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Home My WebLink Aboutpitkin.eh.272909202001 (1983)-09.1 -'aa -t0 I ASPEN#PITKIN ENVIRONMENTAL HEALTH TMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use Q )Repair Work,(Pievicus Permit 1 .) XAIteration of an existing s) M. or installation (Previous Permit 1 _ /i{ .) ( )Use Permit as a result of Sale ( )Others ISSUED TO: DATE OF ISSUE•. Owner Home Mailing �J Address blq_ ('fit' �7L(tl y 133 i A Agent NaKie Phone Mailing Address Sewage Disposal System Work to be performed by �'j(,t/&_64/ t�)LL� � This permit valid only for premises )oeation by the following legal doucriptiont at.+V Jpt"Sc- SF AAOVC# LOT SIZE '10 �(�� WATER SUPPLY J/'r��/�/� AVERAGE PERCOLATION RATE. S This Individual Sewage Disposal Permit is granted with regard to the following usee 91WA&C C. t�/�M�L r C.'sG Nutaber oft Dodicoms _-3— Lofts Q Garbage Disposals_ ® Dishwashers— —_ ,/ Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD —q50- GALLONS. s - THE NATURE OF THE SYSTEM INCLUDED J UNDER THIS PERMIT: Type of Tank or Treatment Units 5 FPr#c AAJK_ Tank. Capaci /Callon Minimum Method of Final Disposals SeeeAG E k7E b Absorptioa. Area Square Feet Minimum Description (including brand name, if any) of other equipment or'appurtnancess A10A1E _ ..Other Conditions or Specificationes STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ' (ADefore Excavation Upon completion of excavation and prior to placement of gravel X Before covering distribution ��// \, system of absorption field ( )Prior to backfill of any component ( )Other, Specifyt AId A // e Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Permiss).on is hereby granted to the. owner or his agent to perform the work indicated above in accordance with the Pitkin County Individual Sewage Disposal Rc•ntlations in effect on the date of issue. In add/{� �sition ;; r 1 provisions act forth on the reverse hereof, this Permit is sutject to Use following additional terms and conditions 'r r APPROVED FOR ISSUE BY / (title) i The above individual sewage disposal system installed by i has txcn in:spcctcd for use by a representative of the Aspen llttcin L'nvironm.:nta )icalth Deparuncnt. TRO ownor asnumos all runponsibility in case of failure or inadequacy of thio sewage disposal system. Complete as -built drawing attached. t DATE OF FINAL INSPECTI N % ' I BY: TITLE i 130 South Galena Street Aspen, Colorado 81611 � 303/925-2020 fo 00"-A ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER _/�% 1� j��C�/� PHONE�� Address of OWNER,% �%7 T{�% .- �� Cf1�6,I) 1`� LI//a Name of APPLICANT T/.•G.�G,�i'� PHONE . _ C"'7� ^f"� PERMIT To BE: (�')Yicked Up ( )Nailed tot TYPE OF PERMIT: ( )New Installation ( )Repair 6-fowner (l,�Applieant ( )Emergency Use (Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM: Legal Description . l ! LZ /) 16 C7�� ' l.) �� V f C_� 6 i Lot Block_ Filing subdivision Size of Lot ,/, acres OF STRUCTURE: (6 -)Single Family Dwelling ( )Other: Do you plan any further additions to the TYPE residence? ( )YES (G NO No. of bedrooms 7 No. at Lofts_ L - No. of Garbage Disposals Li No: of Automatic Dishwashers —� No. of Automatic Clothes Washe:•s / WATER SUPPLY: ( )Private Well, Depth or ( TPub11e, Name of System tA— Spri::9 trcam 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 PORTION OF THE SYSTEM. Application for an individual sewage disposal permit is hereby submitted. The undersigned acknowledges that the above information is true and that false informatipn will invalidate th / pp l io) and any subsequent permit. Signature of Applicant 4�•.�� / �i �: % LG_L DATE 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 hereby acknowledges receipt of this individual sewage disposal permit application and a permit fee in the amount of i , Receipt Number Date Fee Received r- by Administrativo Officer NOT PCI 130 South Galena Street Aspen, . Colorado 9`9611 303/S25-2020 PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER ///" PHONE MAILING ADDRESS LEGAL DESCRIPTION OF PROPERTY LOCATION OF TEST HOLES ° E. Three (3) test holes required per system AK Test Hole Depths (24" minimum) Diameter of Test Holes Water remaining after 8 hour soak TEST HOLE No.1 TEST HOLE No. 2 TEST HOLE No. 3 �3 1 L - Drop Time Drop Time Drop Time 5 zv - 5 _1b 7 _ Percolation Rate Each Hole Average Rate ' Comments on soil or site: Signature Date f ys-rpL /'IVES Sem C LO-T- $roLti