HomeMy WebLinkAboutpitkin.eh.272917401003 (1993)C)/ --003
A �
ASPEN*PITKIN
ENVIR DI141VIE1 t4LIsNo ! AE �T�o DE ARS T�VIENT
TYPE OF PERMIT•
X.•)Initial Construction ( )Emergency Use ( )Repair Work,(Pcevious Permit 1 .) ( )Alteration of an existing system,
or installation (Previous Permit 1 )
( )Use Permit as a result of Sale ( )Othors
ISSUED TO: DATE OF ISSUE'M} 4`Z i"VZ Zq 3
(hwllerN-UelIA,'P— P/ f �'e�' Home Phone"?k3 %59y Business Phoneq& 3
Mailing
Address OGS 2Z AoWS:yyL e &p6
Agent SO— �� Phone
Ma i l.in g
Address
Sewage Disposal System Work to be performed by .SE L-�-
This permit a id only for premises )ocation by the following legal
deucriptionsL-j% !2y ,f%aCK/G
LOT S I2F. J WATER SUPPLY s Lj/vc --. ((ZU , AVERAGE PERCOLATION RATF.
This Individual Sewage Disposal Permit is granted with regard to the following use: S//tq�C� )�Ii'
Nutaber ofs Dodreoms 13 Lofts Garbage Disposals_ / Dishwashers^ Clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD GALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
Typa of Tank or Treatment Units S 'ep /rte- 7--?AoK— Tank Capacity (� 0 C) Gallon Hinimura
Mcthod of Final Gispo3als rf1.�F � �r Absorption Area ar %fir Square Feet Minimum
Je:cription (including brand name, if any) of other equipment orIappurtnancess
Other Condition! or Specificationss
-
7 Z� i�Z<fiGi7'e> r /ice rz CE�%c/ 6
STAGES REQUIRING INSPECTION BY THE HEALTH DEPAR'TPIENT: '
( )Before Excavation { )Upon completion of excavation and prior to pja_ement of gravel XBefore coverin•q distribution
system of absorption field
Prior to backfill of any component ( )Other, Specifys _
Plans and specifications of the proposed sewage disposal system have been reviewed and r.rn ecnsidered satisfactory. Perniss).on
is hereby grat:terl to tl.e owrer or his agenr to por£nrm the work indicated above in a_cordance with the Pitkin County lndivival
Sewa;e Disposal Re-nilations in effect on the date of issue. In addition to general provisions set forth on the reverse hereof,
this Permit is subject to the following additional terms and conditions:
APPROVED FOR ISSUE BY (title)�'C
The above individual sc•.fm)o disposal system installed by
has been in:tpcctcd for use by a representative of the Anpen Ilit in Lnviron;- nta lira t. Dep-trtmcTm
nt. he uwnur as!tuoa a
ruc;ponsibility in case of failure orl�inad"uacy of thin sewageLilispocal system. Completo as -built drawing attached.
d tL/1 `� i i1 �h.t M Q r� i (� bor, •yil+� — vim:
DATE OF FINAL INSPECTION 11-�� �(�, ti'^ k,-ri r'o
T I TL E C _a,,
130 South Galena Street Aspen, Colorado 81611 303/S25-2020
ASPEN*PITKIN
ENVIRONMENTAL HEALTH OEPARTENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT
Name of
OWNERA*�
Y I' `c(L-
PHONE
Address
of OWNER
0CZ--`Z-
1
ASPEN*PITKIN
ENVIRONMENTAL HEALTH OEPARTENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT
Name of
OWNERA*�
Y I' `c(L-
PHONE
Address
of OWNER
0CZ--`Z-
Name of APPLICANT 5q PHONE
'rfdtIT To 0 ( )Picked Up • f$( Kailed to: - TYPE OF PERMIT: (/y ew Installation ( )Repair
( )Owner ( )Applicant . 1 )Emergency Use ( )Alteration NOT due .to failure
regal Description �* S eC6tZ
:,ot S. Block riling Sub
ze of Lot acres
TYPE'OF STRUCTURE: Bingle Family Dwelling ( )Others Do you plan any further additions to the
residence?. ( )YES ( )NO
to. of bedrooms _ No• of Lofts No. df Garbage Disposals 3io: of :.utoastic Ciah::ashers
go. of Automatic Clothes washers
TATER SUPPLY: ( )Private Nell, Depth or (*Public. Name of System
( )Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SENACE DISPOSAL SYSTEM PROPOSED:
Septic Tank/Absorption Field ( )Aeratioa Plant/Absorption Field ( )Composting Toilet ( )IncinQlaLlOn Toilet ( )Mound
to�( )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 disposalTgreby submitted. The undersigned acknowledges that the above information
is true and that false o ion will inval lication and any subsequent permit. p
Signature of Applicant t/1 Ay"-�— DATEZ-
(This application becomes. invalid 12 months from the above date.)
OTE: PLOT PLAN must be filed with this application. SQ e'-
N _
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. ).r
<. 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 p�d(�f--!
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 rmit fee in th amour.
of S L 5(2 , Receipt Numbers ����_—� Date Fee Received ' -?-� -U-by
�. Administrati officer
130 South Galena Street Aspen, Colorado 81611 303/9130-6070
He
E
J
1-7,o
co
cd-rM '7A
P, IVe
-et
1000
i
i +
-ou
-r te, -7 tlw< 000 AA4—o A�
I- /.5 ? -Z�
---------- i—T-1
er I x—
Ii
�Ar '
7 Z°
100% recycled paper