HomeMy WebLinkAboutpitkin.eh.264503200005 (1996)ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT
APPLIC ION FOR INDIVIDUAL SEWAGE DISPOSA' -YSTEM
130 S. Galena St., Aspen Colorado 81611 ate/ T y� +� 3,5
Phone 970-920-5070/Fax 970-920-5039 �1,t�alla
/ G_Permit # 1 arcel ID # co�{ 7 �� �plPermit For: New pair ( ) Remodel ( ) Emergency Usebf' t.
Name of OWNER {� L �i ti G E
Owner's Mailing Address Z " P � f (] �' D
Rusiness Phone: Home Phone:
Primary Contact Person 1C_
Contact Mailing Address 22
Business Phone : b'71 C9737 Cell Phone: Fax
Copy of permit to be sent to: Owner (A' Contact Person ( ) Both ( )
Street Address �7 J S N ] J MOSS L.�e-
1�--
Legal Description: Lot '1�(oLk VO ,Block S YL ��` W Subdivislo
Size of lot: acres Type of proposed structure+A(t A tial_ i�f�4�'`� Size Idg. envelope:
Total areafiiving space (sq. ft): 3 30 C� # of Bedrooms, offices and similar size rooms:y � ' P_
Caretaker Unit : ( )Attached Detached # of Bedrooms, offices and similar size rooms:
Water:( )Private well( X)Spring ( )Stream( ) Community/Public (Name of System)
Is Proof of Adequate Water Attached (required) ? (�J Yes ( ) No
Has this project been approved by Pitkin County ? (X Yes ( ) No
Is a copy of the floor plan attached ( required ) ? (4 Yes ( ) No
Is a copy of the site plan attached (required) ? (,) Yes () No
Application for an individual sewage disposal system is hereby submitted. The undersigned acknowledges that the above information is true and that false information will
invalidate the application and any subsequent permit. Issuance of the permit does not imply the approval of any other permit required for construction pursuant to Pitkin County
codes. No construction may be undertaken until all appp/rro'''�vaals and permits have been obtained. The owner assumes all responsibilities in case of failure or inadequacy of this
system.
�C'11
L� Date � �✓ � `�'
Signature of applicant
For department use below
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PERMIT FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM
Design Criteria of system to ue nraranc� �„y�� • - -- feet
Perc Rate /& min per inch Profile Hole: Depth to bedrock/groundwater
Septic tank capacity: p jlI _
gallons Absorption area: sq. ft. X
Ns ;.s do tcda,fiz-1 40 6Gq 2Xi3fi`n j 5e -eh -c- i -Sh�ic . I4 /Do0 qa1 w�64cl 5e fb'c- �,1r-
5ito,ld k added be4teei 441c. /iousL d txl.5finJ fun iaoo -�{'' o� lea' rs &I sf{�
50 x--24 ffy kU>t he crit kJ -6 41- -k-ei)d S 0h+ch ;s °75 /trcutl �ut. V 1s n-cryM#YA j Hca#
p;et- % gr"e.l be u5edf0dw Gic&1t wha- is 4hire. INo Ireack- (An be .ion 6r- A&n Ivo k. F.
�e tics AW_S CteLin44,19c)e- 4 xdv-d cku� ,' �dt act 4I a ck��•-1tt¢,t +� �ItLSe
An inspection is required prior to backfill of any component of the distribution system.
Design 9 q
n b Engineer Re uired ? ( ) Yes (O No All plans and specifications of the engineer must be followed. Any changes must be approved in
writing and the engineer must certify the final installation ttoo the Environmental Health Department in writing. r' /
Permit approval by: ?� Z' I" Date 10
( Plans and specifications of the proposed individual sew. a disposa system have been reviewed and are considered satisfactory. Permission is hereby granted to the owner or
the agent to perform the work indicated in accordance with the Pitkin County ISDS Regulation in effect at the time of issue. This permit becomes invalid 6 months from the date
that the permit was issued unless system construction has commenced or an extension has been approved in writing by the Department.
