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ENVIRONMENTAL HEALTH D�EPARTIVIE
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:YPi CP PERi•iIT.
C 'rTnl.Lta: C0n9tructiun t !rm,,r�;ancy UseX
2cpair work,(Pravious Permit t ��.j t )Alrerstton of ,n erfsti:nq sr•atimt
or irs�tllati,n (rrtvious P?S.^..it •S
c )res.,, per -tit as a r:.^u1L of Salc d )At`cr:
T S SM 17 TO: DA i E. CF i S StIF:
Ow-llee ,Oe. 0, GAG T-1 .__ _T.:,me Phone 20? 439 f Bu:.iaess Phon:. _ __•.____ ,
Fic+d re
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Agent_ l'ilone�2�a
Seusge Disposal S; !F�tem Work .-o he pprf.!^•r-ed bYL.�1 a
Thi, pc_n.li: valid only far prr,z-.acs lo-aLien by _ha cal u:ng ..y.l daacriptiat.t %•� C.�iS ���� //`►,Ql _.
Lnl• $t1.lEf%�L��, t'AYtR SUPPLY �/(�E� ltY%RTr'r. P::Rr71cit0N :iiPw:_. 0 (_,i
Thi+ lndl,eldual icwaqu Ws�n?,s,+1 Permtr. is /granted Vii: 1, t4• ;.rc; to the roll.uxing I.se.
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of: Dae,,_... _�.G Laft'_ V __ �arb:.rc' G 9tro&.lis_..._ .. V1zhva:.%c: ---r-_. .._._._.:.F' ,acs M..1 .
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THF NATURE OF' '". S •tiI "1'I'7ER t7LGn^' ..r,r'
.ypa of i's:::, or Tra•att:enL VAt: -r.,Orla- /l7/VK
ewthod a." Final 011po—ga2t S9EA/ 7
r'tarir:ttSraGa
�—.zc:ilption (including `slraoci cacw?, Lf any) oL' c:i:htr a.laipuu±ut .r a o:.tzit:arcees
'.. - it �J"l/ i mac•.
r'",•r CmeLTion:! Spe�.ts:cyt,f+ttit '
;iTA, .SES R_E` UTRING 7NSJECTTON 3Y T:i : 'si:'AL:t.11
°fzrle l�..pacALf,_�OQQ _ __{:alle,. Ylniauc.
?res _,..�.'�,LG_...^�__.�_ `,cyuoKe c-.,^>. F'ini>R•trr
c ils.=tare E>cavatio:t t ;Ik+on tar,lrttan o` cxcavaticu rnd prior to peasement: of grmvel ( yltaf c Vove.-i::� di::tri'saticd
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sur S. ba.tK:1t �•. and cc>mp,.•ncnr. 1Cthess :,I,cci{pt
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is ::C..'Cr)j Granted to t:' CdGC t.is acen: '.p p::rfor ch!t Ck };ut t: 't^•t ihr . f.^ "O �a+:_. tl:t1; it ':y
5c•. Di :oral A4-;L{1.It]Un`7 in of f:_ct On U),7 dace ai i �rs.�e. t,: . •ki : e+ n r s
Wig^ �i i^r' rC^ :CY :':A.,:S JGl L,.:•t.`. C•) :7{ rl='!l!� =� .�;6f�_6
thiA Pcrm+ t i3 sur ccc to tN'i fo;,loM•in., widattonal terms nno ca^+rigor
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A-KROVED FOR I:5S-1E LIN' ��. (t _jeL
7h at:eve ::awb—, Zis,,a al sy:.iar5 ln3en12rd Lp _fes 1_. /✓%E P/C�$E _ __. -.--
.+ti 'skc•n lt.:�•c.^tc.l (or : c "•y y repro entativ: of t;+c 1- rn.P:t.�ctn L•,4tc.�n;r.:iaol !i:a t1 .,^�.::�:ar:t_ t. _t .anuz"a:+s:_+sao
r.,,tron:>abi.lIty r.n Coat of .. il;:rn of i•.-A.tr •w±tY of than __.�WQQ..n .ila;1eCCa'NI ry:.rn, C,•�.r,•:;-„ mu• bu.l: :i:a i.ty x nett .i.
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130 South balena Street Aspen, Colorado 91611 303/925-2020
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ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
i PPLIC,NTION FCR AN INDIVIDUAL v= -IMAM DISPOSAL- PERMIT
Jti_r:tit: U OWNER _��. O• 01,116,6 7 % PHONE g a
`;...dress of OWTIER ?0/I E�iQINLLL ac�'t-MAJ _
27ame o L ci.P-PLICANT A 8C PRONE 9G
N:7,1417_3(1 ?F.: ( )Picked Up )Mailed to: TYPE CF rnLxrT: ( )Nzw Installation 'p4,.Repair
`S.<pvner Applicant ( )Smersen.:y U.e )AIG _aria:: NOT dnn to failuie
. *ryr'�:'1'IO'� O?•' pn7P�c_c:D SYS;F.t7t
� SSit tion • _ j�V R/ ooar- ac _
P't-- Flock_ —_ Y'ilints of La! V
i1[S5in,:la Family Dwelling ( )Other:1:•v yuu plan any f-trtn.:r ic-ditior:.4 to zhe
�^ rcaleznce1 ( )YES ( )t7]
:ir. Rk J_zrams� No. of Lofts 'V No. of Garbage Disposals N:,. Of ; ttcmatic oishwa•+hare
Na. of F.atumatic CIILhas iiashersOr
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7.h'iRk 5'.tPFr.Y: ( )Private well, DepthlXf
or public. Na.Te of System Y d. ��/�%• �.__��W�.
