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HomeMy WebLinkAboutpitkin.eh.273503200021 (1975)4 PTTKTN PERMI Owner Owner's Mailing Add=cess M, �/► Contractor0 � V v Q Address Systems Contractor's Name Address Legal L a4-3sJ03�) -CO _�' • COUNTY HFALTH DEPARTMENT , Q RECEIPT NUMBER Ij M In Phone # S 7,T ( I Phone # C11) 5 �(Y I f Lot Size 45', A 00J11V� � Type of Building by Use �V✓ Number of Bedrooms ' Type of Water Supply Type of Individual Sewage Disposal System Type of Soil or Soil Classification ��C/t��nai y'a C��.9i1EL G 64A'l FIA 16S ,/ Q Proximal Location of Bedrock 'lo a f��x i� %/I�CL,1� Proximal Location of Owner's Signature PLOT PLAN: Table IV() ,0 , r Percolation Test Data Minimum Recommended Absorption System Size Minimumecomme ded Tank Size 7_5 iJ Permi appli tion valid one year from Dat after lower portion is completed and signed by the Sanitarian. RETAIN THIS FORM T THE CONSTRUCITON TE. Date9 Sanitarian • ( awing of system on back) /N't=-D > q7� _ Date OERCOLATION TEST FIELD SHEET N t NAME OF OWNER �pn( /V 0 'IIUAIO Al PHONE �p .ADDRESS 1-30"e �? 3 ) LEGAL DESCRIPTION OF PROPERTY IA5 T goT rexw,/ At least two (2) test holes per system must be run. They should be in the area of the proposed leaching system and dug to the depth of the proposed system, generally 2.5 to 3 feet deep. The holes are to be soaked for a 24 hour period prior to running the test. Tlatqh Hole I Tes--#–'lole II Read-ing ro Time Readin D Time 33 .3,YA, i Z � A JO // 7' i5�i 8 i i l 13 0 YY i'�0 %i 7 PERCOLATION TEST E ULTS: ' J t Hole I A10 Minutes per inchp Hole II tL,/ Minutes per inch 57 Average percolation rate: 51Minutes per inch/ Comments on soil and/or site: C,lff�/ 1-44141 TD 61,11 Name of person running test://--l-/—,V441j�honeAA: Address: Signature: Q • PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER N PHONE MAILING ADDRESS LEGAL DESCRIPTION OF PROPERTY LOCATION OF TEST HOLES Three (3) test holes required per system Test Hole Depths (24" mini -mum) Diameter of Test Holes Water Remaining after A hour soak TEST ALE #1. TEST,4jkLE #2 TEST HOLE #3 Dro Time Drop Time Drop Time 2— 2Z ' Z _ v Percolation Rate Each Hole Average Rate Comments on soil or site: SIGNATURE DATE C i 01CLL or to©� 42' ORlyg. 750 GALL04 COP€LA"o C #WkeTE -)EPjIC--rA4 K Applicant Name C Property Owner It _ Property Address C�`3 Schedule Number From Mailing Label REG Type of Structure: Single Family Home Duplex Townhouse Commercial/Office Vacant Lot 7 0 -oma �a-1 Number of fireplaces? 0 J Number of gas log fireplaces? Number of fireplace inserts? Type? Catalyst? Number of w000d/d�toves? '' \\__ Type? `�w-t�T C�Ltiz�� Catalyst? Number of coal burning devices? Number of gas fireplace appliances? Your signature Please fold inside out, seal and return both portions of this postcard as soon as possible. Thank you. U R G E N T !!!!! Bulk Rate FIREPLACE REGISTRATION REMINDER. U.S. Postage PAID DO NOT DISCARD, EVEN IF A s p e n, C YOU HAVE ALREADY SENT BACK A Permit No. i FIREPLACE REGISTRATION FORM!!! PLEASE SEE INSIDE. 0-0372E3 PLEASE RETURN THE ATTACHED FIRE- PLACE REGISTRATION FORM EVEN IF MC K I N N O N, D O N YOU DO NOT HAVE A FIREPLACE OR POST OFFICE 3 O X 831 WOODSTOVE OR EVEN IF THE PROPERTY ASPEN, COLORADO IS AN OFFICE OR VACANT LOT. 81612 A PARTIAL LEGAL DESCRIPTION OF THE PROPERTY WE REQUIRE INFOR- MATION ON IS LISTED BELOW: A PARCEL OF LAND SITUATE IN'THE NA4SW4 AND LOT 19, OF SECTTON 3-10-85 Our records show we Akle' 'rLot � yep- received a f1EDtAkeCa '13 -'o re,_stration form from ou the property listed o r' L1 front of this postcard. Perhaps there has been a change of ownership, or perhaps you own more than one piece of property and we did not receive a form for each. To help you determine which property this form refers to, please check the legal description on the front of this postcard. . K♦ Co Aspen/ itkin Environmental Health Dept. 130 S. Galena Aspen, CO 81611 Even if this property is an office or a vacant lot, or has no woodstove or fireplace, this form must be,,, ed. As you may know, ),, en and Pitkin County have recently passed laws requiring registration of woodstoves and fireplaces in the City and Metro Areas of the County. There is a $300 fine for failing to register. Most of the fireplace registration forms we sent out last summer have been returned. This reminder is another chance for the few people who, for one reason or another, did not return their forms the first time. You are one of the people from whom we still have not received a registration form. If you believe your property does not lie within the metro area boundaries, please return your registration form with this information so we are able to update our mailing list. If you have any questions, please feel free to call Lee Cassin at the Aspen/Pitkin Environmental Health Department, at (303) 920-5070. 1 7