HomeMy WebLinkAboutpitkin.eh.273503300028 (1987)z73s- 0 33-00 -02.8
ASPEN40PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PEFl-11T NO. 8700
TX
YPE OF PERMIT:
nitial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit 1 .) ( )Alteration of an existing system,
r installation (Previous Permit 1 )
( )Use Permit as a result of Sale ( )Others
ISSUED TO: DATE OF ISSUE. 012197
OLaner�EF y �• 7uSEM Home Phone 92.0-20—Business Phone .
Mailing L NYMa� J Q� _
Address T / F.EN. W
Agent_j
Ma il.in g
Address
Phone
Sewage Disposal System Work to be performed by G��
This permit valid only for premises )ocation by the following legal description; t� b'l�Jt!�+/ w� /�/ ��/•
LOT St2EAAMS WATER SUPPLY&(,I.. AVEItA(E PERCOLRTION RATF,_,?(pKjhjjjCom.
This Individual Sewage Disposal Permit is granted with regard to the following usa&"LE Iyi 451I>CA142C
Nut.bcr oft Bedrooms �— Lofts_ _ Garbage Disposals_L Dishwashers �� Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD D GALLONS.
T'11F NATU?.E OF THE SYSTEM INCTLUDFyD UNDER THIS PER11IT:
Typ.2 of Ter.k or Treatment Unit,SCPr1C 1A,#JK��/���C Tank Capacity -5O Callon btlnin,ua
M. thud of Final Di_P.3a1.PaSOQP%DA)TG/�rTGS Absorptiop Area Square Feat 141,nirruana /
Darcriptionincluding brand name, if any) of other equipment or appurtnancest
I4o�IE
to 10VA- G(I�iTl5ie SYSTEM
A -
. Other C.unditions or SSpecifi/c/a'tionst p
A Qcy To A A140 ✓WO OF
fbt)e 5Now6k11_AV 61.0-0011-05
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Before Excavation Upon completion of excavation and prior to placement of gravelBefore covering distribution
system of ib:orption field
Prior to backfill of any coapenent ( )Other, Specifyt
Pla,is and specifications of the proposed sewage disposal system have been reviewed and r.rc considered satisfactory. Perninnion
in hereby graated to the owner or his zioenr to p•^rforn the work indicated abovein a.:Cordance with the Pitkin County Ilidivi sal
Snwj,, Disposal Reulations in effect on the date of issue. In addition to general provisions _et forth on ?ha reve
,;varse Lerzof,
this P.-rmit is subject to the following additional terms and conditions:
APPROVED FOR ISSUE BY �� � --
(tit1e)LII✓/Ra�[N�V7r_ KAOrg &AT&
Thr• c`<ivc in.iividual nc".1,10 disposal ayetem installed by
has U.cn ln�a.cctc2l Wr enc by a rcp[rscnt.ittve cf the Asl.cr+ 1'.rn t'nvs [c: n::�..rnta tical t!tcp•rrunent .- Tho „woes asau.,.o a—arl
recpons blltty in Ccsc oC fallurc or .road quaCy of tht sew,l�,teQQd:ayou4ayittm. Ccmpleco as -Guilt drawing attached.
DATE OF FINAL Ii`iSPI:t"''I
�y 9�6_ ____ _ TITT,11
'?th Galena Street / Aspen, Colorado 81611 303/825-2020
3�P� LL ('lvtS �r
Pe-,Slg� t O OLA-F1OMS - )4ssVME TDTA(- Fl-oa) of 4600 CPb
�25-0 Gu.oa1S -TO
QzY GliaTe-P-- --
75-0
CA-LC,0n)
-rAAIV
3So GA L LoNs — ro
6t..qcr- G�i�4T� ---
l oaU
&Aum [.m
—n i K
69Y uMTE,e A&"
s
72---
1,?-
2-
1,?- 0-0
ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT
Name of OWNER Jeffrey S. Yusem PHONE 9?()_?1Rn _
Address of OWNER 300 E. Hyman Ave. Aspen.,.CO 81611
Name of APPLICANT
same
PHONE Qame
PER.MfT TO BE: (X)Picked Up ( )Mailed tot TYPE OF PERMIT: (K)New Installation ( )Repair
( jOwner ( )Applicant . .( )Emergency Use ( )Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEM:
Legal Description S e e
Loot Block -
attached
Filing Subdivision
TYPE OF STRUCTURE: (X)Single Family Dwelling ( )Others
Size of Lot acres
Do you plan any further additions to the
residence? ( )YES ()ONO,
No. of bedrooms 4 No. of Lofts No. of Garbage Disposals 1 No: of Automatic Dishwashers 1
No. of Automatic Clothes Washers 1 y
WATER SUPPLY: (X)Private Well, Depth �i 7 ® or ( )Public, Name of System
( )Spring
( )Stream 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 informat invalidate t„plication and any subsequent permit.
Signature of Applicant -_ DATE
(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.
