HomeMy WebLinkAboutpitkin.eh.264932100019 (1977) Upper Houseti a6 0-32(—ne-oia
PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER
Owner A 6AIFCZAICI�JF7741-- Y
DU6AJ"Ad S75%.�la
Owner's Mailing Address
If
Address l E-3 I116t t W Y l 3 3,
System's Contractor's Name 5S
Address
Legal Description
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RECEIPT NUMBER 4C4 i2 /P—
Phone No.
Phone No.
A)D 200 / _�—>
OF 4T"Pm.
Lot Size/ AC,�s Type of Building by Use
Number of Bedrooms 3 Type of Water Supply
Owner's Signature Date Zo,� /-
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System F SC MAIK -2C IF" 2 /J>`lJ
Type of Soil or Soil Classification L,410 7-0 6q i
Proximal Location of Bedrock Q / e!5'M1A14FZ2 F�
Proximal Location of Ground Water Table % YD %E-�. � e� 7 .> F
Percolation Test Date Q � 7\ � — O Minutes Per Inch
Minimum Recommended Absorption System Size D ()-
Minimum
Minimum Recommended Tank Size �/1000 -1/4LOIZ\
Special Conditions of Issue: NOTICE properly signed for issuance, this application
/046—
bcomes your permit. Application valid one year from
/}\ date. If an individual sewage disposal permit is issued
for property on which no building permit has been
issued, the individual sewage disposal permit shall
expire 120 days after its issuance If construction has
not been commenced. Any change in plans or speci-
fications after the permit has been issued invalidates
the permit, unless approval is secured from the Health
Officer for such changes.
Approved for Issuance By
� Date Z °(
FINAL INSPECTION APPROVAL ate
(Drawing of System on Back)
318
A-1000
1006 GA«.Onl
COPELAAO" CbW- a*7E' SEMC Z
lot
i STOky W H ire
S~tueeo Houst"-
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER t�eZLPHONE
MAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 24 hour soak
C'
TEST HOLE No.1
TEST HOLE No. 2
TEST HOLE No. 3
DropTime
, -6".
Drop Time
; 0 L
Drop Time
1 2.
�e2 3Zz
z
Percolation Rate Each Hole
Average Rate 1-2,—
Comments
'Y
Comments on soil or site:
Signature
,
Date �� : -�
0
130 S. Galena BUILDING PERMIT APPLICATION
Aspen, CO 81611 ASPEN*PITKIN REGIONAL BUILDING DEPARTMENT
303/920-5440 PITKIN COUNTY CITY OF ASPEN ❑
Applicant to complete numbered spaces only. No.
General
Construction
Permit
C'
I o
JOB ADDRESS
AS
LEGAL LOT NO.
c� �Dp�, Z 1` BLOCK TRACT OR SUBDIVISION f S A ACHED SHEET)
2 DESC. See / /So
OWNER MAIL ADDRESS ZIP PHONE
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
4.
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
ENGINEER j J j / MAIL ADDRESS PHONE LICENSE NO.
6. I
CLASS OF WORK:
❑ NEW XADDITION ❑ ALTERATION ❑ REPAIR El
SOLAR FOOTAGE
2(X-'
ZONING FEE
I
CENSUS CODE
7
FIRE MARSHAL
8. !
SPRINKLER
USE OF OF BUILDING
u(. / ✓1��
OTHER
PLAN CHECK FEE
PERMIT FEE
3% USE TAX DEP.
VALUATION OF WORK
10. $/C/ ODD
Type of Construction
Occupancy Group
Lot Area
/_5`C3
` _ T
11. Remarks �Y t;
T / G
/ /, �1,.`T ,1
L ✓ ' ` `/V
Size of Building
(Total Square Ft.)
No. of Stories
Occ. Load
J � T
t�U OF BEDROOMS
Use Zone
111
� � _
Fire Sprinklers Required:
11 Yes C No
OIST1NG
OI
AD
��S
vne E C"
:' o -,r)
i "
6naj
v
No. welling Units
/
I
OFFSTREET PARKING SPACES:
C red /
&'
Uncovered ,
_
I / � � �
�-1616- A
L L
'.�V ISPECIAL
APPROVALS REQUIRED AUTHORIZED BY DATE
L�J�C ,+TK
_Z n
11017'92
Fixture Co t A% fu �? i •� l'C �1 �%'i
PRESUBMITTAL APPLICATION ACCEPTED PLANS CHECKED APPROVE C FOR ISSUANCE
BYDATE DI1TE DATE - DATE
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120/180 DAYS, OR IF CON-
STRUCTION OR WORK IS SUSPENDED OR ABANDONEDFOR A PERIOD
OF 120/180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND
KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND
ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH
WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF
ANY OTHER STATE OR LOCAL LAW RE TING CONSTRUCTION OR THE PER-
FORMANCE OFC PSTRUCTION.
SIGNATURE OF C ACTOR OF HORIZED NT (DATE)
StGNAT)RF OF r VNFR IIF O NFR Rk Ilt ['FR r —. t el
PARK DEDICATION
HEALTH DEPARTMENT
FIREPLACE
FIRE MARSHAL
SPRINKLER
WATER TAP
u(. / ✓1��
OTHER
SELECTION OF METHOD FOR PAYMENT OF USE TAX
C MONTHLY USE OF QUARTERLY RETURNS WILL BE SUBMITTED.
❑ DEPOSIT METHOD: 3% OF 25% OF PERMIT VALUATION PAID NOW
AT ISSUANCE. FINAL REPORT ON TOTAL ACTUAL MATERIALS
COST MUST BE FILED WITHIN 90 DAYS AFTER COMPLETION OF
WORK. GENERAL CONTRACTORS CHOOSING THIS METHOD
MUST REPORT AND REMIT TAX FOR ALL SUBCONTRACTORS
THAT DO NOT OBTAIN THEIR OWN PERMIT.
L, EXEMPT: STATE & PITKIN COUNTY RESALE NO.
EXEMPT ORGANIZATION
THIS FORM IS A PERMIT ONLY WHEN VALIDATED.
WORK STARTED WITHOUT PERMIT WILL BE DOUBLE FEE