HomeMy WebLinkAboutpitkin.eh.264921200003 (1992)ASPEN4kPITKIN
ENVIRt-AMENTAL HEALTH DEPART ...+ENT 2214 QQ —oo3
INDIVIDUAL SEWAGE DISPOSAL PERMIT 'NO.�
TYPE OF PERMIT:
( )Initial Construction ( )Emergency Use XR-pair� Work,(Pievious Permit i�.? ( )Alteration of an existing system,
or installation (Previous Permit 1 .)
( )use Permit as a result of sale ( )Others
ISSUED TO: DATE OF ISSUE - J ��
Owner l RN � / Home
Mailin
Address ��� U (.-�L �ci VlertJ zj V a
Agent
Mailing
Address
iness Phone
Phone
Sewage Disposal System Work to be performed by /rte eX TAVA�RA/ C
This permit valid only for premises location by the following legal descriptions ��- Tlt'N'
LOT SIZE (�2 A" WATER SUPPLY iC �-� . AVERAc.r PritcoLITION PATF. 17
This Individual Sewage Disposal Permit is granted with regard to the following useslfu{G'L-r`��- ftr�IlL-
Nuraber oft bedrooms _ Lofts 6) Garbage DD,iLLsposal$ f / Dishwashers Clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD T� GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:.
epe of Tank or Treatment Units) r ���� C- �` tank. capacity V Callon minimum
=shod of Final Disposals 3-5oc-ri0"Ep Absorptiop . Area 1�f� square Feet minim .
ezcription (including bravVPJr
name. if any) of other equipment or appurtnancess
;thcr Conditions or Specificationst
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )before Excavation ( )upon completion of excavation and prior to placement of gravellsefore covering
of distribution
ystem
( Prior to backfill of any component ( lother, specify:
Plans and specifications of the proposed Sewage disposal system have been reviewed and are considered satisfactory. Permission
l.
is hereby granted to the owner or his aacnt to perform the work indicated above in accordance with the Pitkin Co.r.ty Indivi3va
Sewage Disposal Rcsulations in effect on the date of issue. In addition for eneral provisions set forth on the reverse her•,or,
this Permit is suhiect to Ole following additional terns and conditions: ► JI
APPROVED FOR ISSUE, BYA&3 (t i t le)MM
;Iw alxwc individual sc<ragc disposal aystca installed
the by
hes txen in::pected for use by a rcpresent.icive of the Asl:en I'itTin Lavironr�.'nW Nealf.. Orp.<runcnt. Th.e swear attached.
a 1
rc:;ponsibility in c.:ne of failure or inad,-quacy of thio rcwa,le disposal system. Complete ax -Lunt dr wing attnchod.
DATE OF FINAL INSPECTION 12-/3")
2 _
BY: /��'�.�7 �G�y2 TITLE
a�
130 South Galena Street Aspen, Colorado 81611 303/920-6070
El
r
,.s
S
N
ASPEN*PITKIN
ENVIAMENTAL HEALTH DEPARTNIENT
FIELD TEST DATA SHEET ON PERCOLATION TEST
Legal description: TAT 14 C�"T P�I� 12��s '-eez
Address of Property:
Name of Owner: U- /-1
Address: ;2'SU43(941CN ✓i e- W A 1/6 4c .ti po �' Nis Co
(# & sty,/ o. box) city) (state) (zip
Name of A§ent : S ! M 1-w -Lis — IJEWAAtr `T -EW /�%Ff I T -
Lot Area: l79 -Water Supply:Public Uti 'ty Subdivision
Private Well Other 113
Distance to Nearest Surface Water 9n J Type ' (S-rAL IVC9,
Dates Observations Made: Soil Borings: l;? 03Ay� by
Percolation Tests: lZ 2 -_W2 -by
SOIL BORING TESTS
PERCOLATION TESTS
Total
Observed Depth
Estimated Depth
Character
Diameter
Depth
to Groundwater
to Groundwater
of Soils
j -Y4
/
S'AmDy �3/c- a'
183 t'c
PERCOLATION TESTS
MMIN-1
P-1 P-2 P-3
Depth
` 0
Diameter
12` -7x\-
Depth of Water
(left after 8 hr. presoak)
MMIN-1
Is
MEW
ISAMIM
wad,111
MINA
Rate P-1 1— Rate P-2 It Rate P-3
AVERAGE RATE: � �inutes/inch
Plan of the site and location of test holes on the back
Comments on Soil or Site: 2
D.
