundersigned �ieby acknowledges receipt of this individual sewage disposal permit apion and a permit fee in the amount
of S / , Receipt Number , Date Fee Received pl nt,by 4LZ14
'+^_-
t Administrative officer
130 South Galena Street Aspen, Colorado 81611 303/925-2020
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