HomeMy WebLinkAboutpitkin.eh.264929102009 (1987)TYPE OF PERMIT:
o ASPEN*PITKIN Z yll - a q i- C, a_ 009
ENVIFVMENTAL HEALTH DEPARTMENT2�(p
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO.
,(Initial Construction ( )Emergency Use
j� Ir installation
( )Use Permit as a result of Sale
ISSUED TO:
( )Repair Work,(Piovious Permit 10 ( )Alteration of an existing syutem,
(Previous Permit i )
( )Othort
DATE OF ISSUE.
Olrner �LJfjM��R/�.
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Address %/D$ Alnerk
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Address
Phone
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Sewage
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Sewage Disposal System Work to be performed by'"&M Lx -c--
This permit valid only for premises location by tho following legal de criptionS
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LOT SIZE 437.AUES , WATER SUPPLY s, 6QjV1g1olli_ AvERAar PERCOI.ATION RA' 7 N,
This individual -Sewage Disposal Permit is granted with regard to the following use:3 lid Gl E /lilLy S
Nutaber oft Dodicoms Lofts 0 ' Garbage Disposals_/*� Dishwashers! Clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD S&O GALLONS.
THE NATUF.E OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Type of Tank or Treatment Units sef-rjal IjrY Tank. Capacity 0 . _Gallon Mini..
Mcthod of Final Disp03als OCUPA &r Top Absorption Area Square Feat MinimumQ
Description (including brand name, if any) of other equipment or•appurtnaneoat ESC ` � riO'f.0
�} f35o2 PTionl f ll�Ei9 /('1 ]1ST .6E ,�S FT." �iPD/NJ /,OATER L- /t1 cam.
5��,es G�ia,er/E,e �o/SETS Mord/El-,f�TTfPL'fJ�y�
. Other Conditions or Spccificationst IVQ -DISPOSAL. •TD Be, S*TA1, ,GD Id +N00S�� �' s�$1/N6 7V/648
%4Bso9MIDW �rEs MAY BE 046C> �-U D Ori BSD JQ .F oto
STAGES REQUIRIN_ PPECTION BY THE HEALTH DEPARTMENT: �}SD
( )Defore Excavation (IR(Ipon completion of excavation and prior to placement of gravel `sr'Before covering distribution
,���� 7/' �� Ksystem of absorption field
�JQ Prior to backfill of any component ( ]Other, Specifyt
Plans and specifications of the proposed sewage disposal system have born reviewed and are considered satisfactory. Perninsi.on
is hereby gra:aed to tl,e owner or his agent to porform the work indicated above in accordance with the Pitkin County Indivi ijal
Srwa,;c Disposal Re,iulations in effect on the d:,tc of issue. In addition to gencral provisions set Corth on tt,r; reverse herzei,
this Pormit is subject to the following additional terms and conditions: _
APPROVED FOR ISSUE BY (title)
11•o attiive inaivldual scvago disposal system installed by 1✓1 QtCr✓�
i has brcn tn::pectcd for use_ by a rcpresentaeivc of the Anl:en t in zr:won:wn'a ttcalfS DeparUntnt. The „wnar as:ru:as 7af
rc wnsibilt!y in ccs-. of failure o; inad,-quacy of :is sewagea
diappsl ay -stem. Co ple!e Ax -built drawing a:tachod.
DATE 0' INAL INSP CTION�O
T I' LE
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130 f8oiith �Gailen . i.- PL et jt� Aspen, Colorado 81611 03/925-2020
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ASPEN*PITKIN
ENVIRLPNMENTAL HEALTH DEPARTnAENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT
I( - /p� ��Y '4z YPHONE�02—CJ�4 W3fa
Mame of OWNER � i � l ('� WI -vi • /1' �.a ( � m2_► BY E N�ff••t
Address of OWNER
Name of APPLICANT
PERMIT TO BE: ( )Picked Up ( )Nailed tot
( Towner Applicant
* F PROPOSED SYSTEM,
TYPE OF PERMIT: t"yNew Installation ( )Repair
(()Emergency Use ( )Alteration NOT due to failure
IpCA.ION O ,
Legal Description tr)
Lot Block Filing Subdivision Size of Lot _acres fi
TYPE OF STRUCTURE: (`,)Single Family Dwelling ( )Others Do you plan any further additions to the
residence? ( ) YES (;11) NO
No. of bedrooms No. of Lofts No. of Garbage Disposals No. of Automatic Dishwashers w
No. of Automatic Clothes Washers
WATER SUPPLY: ( )Private well, Depth or ( )Public, Name of System
(,))Spring .`� i F c is 4i !I O(%�.N, �� s5c%C 6Ci� '. CSG'( W\&- ,e v 7 4ti 15 "T i,�
I ( )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 ( )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 PORTIO`,
OF THE SYSTEM.
