Loading...
HomeMy WebLinkAboutpitkin.eh.264505404005 (1991)ASPEN#PITKIN y U — (4 -.5 ENVIRGn%IMENTAL HEALTH DEPARTQENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. TYPE OF PERMIT: XInitial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit 1 .) ( )Alteration of an existing system, or installation (Previous Permit I ) ( )Use Permit as a result of Sale ( )Other: ISSUED TO: DATE OF ISSUE -9 Z6 1 12 Owner Mailing Address V)—_Z/Ni Business Agent /�C� be 06 Lj1AAkX Phone 2_,5-: Mailing Address Sewage Disposal System Work to be performed byAs&�bi fijwyms This permit valid only for premises location by the following legal /deevc Iptions 4cI LOT SIZE , WATER SUPPLY __<309 %S/0,(/..., AVERAGE PERCOLATION RATF. v This Individual Sewage Disposal Permit is granted with regard to the fol/lowing use: %Aj- /L1 Number oft Dedicoms -3 Lofts _ Garbage Disposals_ / Dishwashers Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD 11: ( GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: ypn of Tank or Treatment Units SeF3r/c-_T4 AJK Tank.Capacity /Moll Callon Minimus et -hod of Final Disposals�2e'�(`` //](��'HCS Absorptioa Area l Square Feet Minimum escription (including brand name, if any) of other equipment or appurtnancess )they Condition! or Specificationsti �� T �l ii©v/��itlf�L �L��-�� fi /��G���1� �II�J' /,ST�IL� 500 C'A-ZWA13�A)K AID 25-0 SQ , -r, Dr 746I -1 7_0��io�0 STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Before ExcavationUpon completion of excavation and prior to placement of gravelAsystein efore covering distribution // of absorption fi4.ld !(r'}Prior to backfill of any component ( )Other, Specifyi Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Pernission is hereby granted to the owner or his agent to perform the work, indicated above in a_cordanee with the Pitkin County Indivival Sewap, Disposal Revelations in effect on the dote of issue. In addition to general provisions set forth on the reverse Ler-^_ei, this Permit is suhject to the following additional terns and conditions: APPROVED FOR ISSUE BY / (title)& 4) The aixive individual sewaga disposal system inatalled by 5PeAJ �'`� /19Vlk(a _• has b, -en in:pccted for use by a representative of the Aspe tin Pit in Lnvironrta t. lies . Dcparun<vrt. The uwnor assurnos a. reoPonsibility in case of failure or inadequacy of tth�iu sewage disposal ao�stem. Completo a% -built drawing attached. DATE OF INAL IN'PE T N ��=—%c10 q Aspen/Pitkin Environmental &°�: °iATITLE Health Officer 130 South Galena Street Aspen, Colorado 81611 303/920-6070 ASPEN#PITKIN ENVIR%-AMENTAL HEALTH DEPARI o0ENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT Name of OWNER JG��'^^'1""'` PHONE �aJ ' RG�Qa Address of OWNER `-/*) Name of APPLICANT PERMf� T TO BE: P) Picked Up • $XMailed to: . ( )Owner ( )Applicant , c JJ4 PHONE F1-6-061 TYPE OF PERMIT: OJ New Installation ( )Repair 1 )Emergency Use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM Q Legal Description C� _ ` ��'^�"` '• Lot Block Filing Subdivision Size of Lotits—_ecres TYPE OF STRUCTURE: ()dSingle Family Dwelling ( )Other: t' C„ Wkt- /.Y. f" Do you plan any further additions to the —J residence? ( )YES ( )NO No. of bedrooms_ No. of Lofts C No, of Garbage Disposals No: of Automatic Dishwashers No. of Automatic Clothes Washers A' WATER SUPPLY: ( !Private well, Depth or ( )Public, Name of System /K w - r )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAnE 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 MU T BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION OF THE SYSTEM. Application for an indivi sew"e al permit is hereby submitted. Theunderaign d a.knowledges that the above information is true and that false i atjk w validate the application and any aubaequent Signature of Applicant /(//l(// DATE (This application becomes. invalid 1 mo 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. 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 9ta (application and a permit fee in the amour. of $ ��y,�� Receipt Number 4G Date Fee Received ' by Admintrativo Officer 130 South Galena Street Aspen, Colorado 81611 303/920-8070 Alo 77// u� P�3 �l aP-z 5 i L� �17k,e,ivl A WTI �WWN. W -mw� a P-1 N1Q P"3I P-3 � ���u—lz.00 %13`15 e--- ------------ Elf R s Lol G 1 .1