HomeMy WebLinkAboutpitkin.eh.264916101017 (1985)V
ASPEN40PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
•INDIVIDUAL SEWAGE DISPOSAL PERMIT NO.O
TYPE OF PERMIT:
( )Initial Construction ( )Emergency Use(Repair Work,(Piovious Permit 1 NU N IE .) ( )Alteration of an existing system,
or installation FOUf�D (Previous Permit 1 )
f lUse Permit as a result of Rrlw ( )nthnrt
ISSUED TO: DATE OF ISSUE. U-122-95
Owner s (;, 67YDE Home
Mailing n �% /�
Address 0I).S &Y'TAL- �1&-LE' (�Ak6bA
Agent _ ��(j
Address OF peke - OP -1 &YSTAL-Akdt-C
Sewage Disposal System Work to be performed by Rig C Wj( i. XMVATI0
This permit valid only for premises location by the following leg
lal/`�dencription: �2�'�yj"jq(rivljj��(J[�T/C�F f�T�
LOT StZE� �'I
t C9C—orWATER SUPPLY `)(�8�� 1/(SJON 9peIN6 , AVERAr E PERCOLATION RATF. 30 MIn1JTESl1JCN,
Phone G3-3.54 Business Phone
0ALt
23
Phone
This Individual Sewage Disposal Permit is granted with regard to the following use:
Neral-zr of: Dodreoms _ 2 Lofts V Garbage Disposals_ V Dishwashers Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD � � GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Tye of Tank or Treatment Unit, SEP-rjC o/ jr- _ Tank Capacity /5-a _Callon Minimus
Cr_thod of Final Disposal, SEEPAGE-• BQD Absorptioa. Area ��� Square Feat Minimum
Jcser:pti.on (including brand name, if any) of other equipment or•appurtnancest
Cther Conditions or Specifications,
STACES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: '
( )Defore Excavation ( )Upon completion of excavation and prior to placement of gravelj� Hef..re covering distribution
`system of absorption field
0�;'rior to backfill of any component ( 10ther, Specifyt
Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Permis.-O.on
is hereby granted to the owner or his agent to perforn the work, indicated above in accordance with the Pitkin County Individual
Scwa ,e Disposal Re-iulations in effect on the date of issue. In addition to general provisions act forth on the reverse her -:!0f,
this Permit
is
suhject to the following additional terns and conditions: IVOA)e
APPROVED FOR ISSUE BY /, (title)
The above in:iividual sevago disposal system Installed by 610,HbRO XcAvx "t"
has b, -en i.j:-.prctcd for use by a representative of the Aspen I'1t in Lnvironr,�•ntal llcaltWi Deparunent. The ownur assunoa all
recponsibility in case of failure or inadequacy of this sewage disposal system. Complete ns -built drawing attached.
DATE OF FINAL INSPEC ION I2_
_ r t
BY : T T'L —
130 Sou a ens reet , C=IorildtrB�
ASPEN*PITKIN
ENVIRONMENTAL HEALTH .DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
Name of OWNER PHONE
Address of OWNER �/ � �� / 5 A
Name of APPLICANT PHONE
0'
PER.MfT TO BE: II)Picked Up ( )Mailed tos TYPE of PERMIT: (7)New Installation Repair
( jowner ( )Applicant ( )Emergency use ( )Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEMS
Legal Description
Lot O Block Filing Subdivision&y"SIALJLtYE d4WM/9i ire of Lot 2--t- acres
TYPE OF STRUCTURE: (V)Single Family Dwelling ( )Other: Do you plan any further ayditions to the
residence? ( )YES ( NO
No, of bedrooms 2,-' No_ of Lofts_ No. of Garbage Disposals _119eit No: of Automatic Dishwashers
No. of Automatic Clothes washers ( JJ((((�� C/n� ' �y�C
RATER SUPPLY: ( ! rivate well, Depth or Public, Name of System ���_ ll(I�ERy��a / V'TMF5
(Vlspring
( )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 ( )Others
The initial site inspection rust 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 disp,s 1 permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false infoa ion wi inv li ate the application and any subsequent permit.
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.
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 unde/{rssjigned hereby acknowledges receipt of this individual sewage disposal permit Application and a permit feei in the amount
Of $ dV Receipt Number , Date Fee Received DY
Administrative officer
130 South Galena Street Aspen, Colorado B1611 303/S25-2020
� $ "OF 6y2AAL
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