Application for an individual sewage disposal permit ia--ttereby aubmitted. The undersigned acknowledges that the above information
is true and that false information 'will invalidate t ppl tion and any subsequent permit.
Signature of Applicant %� s
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 undersigned hereby acknowledges receipt of this individual sewage disposal per/m�it appcl�ica on and a po f a the amount
of $ 2 S'f�- ` , Receipt Number , Date Fee Received V � / by
Administrativo officer
13p South Galena Street Aspen, Colorado 81611 303/925`2020
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TWAL BM
owners
manual
IMPORTANT
Read these instructions
thoroughly before
beginning work.
Save This Manual For
Future Reference
C
ALL CHINA
ONE-PIECE
WATERSAVER
TOILET
• Installation
• Adjusting
• Repair Parts
Sears, Roebuck and Co., Chicago, III. 60684 U.S.A.
AW
Save This Manual For
Future Reference
C
ALL CHINA
ONE-PIECE
WATERSAVER
TOILET
• Installation
• Adjusting
• Repair Parts
Sears, Roebuck and Co., Chicago, III. 60684 U.S.A.
#kSPEN#PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
FIELD TEST DATA SHEET
Legal decription: g
Name of Owner:
Address:
(# & St. / P.O. box)
Name of Agent:
(city)
! A
(state)
Water Supply: Public Utility Subdivision X Private Well
Lot Area: .3� A� Distance to Nearest S rface Waterft.
Dates Observations Made: Soil Borings: i by
Percolation Tests: by
SOIL BORING TESTS
DE.TH TD !ROUND
TEST 70 r•L DEPTH
W•TCA, FEET
CHARACTER OF !OIL WITH
7H IC RN [S! IH FK ET £,
y� NUMBER FEET D!S[IIV[D
7C2
ESTIMATED NIGH
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yk
LOQ M
U1/TH IG7-AG'
B -a
�K YA
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PERCOLATION TESTS
*3�
TE��VE�
HoyR3
WATER ZEST TIME TO TALL
DEPTRACTER Of 301E SING[ NO IN HOLE INTERVAL SECOND TO NEXT TO LAST
%XRME33 IN INCHES IST RCT OVERNIGHT N MINUTE LAST PERIOD LAlT PERIOD ICR100 ONC INCH
mi -Ong. \lad��/� b � 4a
YA LOIYA '' YA
Average Rate: .,)L7 minutes 1 ch
Plan of the site on
Date
' :r Signature
BM NELSON
ASPEN/PITKIN
SANITARIAN
130 S. GALENA
ASPEN, CO 81611
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<S EC 29J
O)c THE 6 TN. P. M.
PITKIN COUNTY, COLORADO
A tract of land situated in the S.E.y N.E.4 of section 29, Township 9 south, Range
88 west of the 6th Principal Meridian, lying between two, thirty foot road easements,
one being on the Westerly side, and one on the Easterly side, described as follows:
Beginning at a point on the Westerly line of said road easement whence the East
Quarter Corner of said section 29 bears S. 40° 47' 30" E. 1001.02 feet; thence
N: 720 20' 00" W. 172.36 feet to a point on the Easterly line of said road ease-
ment; thence N. 17° 40' 00" E. 105.44 feet along the Easterly line of said road
easement; thence S. 72° 20' 00" E. 131.12 feet to a point on the Westerly line of
said road easement; thence S. 03° 41' 43" E. 113.22 feet along the Westerly line
of said road easement to the point of beginning.
The above described tract of land contains 0.37 of an acre, more or less.
November 9, 1967
'1
CRegist ed Land Surveyor