Installer: / r
As -Built drawings must be included with this permit before the final approval will be issued.
Receipt # Time Info Complete Site Plan �c�r� coa �v-/ ` 9(_
4- L Date received Permit issued Floor Plan r +
¢ (_Received by 4"7 Final Insp Requested Well Permit m
Letter
io -9- 4G: Date Info Complete S -4-91 Final Insp Completed _Water System
Final Inspection Approval:
Date: ArEno7res
require eA5 k Irtc�-
TABLE II
TABLE OF MINIMUM HORIZONTAL DISTANCES IN
FEET BETWEEN COMPONENTS OF A SEWAGE DISPOSAL SYSTEM _
AND PERTINENT PHYSICAL FEATURES
U
Spring, Wells, Suction
Drinking Water
Drinking Water
Dwelling
Property Lines, drain
lake, Water Course,
Dry
Septic
Lines
Supply
Supply Cistern
Occupied Building
tiles, Piped, Lined or
Irrigation Ditch or
Gulches
Tnrik
Line
intemuttent Irrigation
Stream
1
Di tch
Absorption Trench, Seepage Bed, Sand
(2)
(2)
Filter, Sub -surface Dispersal System, or
100
10
50
25
6
Drywell
(2)
25
25
20
Seepage Pit
100
50
25
20
25
(2)
50
(2)
25
6
2
Lined Evapotranspiration Field or Lined
10
25
10
5
Wastewater Pond
60
10
25
15
Unlined or Partially Lined
EvapotranspirationSystem Wastewater
100
10
25
15
Pond, or Surface Disposal System Other
(2)
25
25
15
than Aerosol
5
Lined Sand Filter
60
10
25
15
10
25
10
Unlined Sand Filter in Soil With a Perc
10
25
15
10
Rate Slower than 60 Minutes per Inch
100
25
25
15
.
2
Dispersal System Using Aerosol Method
100
(2)
25
(2)
10
10
2
10
50
125
10
Vault Privy
10
25
15
10
25
10
—
50
Septic Tanks, Treatment Plants, Dosing
(1)
10
10
50
10
y
Tanks, Vaults
50
25
5
Building Sewer or
Effluent Lines 1
50
10
25
0
10
50
10
U
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ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT
ISDS DESIGN REQUIREMENTS
DEPARTMENT USE ONLY
Salance
House Size 3300 (75 gpd, 100 gpd, or 130 gpd)
Number of Bedrooms, Lofts, Offices, Similar Rooms, Main House
Number of Bedrooms, Lofts, Offices, Similar Rooms, Caretaker unit
Average Daily Waste Flow 750 # bedrooms X 2 people/br X 75
State Review Required? no
Perc Rate 16.66 (T) ,
Design Flo w (Q) = # bedrooms X 2 people/bedroom X gpd X 1.75
Q= 1750
Absorption Area (A= Q/5 X SQRT)
A = 1428.583 sq. ft. of absorption area required
79 infiltrator units without reduction
Aaximum 30% reduc 's owed for use of deep gravel or gravelless chambered system.
iQpD-008 sq.ft. with reductio
56 in i trator units i ith reduction
Permit #
Parcel ID #
100
5
Type of system: []Absorption trenches []Absorption bed [] Gravelless chambers
[]Dry well []Seepage Pit []Pumping Chamber
Is an Engineer -Designed System required? no
yes reason:
deeMinimum tank capacity 2000 gallons f t
auc( wow -&Id no's`
64�add a�
SETBACK FROM WEL
# of feet 16d aJdA, iiCnaA L(CtA �jj j
= �
Remember: 8 feet of additional distance for each 100 gallons/day of design flow over 1,000 gallons/day
should be added unless an RPE can verify that it is not necessary to prevent contamination.
1 000
(-ZOO
100c) 96cl iut(L
APPROVED FOR ISSUE BY:
SYSTEM INSTALLED BY:
DATE OF FINAL INSPECTION REQUEST:
FINAL INSPECTION BY:
Printed on Recycled Paper
DATE:
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