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Home My WebLink Aboutpitkin.eh.264504303002 (1992)w�rr�r ASPEN*PITKIN ENVIR MENTAL HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. q20" 2 27 TYPE OF PERMIT: (%Initial Construction ( )Emergancy Use ( )Repair Work,(Pievious Permit 1 .) ( )Alteration of an existing system, lar installation ( )Use Permit as a result of Sale ( )Other: ISSUED TO: Owner_L Mailing Address (Previous Permit i DATE OF ISSUE•. �—- 676 Home Phone Business Phone 1 Z-0 ' -5-7-3 S Agent Phone `Va�� Mailing Address ,, Sewage Disposal System Work to be performed by ,- ! SCA) & Tf/1VQV1A1,- This permit valid only for premises location by tho-following legal descriptionsLIZZ&OFILACI LTIL&C ��. LOT SIZE AC4" WATER SUPPLY SQ19PIVISIDNI l�(��U.�, AVERAGE PERCOLATION RATE 14 'e This Individual Sewage Disposal Permit is granted with regard to the following use: �/ %F ly la r.�iy Nutabor of Dedicoms 3 Lofts Garbage Disposals_ � Dishwashers � Clothes Washers % CALCULATED AVERAGE DAILY WASTE LOAD -0 GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PEFJ1IT: .'ypo of Tank or Treatment Units ' r/e% A Tank Capacity Gallon Minimum 4tthod of Final Disposals 5:E eA (;� C--- &e C) Absorptiop Area Square Feet Min.iraum )escription (including brand name, if any) of other equipment or appurtnancess 4�N� 9 Other Conditions or Spccificationes V � of .TiJF1L'74AToe 4ZCA VEE -Ess CP,"71q,8CR S (72-o 1-5 Q- 1t11AJJ,4jj1M STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Before Excavation ( )Upon completion of excavation and prior to placement of gravelefore covering distribution ystem of absorption field ad )Prior to backfill of any component ( )other, Specifys Plans and specifications of the proposed sewage disposal system have been reviewed and are ecnsidcred satisfactory. Permission is hcrcL-y granted to the owner or his agenr to perform the work ind,cated above in a_cordaacc with the Pitkin County Indivi,',ual Sewa;e Dispcsal Revelations in effect on the date of issue. In addition to general provisions set forth on the reverse hereof, this Permit is suhject to the following additional terms and conditions: „ Aspen/Pitkin Environmental APPROVED FOR ISSUE BY � (title) Health Officer Tile alxsve in:iividual sovago disposal system installed by s,0&A &1W_ r�Wq,11 10 hsr:e. s ben inpccted for use by a reprsentative of the Anpon F—lixIn Environr�•nta PTA t,. Department. Th.r uwnnr aseumos a 1 rec:ponsibilrly in ccse of failure or inadequacy of th u s7;�: posal system. Complete as -Guilt drawing attached. DATE 0 FIN INSPE Aspen/Pitkin Environmental BYTITLE Health Officer 130 South Galena Street Aspen, Colorado 81611 303/920-SO70 recycled paper ' ASPEN40PITKIN ' ENVIRbIVMENTAL HEALTH DEPARTMENT t APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT Name of OWNERPHONE Zi `� (0 - Address of OWNER o OC. - A` S000w s�• Name of APPLICANT PHONE a2� -`� t laC� PERMIT TO BE: ( )Picked Up ( )Nailed to: TYPE OF PERMIT: �4,New Installation ( )Repair ( )'Owner ( )Applicant .( )Emergency Use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEMS Legal Description Lot Block Filing subdivision Li'}��`2�-CSize of Lot -1 •?f—acres TYPE'OF STRUCTURE: (,fSingle Family Dwelling ( )Other: Do you plan any further additions to the residence? ( )YES (`1N0 { No. of bedrooms No. of Lofts No. of Garbage Disposals d- No. of Automatic Dishwashers No. of Automatic Clothes Washers I�— �\`�� WATER SUPPLY: ( )Private Well, Depth or ( )Public, Name of System T114 ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAC:E 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.) 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. The undersigned acknowledges that the above information is true and that false information will invalidate the application and any subsequent permit. Signature of Applicant -)L`A•A,�� •�� DATE '31 • 7 (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. 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. The undersigned hereby acknowledges receipt of this individual sewage disposal permit application and a mit fee in he amour. O! S ,iZr, Receipt Number d L%Ci 3 . Date Fee Received '�t �`T , •by Administrat_ o Officcr 130 South Galena Street Aspen, Colorado 81611 303/920-8070 JIv SL QQ• 43Q'Z, Q r> ♦� p I 10, �, 0 N s Al Y G o. D laaysta�k La�� c- '� S �1 - Sun��n i`e.S1C��,Y1C� SUbdiv %s ian —6 ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTINT FIELD TEST DATA SHEET ON PERCOLATION TEST Legal description: /-0-F 7-7- Address of Property: Name of Owner: w -- Address: (# & st. / p.o. box) (city) (state) (zip) Name of Agent: Lot Area: Water Supply:Public Utility Subdivision_ Private W611 Other Distance to Nearest Surface Water Dates Observations Made: Soil Borings: by Percolation Tests: L by n) SOIL.BORING TESTS PERCOLATION TESTS Total Observed Depth Estimated Depth Character 'Depth to Groundwater to Groundwater of Soils Depth of Water (left after 8 hr. presoak) al -4 PERCOLATION TESTS Rate P-1 Rate P-2 Rate P-3 AVERAGE RATE: 1,2/zinutes/inch Plan of the site and location of test holes on the back Comments on Soil or Site: Date -4 1 112" Signature 930 South Galena Street Aspen, Colorado 81611 303/920-5070 . , I,H -1111 I P-1 P-2 P-3 Depth SEMI Diameter Depth of Water (left after 8 hr. presoak) Rate P-1 Rate P-2 Rate P-3 AVERAGE RATE: 1,2/zinutes/inch Plan of the site and location of test holes on the back Comments on Soil or Site: Date -4 1 112" Signature 930 South Galena Street Aspen, Colorado 81611 303/920-5070 . , I,H -1111 I SEMI Rate P-1 Rate P-2 Rate P-3 AVERAGE RATE: 1,2/zinutes/inch Plan of the site and location of test holes on the back Comments on Soil or Site: Date -4 1 112" Signature 930 South Galena Street Aspen, Colorado 81611 303/920-5070 . , I,H -1111 I