%J
Date 3 r✓'` Signature
Robert F. Nelson
Aspen/Pitkin Environmental
Health Officer
130 South Galen -Street Aspen, Colorado 81611 303/920-5070
recycled paper
• ASPEN+PITKIN
ENVIRU%%IMENTAL HEALTH DEPARTI'CiENT
t
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL- PERMIT
Name of OWNER_ PHONE rII„�-.5��1 3
—
Address of OWNER _ G,��, 11;e1i dye as halo. 5 6 s, 84941
Name of APPLICANTdG,rccrr,r%f''�NG ,ySR,f,11-PHONE
�arb�rynda/c Eta r3/G�.�
IrRMft To BE: ( )Picked tip (aj;x sled totem� 27PE OF PERMITS ( )New Installation ( it
(d&ner ofippiicant . 1 )rergency Use ( )Alteration NOT due .to failure
:ACATION OF PROPOSED SYSTEM:
regal, Description
rot Blocriling Subdivision sire of Lot _acres
Block
typlCor rmuc URE: (,4�jj'ngle Family Dwelling (')Others Do you plan any furthera tions to the
residence? . ( )YE? _ (
No. e! Garbage Disposals () No: of Aatoamtie Dishwashers
to. Of bedrooms,_ No. of Lottsa—
Mo. of Automatic Clothes Washers I
LATER SUPPLY: (IjPiiw to Wall, Depth 6j S�Or (YPublie, Name of System
( )Spring
( )Stream or Creek
TYPES OF SNDIVIDUNL_SENwArE DIsPOsAL sYsTEM PROPOsm '
(.)Septic Tank/Absorption-Field ( )Aeration plant/Absorption rield ( )Composting Toilet ( )Incineration Toilet )Bound
(')Recycling. potable use ( )Recycling, other use ( )Vault Privy ( )Other:
The -initial site inspection Bust be arranged with the Aspen/Pitkin.Environmental Health Department /92s-2020. 8:10-9:30 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 TME SYSTEM.
Application for an individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false inff tion will invalidate the application/and any subsequent permit.
p
Signature of Applicant
i� (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, here by acknowledges receipt of this individual sewage disposal permit ap--6)Z—,.
ication and ape! n+ittfe in the am -W11
If S C' , Receipt Number 1l , Date Fee Received Ja ` j Z"� •by
Administrativo officer
130 South Galena Street Aspen, Colorado 81611 303/920-8070
f
s � r/ C FiGC TG 4'cA
8
0,5 ` 4'roin we l% 7-c) s-epi?'C a
pry 5T -
h",Vs-e
To 53 c- i )' c %<
�r well
>>
r
kvA
j05 >>
,>
>>
►� r v r
e
Lv
vel
t%
7ep C.4 "-4
ex;s-livv
:/t>: well i -c; Acs; r;r
1A 6' -'ro? �e e
9
D -C 4? 1, 'vm L r��
d we I pj/
_
l� % car jer� o
c r c eA
►
1
1 p��! dr J,5
pry 5T -
m•.
• • , rl
Y rr. :L ;.
M c 0, is
M G •,., , ., n'i1
Al T1.47,
raw G• T. • . • . ';Z';•
r, .� �,• . v„ qk O
.n
O "*1
8 8
o
-o
::0A
0 0 D
N
rn m
r'1 N
D m
RbW
•'r M Ml ' 1.'
ft
�••�.:� c:a+:,,a,y rte: S�.u.R�rca
y
n y jig Y I � 3 ,, i . r. i M 1� 1 t f t r•' r. ;•:.s`�. ��i
A ' g A " � 1't � t . I.1,k;1��`.n.�,"'�`�7'��i �J�;,�'7,(YIjr}•-�y4�(