5. 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 unddeersigne hereby acknowledges receipt of this individual sewage disposal permit application and a permit fee; in the amount
01 S / i.�'C7L^� , Receipt Number , Date Fee Received by X
Administrative Officer
130 South Galena Street Aspen, Colorado 81611 303/925-2020
EKED
ONT OLLOWING ACCOIJN
DATE
FOR PgYMENT
6.
AMOUNT
I
TOTAL OF INVOICES
LESS _% DISCOUNT
LESS FREIGHT
LESS
TOTAL DEDUCTIONS
AMOUNT OF CHECK
PAY
TO THE
ORDER
JEFFREY S. YUSEM
300 E. HYMAN AVE.
ASPEN, COLO. 81611
cJ'heBank o0�sf�en
P.O. Box O
-� t*PASPEN, COLORADO 81612
'I
I
003L18110 1:LO2LO465Si: 523 84 41�
� � __. >,a"'R-RA-'••��-��-9Q.w3:922!.=���_LLS15'uLmJ//!���it4SC5lt�"'
3118
82-465
l 19 r? 1021
$ Z��a
------'/ DOLLARS
E
-T- -i 0 5.,
o��-F,Q qq.r. e pp C.S.�376
�o Year E aluvv�utia LvvL
.D
V?
s
10
Scc�ie: 1 =loo
p--�o r6baY E a�t �vv�lrl t cwt_ c�� , J
111
to
sfo�/y1,.0. �re�Do.ar- F ccttD C_.S .goi8fl /•'vJe .ti
Z
f1
Fo u.MA 4W ciS5 c r Si� y ca C .
Sec. 3, T.1C) S., 8 W•6� R 1\4.
Legal Description
A tract of land being part of Lot 12 in SE'/4SW'h of Section 3, Township 10 South,
Range 85 West of the 6th Principal Meridian, Pitkin County, Colorado, and being
more particularly described as follows:
Beginning at a point on the North-South centerline of said Section 3 whence a
brass cap found in place and properly marked for the SIA Corner of said Section 3
bears S 00°06' W 311.65 feet; thence West 113.42 feet to the Easterly right-of-way
line of Buttermilk West Road as built and in place; thence along said Easterly
right-of-way line on the following courses: 56.49 feet along a 179.31 foot radius
curve to the left, the chord of which bears N 34155' W 56.24 feet; thence N 430
56' W 154.97 feet; thence 115.54 feet along the arc of a 525.36 foot radius curve
to the right, the chord of which bears N 37°38' W 115.31 feet; thence leaving said
Easterly right-of-way line on a course bearing N 58003' E for 382.25 feet to a
point on the North-South centerline of said Section 3; thence S 00°06' W 451.36
feet along said North-South centerline to the point of beginning.
1 hereby certify that this survey was performed by me on June 29, 1987 and that
this plat accurately depicts said survey and that the same is true and correct to
the best of my knowledge and belief.
By:
4yr rcicoiiAielt__�. f4-fff_ �oua^f S{ lryet
0
11
rl
VAJTY
AN fQo i �
Revs, -
OF 9
Ll
2s,
WA?t-k-
BaW 144eS)
oose
RMM-MW
A0
FoOTERS
4SPEN4bPj',,
ENVIRONMENTAL HEALTH DEPARTMENT
FIELD TEST DATA SHEET
Legal decription:
Name of Owner:
Address:
& st. p.o. box)
Name of Agent:
(city) (state)
(zip)
Water Supply: Public Utility Subdivision Private
Lot Area: Distance to Nearest Surface Water, t.
T' f
Dates Observations Made: Soil Borings:.
Percolation Tes't*:_1' by
7—
SOIL BORING TESTS
PERCOLATION TESTS
f"X .1
D11T. To SRO ..0 1EE11
yt-T
V..C.
TOTAL DEPTH
... T
i
---
CHARACTER 00' SOIL WITH TNTC
--ESSIM ft
ET
DROP IN WATER LCIKL, '"C"12
0
EST..ATED IG
"1111011�
"ATI"
TEST TIME
.,.UTtl
COP
c.v To
LAST
TEST
B-1
CHARACTER Of 301L
SINCE Ho
'.NOLO
-
TO FALL
.U..c.
INCHES
T .1c..El, I. .—E,
IST WET
0vrRHjGkT*,
MIHUTES
LAST PERIOD
LAST PERIOD
PERIOD
o.E ..Q4
-7/
P-1
PERCOLATION TESTS
f"X .1
DROP IN WATER LCIKL, '"C"12
"1111011�
"ATI"
TEST TIME
.,.UTtl
SECOND TO
c.v To
LAST
TEST
DEPTH
CHARACTER Of 301L
SINCE Ho
'.NOLO
INTERVAL
TO FALL
.U..c.
INCHES
T .1c..El, I. .—E,
IST WET
0vrRHjGkT*,
MIHUTES
LAST PERIOD
LAST PERIOD
PERIOD
o.E ..Q4
-7/
P-1
4
Y4
P-2Z_n
e
J
,P-3
-Pow
�
Average Rate: minutes/inch
Plan of,the site on the back
Date;, Signature 4ajV�
b0b NELSON
ASPEN/PITKIN
SANITARIAN
130 S. GALENA
ASPEN, CO 81611
}
f
i