( 'Spring
( )Stream or Creek
It;DrV2%Di.L S:=SvACE DISPOSAL SYSTEM PFOPOSF.D:
Lr{tlu `:ar,k/i. s.rption t'iald ( );,::ration P)•rt/Ah-var.pcinr. Field ( )Composting Toilet ( )Inciner!ttitln Toiler ( )hie,und
( 3�erjrli'.tgr ?o^a;alc Lon ( )a?cycling, ..cher ua { )vxul: Yri•ry ( ).,r_herr_
^h.• 1nlltia1 rite ia:T;.^ct'cn meat b-! r•riar;cZ with tt:e ;spc-,/?2 tir. Ene'_�o:r.nutal 7tc..2' Lr_7a-tmcr.t t>25-2 <': 8.30-9:?? a.r
b(:for4;- a nermi` ea.1 ;a:=ued. the in.lividual sewage disp_aal t,era:ic mutt be i-iru!6 i;._fore a building permit can tx obtainnd.
;SeAL i:ISVFCT'O(: A FA0VAr,_HUST At ('IVrN by THE ASPE4/-TTK1N ENVr00'ME9TAL Urkf.TH DC"'1R'tPiEv2 PR'.OR Tr,+ DhC rILLLD PNY ,"�h'CSU's
OP T'le
pD;'lAcrt'-oa for an !ndividual 3e a 'i:pcsal -ai: it, herebv submittee. T:.e u..dr.r�iinud aet_ncv1c6,ez .•hzt tY. aLa•:a 1rf'3.matica
1:t truo snd that £sloe i..^.f :t' wii i va" d to the polica.lor. cci any aubsc-,-.ent ...
1,fn.:t V.0 :,f Arp�.i:'Int DATE � ,r/
('ahlz .sQlsllur,tion i4Cn:.as. 1nva::c! 1 ntt.s tram the above d(ste.)
NOTE: PLOT PLAN r:tust he filed witli Unis a -pp Li,-aLion.
V.ease locate the following .items by measured distances:
pr perty lines ..nd dimensions.
2. li:c, f—.Dsed and -z:xisciag wacet wei 1 s ton su'o jest ?Coje_ ty and
nej cent property.
3. Wmestic water service iilea.
i. and existing buildi.^.3s, dr.i.vew=_vs, A7-4 oaths
. str-ictures.
Y. Stre.ams, Uikes, p•.)'1!is, irri jatior tl..tcl•I^_s, arcs z• hi—r W 7.'.:er
e.3 .
6. trO�3s0d and CJCS ting 1nd7.7i�Jual i�:'�.�^. systrras cr,
1
ajIMAz'I \ 2Ev'ISEB I'I,b? FL7N PRIOR TO C NISTRUCTIO`x 1F INS AT.LATTCN ILS TO
s: C HtLNGEID FROM ORIGINAL PLAN.
ackrowlydgea receipt o jis,Xtvj,fival newage disposal p:rmit s.p;<<ics_ticn and a permi 1'r:e f((: the amc.,ina
Aicsipt Numt-cr (�.�./._ �/.. Date Fza Re;:eivao- ..._.._•r-_� __.._..._,t by _..��
Rclr:inis_.e:lvo Ofiiccr
130 South. Galena Street Aspen, Colorado 81611 303/925-2020
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER
MAILING ADDRESS l�/U4 lJ,ff
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 8 hour soak
PHONE
TEST HOLE No.1
TEST HOLE No. 2
TEST HOLE No. 3
/l
e"
Drop Time
51
TEST HOLE No.1
TEST HOLE No. 2
TEST HOLE No. 3
r�
Drop Time
SS /—
Drop I Time
Drop Time
51
7&%
1
Ll V o
_
sa
Percolation Rate Each Hole _ /C
Average Rate
Comments on soil or site:
n �
:�f ��/ ,��•-�'�`r'�`� +�.'r/ `v—' fit" (C�
Signature p
6 -
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Date (/,��
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
y"a
PROPERTY OWNER PHONE
MAILING ADDRESS
4"
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 8 hour soak
//
/;
3 rt
ve-1
TEST HOLE No.1
TEST HOLE No. 2 TEST HOLE No. 3
Drop Time
IL
Drop` Time Drop Time
t7
t
Percolation Rate Each Hole
Average Rate
Comments on soil or site:
O�4 Aa4j -t>
1
i
Signature
Z�'0
Date