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HomeMy WebLinkAboutpitkin.eh.272929201029 (1989)ASPEN*PITKIN ENVIRONMENTAL HEALTH OEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. n-00 TYPE OF PERMIT: Kirnitial Construction ( Mr-ergency Use ( )Repair Work,(Previous Permit / .) ( )Alteration of an existing system, installation (Previous Permit i ) ( )Use Permit as a result of sale ( )Others QCT ISSUED TO: DATE OF ISSUE �� t� / Ownerr� �'� �/Li1TN Home Phone�(3 10%�Business Mailing �/ Address QQSw eLK / kl ;z �ie/lf� f��-°l3nnl iJfIG , Agent U Address Phone Phone Sewage Disposal System Work to be performed by This permit valid only for premises location by tho following legal description: J L / v�,e LOT SIZE /7( IC WATER SUPPLYedSTOn/Ef��f�Eo AVERAGE PERCOLATION RATE 13 This Individual Sewage Disposal Permit is granted with regard to the following use: Ntuabcr oft Dodreoms Lofts C} Garbage Disposals_ a! Dishwashers- Clothes�vWWas/hors CALCULATED AVERAGE DAILY WASTE LOAD �!; ,� GALLONS. (2� cA45 . `r:% Mex THE NE ATU OF THE SYSTEM INCLUDED UNDER THIS PER 'M ` $� GAPS � Gl�� �»Tr�� Type of Tank or Treatment Units SEPTIe- 1AA114 Tank. Capacity _Callon Hinina:a Mcthod of Final Disp03alS Ae,5f9eP77Clul 1Ej&levtf-S Absorptiop Axe& 1440_ Square Feet Minimum 1 Description ( including brandnamn, if any) of other equipment or,appurtnancess F©g 13LACK. v)ATM a iS11M Other Condition! or Specificationst j��! �� r i 10 JAI L G�� y _ .2S© Se -p-110- -TtI k e 1g1Q,O A �320 jrt/S% STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ' ( )Before Excavation Upon completion of excavation and prior to placement of gravel system ofefore vabsorption fFstri�ldon kPrior to backfill of any component ( )Other, Specifyt Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Permission ix here'.:/ granted to ti..? owrer or his anent to perform the work indicated above in acccrdance with the Pitkin County Individual SvwJ,,1 Disposal Rev!ilations in effect on the date of issue. In addition to general provisions set forth on the reverse her -Qi, this Permit is subject to the following additional terms and conditions: OR ISSUE BY i�! /• 2�— (title) APPROVED F Aspen/Pitkin Environmental Health Officer __ Tho ahcwe individualsjc%�aqa disposal system installed by tit�IP S has been in;pected for use r,y a representative of the Aspen Ptt in £nvlrUnm.rnta Ilca t. Dcparunent. The uwnor assW:.os a rc:;0onsibility in cede of failure or inadequacy of thi sews disposal system. Compleia as -built drawing attached. I�FI r 1NSPE 'T N % z-- ,�AJE'Or' Aspen/Pitkin Environmental L7: , _ TITLE _ Health Officer 130 South Galena Street Aspen, Colorado 8161:1 303/925-2020 ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER R1 C - L Z r te-' _ __ PHONE 2 !C) 3 2— Address of OWNER 3-6 Address Name of APPLICANT S -n PHONE PERMIT TO BE: ( )Picked Up (()Mailed to: TYPE OF PERMIT: ( New Installation ( )Repair (x)Owner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEMS "' 1/ % Legal Description. J_ A' '{• 7 `- _V 5 V c, PAr k Lot Block Filing Subdivision Size of Lot acres TYPE OF STRUCTURE: (L !ftngle Family Dwelling ( )Other: Do you plan any further additions to the / residence? ( )YES (--MO r No. of bedrooms No. of Lofts No. of Garbage Disposals > No. of Automatic Dishwashers / No. of Automatic Clothes Washers / WATER SUPPLY: ( )Private Well, Depth or ( )Public, Name of System i'Z Bd S fy e- N'd r`�' ( )Spring ( )Stream or Creek TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: 05eptie 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 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 Dereby submitted. The undersigned acknowledges that the above information is true and that false inforidi-tibn willinva dat he plication — nd any subsequent per it. Signature of Applicant" DATE !a application becomes .invali12 mdnths 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 bereby acknowledges receipt of this individual sewage disposal permit application and a permit feel in the amount f,1 . by of S �_`� L7 C� , Receipt Number , Date Fee Received I/fri Adm�'' t� ` C' � 'i`nis�traitivo Officer 130 South Galena Street Aspen, Colorado 81611 303/S25-2020 S N M w 0 M iC r�w��n�o�rw, +�w�r