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HomeMy WebLinkAboutpitkin.eh.264517400001 (1992) Cabin BASPEN46PITKIN 26 %y—{)D—Oc)� ENVIROr (ENTAL HEALTH OEPARTr NT cflro ,� INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. 9207z__ TYPE OF PERMIT: ( Initial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit f r installation ( )Use Permit as a result of Sale ( )Othort ISSUED TO: Owner. Srya Mailing a, Address Agent,A MaiUng Address 72P �>J� DATE OF _.} ( )Alteration of an existing system, (Previous Permit 1 ISSUE `Home Phone Business Phone Z- 160 ` 7/ fl,DeS 1G11j C" LJ_' Phone 30.'2-% Sewage Disposal System Work to be performed by This permit valid only for premises location by the -following 1ega1 descriptions IeF6 ( LOT SIZE 5r / o A , WATER SUPPLY WeLL . AVERAGE PERCOLATIO4 RATE 3 M1 . e'A6w "A � % i1 .t This individual Sewage Disposal Permit is granted with regard to the following uses Number oft Dodicoms �^ Lofts C' Garbage Dispoossall$ l/ Dishwashers Q Clothes Washers d CALCULATED AVERAGE DAILY WASTE LOAD 2 — GALLoNs. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT: 1:--A of Tank or Treatment Unitt —qe /"/ (2 / �� Tank -Capacity Gallon Minim= t.hod of Final DisposaltAesooeA/Q geAI(44e-<' Absorptlop .Area Q Ca Square Fe<t Minimum -;cription (including brand name, if any) of other equipment or appurtnancess :ther Condition) or Specificationss7 0 )CE,O . 7 �'�l1lR�l� ft p �' s� - 7,-e� 0A -r5 STI�GES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: )Before Excavation Upon completion of excavation and prior to placement of gravel �eefore covering distribution / \ system of absorption field Prior to backfill of any component ( )Other, Specifyi _ Plans ani specifications of the proposed sewa(le disposal system have been reviewed and are considered satisfactory. Pernissi.on ix hereby granted to thfc Owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewa e Disposal Revulations in effect on the date of issue. In addition to general provisions act forth on the reverse her=oi, this Permit is sutject to tlje following additional terns anti nditions: Aspen/Pitkin Environmental ���® Health Officer . APPROVED FOR ISSUE BY F (title) r L-2fYiiv�. -711C. atxlve in:tividual xeaago disposal syiLc:n installed by — hns txcn lo::rcctcd fur use by a rcprescntative cf the Aspen i'tt.an t..V1r rn flta I. t.. neper n ot, Th.t u..•nor ur.0 a ni rv:a>ons:Lili(y in cele of failure or inad,-quacy of Chia/sewa'fe disposal system. Complete as- lit dr wing attached. DATE OF FINAL INSPECTION / 3 BY : T I T L EL�t,(, `� .� 130 South (3alena Street Aspen, Colorado 81611 303/S20-6070 e L,e ANOk-r iz I ,.. eAg�N r'g,r ti o ��/000 ��llbN NORA1ESCv PkASTIe. , /IV FI LTRr4- A- iQ -rAEA)eHe �¢ UNITS N eae+t-ZRCNeFi (�X�Xlk 7S = aaSAW . R�U�ecvR-y (Z�7RER-r N0Ksc 1CttaOj T 17' CoPEL-RNd 7-,IPK - /500-JIIA/ 0 3 �� sE ftS a Sgu.Tlc�a 8a� ro' T. 52 INFI�.-rRfFra/Z 1N 3-'Q,OAJe}lef / 5 aAsI-r s (�t2 'TRenle� ASPEN*PITKIN ENVIF NIMENTAL HEALTH HEPAR RENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT COHiC�' - Name of R .� �je4�4 bc � PHONE �27' Address of Name of APPLICANT �' U- U PERMIT TO BE: Picked Up ( )Nailed tot TYPE OF PERMIT: ( ]Owner ( )Applicant . IdCATION OF PROPOSED SYSTEMS Legal Description PHONE q Z -7 '' �2 ( New Installation ( )Repair l )Emergency use ( )Alteration NOT due to failure Lot Block filing / Subdivision Size of Lot acres TYPE'OF STRUCTURE: -( )Single Family Dwelling ( )Others[ 1 K Do you planani//further additions to the residence? (�YEs ( )NO No. of bedrooms No. of Lofts No. of Garbage Disposals © No: of Automatic Dishwashers No. of Automatic Clothes Washers WATER SUPPLY: ( )P vate wall. Depth or ( ,Public, Name of System Spring ( )Stream or Creek TYP&2 OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED, (0&ptic 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/PitkinEnvironmental 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 HE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION OF THE SYSTEM. Application for an individ se is sal permith.pplication hereby submitted. The undersigned acknowledges that the above information Is true and that false inf on 11 vali and any subsequenttj�permmiit:�9 Signature of Applicant e.C/L. 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. <. Proposed and existing buildings, driveways, and other strubtures. 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 permit fee in the amour. o! S Receipt Number Date Fee Received ,.by Administrative Officer 130 South Galena Street Aspen, --alorado 81611 303/920-E5070