HomeMy WebLinkAboutpitkin.eh.272904300008 (1986)0
ASPEN*PITKIN
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ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. O �8
TYPE OF PERMIT: ` ,
( )Initial Construction ( )Emergency Use (]� Repair Work,(Pievious Permit 1.? ( )Alteration of an existing system,
or installation / ` (Previous Permit i )
( )Use Permit as a result of Sale ( )Othors
ISSUED TO:
Owner & Q�ome
Mailing 1-5732q
�r-�� 11
Address 1 2q la aAY 133
Agent -1L
Ma il.ing
Address
DATE OF ISSUE.
Phone-T�� �G Business Phone
Sewage Disposal System Work to be performed by-'O'm Eie
This permit valid only for premises location by tho following legal descriptions TgAn /IJ cJt� /� J ✓V /rl v
LOT SIZE ACt2ES . WATER SUPPLY C C��. LL , AVERAGE PERC
�OL
LAATION RATE C
This Individual Sewaye Disposal Permit is granted with regard to the following uset�I LC F4114,, F E
}
Nuraber of: Dodreoms _2- Lofts_r_ Carbage Disposals Dishwashers^ Clothes Washors f_.
CALCULATED AVERAGE DAILY WASTE LOAD CALLONS.
THE NATURE OF THE SYSTEM INCLUDED
UNDER THIS PERMIT:
Type of lank or Treatment Units -P T/ e 'r��L`— Tank Capacity _Callon Minimum
Mcthod of Final Disposals �CPACc 2ED. Absorptiop.Areaa MIN) Square Feat Minimum
Description (including brand name, if any) of other equipment or,appurtnancess CV Cv SA W Talc H Es OsE)
b "A,' L
Other Conditions or Specificationss
�J
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Before Excavation ( )Upon completion of excavation and prior to placement of gravelBefore covering distribution
/ '\system of absorption field
KPrior to backfill of any component ( ;Other, Specifys
Plans \and specifications of the proposed sewage disposal system have been reviewed andare considered satisfactory. Pernission
i:r hereby granted to tt,e 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 set forth on the reverse her_ef,
this Permit is subject to the following additional terms and conditions:
APPROVED FOR ISSUE BY (title) U
i
The above individual sawago disposal system Installed by (WOE
has txen kn:rpected for use by a representative of the Aspen ;'it in L'nvironm.rnta Neal t. Dep•srtment, T o owner as�rurtws +
rc�ponsibility in case of failure or inadequacy of th se'ayo disposal system. Completo as -built drawing attached.
`DATE OF FINAL INSPECTION G
51x�
r
BY: !/� TITLE_iwL yti
�/7�130 South alenie Street/ ) spen, Colorado 9161'1 303/925-2020
oo - oo $'
ASPEN*PITKIN
ENVIRONMENTAL HEALTH. DEPARTMENT
APPLICATION FOR AN INDIVIDUAL/SEWAGE DISPOSAL•PERMIT
Name of OWNER 2-� NC- 00� lU�d2D /�/ �J,�PHONE�i
Address of OWNER 32 -
Name
Z
Name of APPLICANT
ALL /S PHONE
PERMIT TO BE: ( )Picked Upiled to: TYPE OF PERMIT: ( )New Installation �<11tlteration
epair
Xer
( )Applicant 1 )Emergency Use ( NOT due to failure
LOCATION OF PROPOSED SYSTEM;, D
Legal Description SE � /7 SfC1
Lot Block !filing Subdivision Size of Lot acres
TYPE'OF STRUCTURE:()Slagle Family Dwelling ( )Others Do you plan any further dditions to the
residence? ( )YES NO /
No. of bedrooms_ No. of Lofts_ No. of Garbage Disposals 0 No: of Automatic Dishwashers
No. of Automatic Clothes washers
NATER SUPPLY:Private well, Depth li or ( )Public, Name of System
NSpring
( )stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Hound
(')Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Other:
The initial site inspection must be arianged with the Aspen/Pitkin Environmental Health Department (925-2020. 9:30-9:30 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 disposa permit is hereby submitted. The undersigned acknowledges that the above information
is true and that false in rmation w 1 in id he application and any subsequent z it
Signature of Applica 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 undersigne hereby acknowledges receipt of//this individual sewage disposal po t applign and ! Lee i the amount
a perm
r � 7 / 4 6 Data Fee Received by
of i� �J V , Receipt Number Administrative officer
130 South Galen( Street Aspen, Colorado 81611 303/925-2020
ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
FIELD TEST DATA SHEET
Legal decription:�-SEC 4- " 7—/o
Name of Owner: LIJO U
Address: 11.32-1 9WY(� l/
(# & st. / p.o. box) (city) state) (zip)
Name of Agent: S/% 01.w i—
Water Supply: Public Utility Subdivision Private Well
Lot Area: Distance to Nearest Surfac Water ft.
Dates Observations Made: Soil Borings: 12,,o by
Percolation Tes by
SOIL BORING TESTS
DEPT" TO [ROUND WATER. CECT :
TEST TOTAL O[P TM
NUIw •(R T[[T CN All AC TCR OF SOIL 'IT" TNTC RN [[• IN /[[T
ODIC -(D_ ESTIMATED NIGH
Si LT LOAM & 51c7'rRC0� ftAJJ9 f
B-1 Fr 20 T S14AJPY S/ c ' 40 2 C11EIJ-1E
�a B-2 #>
PERCOLATION TESTS
Average Rate: minutes/inch
Plan of the site on the back
Date Signature
806 NELSON
ASPEN/PITKIN
SANITARIAN
130 S. GALENA
ASPEN. CO 816 1 1
€11111101_.
NOEIw3 -WAT[w
TEST "ME
DROP IN WATER L[VEL. INCHES
MIN UTcf
TEST
"C".CHARACTER
OF SOIL
IN CC MOIs
IN MOLE
IN T[RYAL
TO FALL
SECOND TO
NEXT TO
LAST
N UM BERINCHCS
THICKNE33 IN INCHES
IST WET
OVCRHIGNT
M MINUTC
LAST •CR100
LAST PERIOD
•CR100
ONE INW
_,
6I4YWAA1
l2-
71
P-1
is SAao
ac)
P-3
P-4
Average Rate: minutes/inch
Plan of the site on the back
Date Signature
806 NELSON
ASPEN/PITKIN
SANITARIAN
130 S. GALENA
ASPEN. CO 816 1 1
4
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