iviawr5 gj!tus uear "" PJLgalg ci L � oN 31 J�H LL k-\, ASPEN*PITKIN ENVIRONMENTAL HEALTH DEb-ARTMENT Legal decription Name of Owner: Address: Name of Agent: FIELD TEST DATA SHEET (# & st. / p.o. box) (city) (state) (zip) Water Supply: Public Utility Subdivision Private Well Lot Area: Distance to Nearest Surface Water_ ft. Dates Observations Made: Soil Borings: 17 Percolation Tests: by SOIL BORING TESTS TEST M UMSEK TOTAL D[►TN ►[[T DEPTH TO SKOIIND MAT (A, [[ET iD' OBSERVED [ETINAT[p N.C. CHARACTER OF SOIL WITH THICKNESS IM FEET of 11 (/\� B-1 /' 6 NOyR3 WATER TClT TI.E 1 B-2 SECOND TO MEET TO LAST yAr XN 5N �1 �g FN 7R 7N SR 70L JD2 J0C 10t A2 PR R: SDZ A2 7ft A2 5pt %C %t 1tlL Tot SR 70t A2 A2 A2 SR P.i Sft 9R Ri SR 702 Sk k4 %Z Ai Yx :::::i::i: R't PERCOLATION TESTS Average Rate: minutes/inch the back A " Signature -m Plan of 4eite on Date - 4 L ate4L BOB NELSON A5i,EN/P17K1N SAMTARI: Nk 130 S. GALENA i� PE -11,4, CO 81611 � �5 �9a�9tg �[ NOyR3 WATER TClT TI.E DROP IN MATER LEVEL, INCHES MINUTES SECOND TO MEET TO LAST TCST D[►TN CHARACTERO[ SOIL SINCE ..4i IN HOLE IN TER VAL TO [ALL NUM.ER INCHES THICKNESS IN INCN[S M ..IST CT pV[RNIENT N MIMUTES LAST PERIOD LAST PERIOD PERIOD ONE IN P -1 Kl vvi boll ' V P-2 P-3 P-4 Average Rate: minutes/inch the back A " Signature -m Plan of 4eite on Date - 4 L ate4L BOB NELSON A5i,EN/P17K1N SAMTARI: Nk 130 S. GALENA i� PE -11,4, CO 81611 ENVIRONM Legal decription Name of Owner: Address: Name of Agent: (# & st. / p.o. box) (city) (state) (zip) Water Supply: Public Utility Subdivision Private Well Lot Area: , Distance to Nearest Surface Water ft. Dates Observations Made: Soil Borings: Percolation Tests: SOIL BORING TESTS by by r DEPTH TO GROUND WATER, FEET '+`+• rE.T TOTAL DEPT. FEET DROP IN WATER LEVEL, INCHES CHARACTER O/ SOIL WITH 7H IC AN [[• IN /[[T NU.§cA o'[a%[Rv[D EGnrHATED NICK TEST TIME NI.UTCZ TO FALL TO LAST TEST NUMBER B-2 fix° M 99�N �Niii PERCOLATION TESTS Average Rate: bo minutes/inch Plan o tT site on the back Date Signature Ail BOB NELSON ASPEN/PiTKIN SAr,,iTARIAN 130 S. GALENA ,, PE -N, CO 81 b' 1 DROP IN WATER LEVEL, INCHES NOVAS WATER TEST TIME NI.UTCZ TO FALL TO LAST TEST NUMBER DEPTH INCHES CHARACTER 01 SOIL THICKNESS IN INCHES .SINCE, NO LIST WET IN HOLE OVERNIGHT INTERVAL 1. HI.UTES SECOND TO LAST PERIOD NC.T LAST PERIOD PERIOD ONINC" � � i C' / 8 S-7 P-1 1 iL P-2 Ye4 P-3 Yew P-4 Average Rate: bo minutes/inch Plan o tT site on the back Date Signature Ail BOB NELSON ASPEN/PiTKIN SAr,,iTARIAN 130 S. GALENA ,, PE -N, CO 81 b' 1 22Z L .2 lD ��g 2�5' 8' jg ��� �% _ '",Z YO /0 2'12, 2y5' 25-0 'qyo71k .�'� 9 �� b 2,, 30 3 `pf�l... . ...... -*----------------�,--,-, oP3 ,� 9 P Y AV I , a ~ ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTMENT Legal decription Name of Owner: Address: Name of Agent: FIELD TEST DATA SHEET (# &st. /J p/./o. box) (city) (state) (zip) Water Supply: Public Utility Subdivision Private Well Lot Area: Distance to Nearest Surface Water ft. Dates Observations Made: Soil Borings: by Percolation Tests: �'by "<fW SOIL BORING TESTS IOV TM TD ..ODND wAT CII, FEET ... TOTAL T. Mu..c� FEET — CHARACTCR Or SOIL wITM TH IC KM [[i IN ft LT v O83[.V[D ECTIMAT'K. HIGH ... vx B-1 !/w K, i% f B-2 x��+ �oe f2 i; S:: ia:: ; 't •.:¢ x` iR fac fa: kt f-,% fat fdc Sf. # Sfc :ti < i Rt R¢ Sot 3g A4 At A2 PR A fR PR PR 1i R¢ g Ai R4 At At SX FR Ai At J.R iac £N 32 iK kc :'✓. k f:: %t :::;% :::::: ff::?t PERCOLATION TESTS Average Rate:1-� minutes/inch Plan of th site on the back Date Signature 4evlwll��� BOB NELSON ASI,EWPITKIN aAWAMAN 30 S. GALENA CO 81611 S NOYRWAT[. M TC]l TIE DRO► iN ..TC. L[V [L. INCHES I MINUTES - SECOND TO MC.1 TO LAST TO FALL TEST NUMRCR DEPTH INCNCS CHARACTER Or ]OIL THICKNESS IN 1MCH[3 SINCE -OLrb IN HOLE IST INET OVCRMIGMT INTCRVAL N MINUTES LAST PERIOD LAST ►[.IOD P[. OD OM[, IN P-1 S S Y,14c, P-2 I 94 �J '� Y1 Z P-3 P-4 'e tffi >M�( {; xf iM CJS f'n` SK fR At SA FR fa: Y7: i" f6c P£ At Ri 5R hC 5ft SSC Ri yQ pI pR flt > fR SA AC fA Ri 72 ]mat "io. .. f.... ff: Average Rate:1-� minutes/inch Plan of th site on the back Date Signature 4evlwll��� BOB NELSON ASI,EWPITKIN aAWAMAN 30 S. GALENA CO 81611 ------------ RESIDENCE FOR: Richard and Jean Smith