HomeMy WebLinkAboutpitkin.eh.273504300008 (1989)ASPEN#PITKIN
ENVIRONMENTAL HEALTH OEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. � 070
TYPE OF PERMIT: �J
( )Initial Construction ( )Emergency Use (J(1Repair work,(Piovious Permit f .V il .) ( )Alteration of an existing system,
or installation (Previous Permit 1
( )Use Permit as a result of Sala ( )Othort
ISSb-ED TO: DATE OF ISSUE
Own e rC,'nl>�1Fhi �]%�rz Y Home Phone Business Phone
Mailing lei PEEKZ19rP,
L32�/li
811 STA PL EMAJ 7
AddressQ �
Agent 8l L L �;IA PLS Phone 9,2,--�-5—VS
Mailing%},'; u/ '
Address �OyC '3 �2 As� E l 0
Sewage Disposal System Work to be performed by
This permit valid only for premises Jocation by tho following legal descriptions 14, IAIS / /,0 -1 NJ
7 I �oF. c o �(
LO2 5(2E� WATER SUPPLYP.�'111y AV RAGE PERCOLATION BATF. X / C M hIC�}f
T11s Individual Sewage Disposal Permit is granted with regard to the following uset�( F—Am1Li)i�E-JiDf: ,,c
21traber oft DedicOms 3 Lofts C-' Garbage Disposals Dishwashers Clothes Washors
CALCULATED AVERAGE DAILY WASTE LOAD /20 GALLONS.
THE NAT0,E OF THE SYSTEM INCLUDEDUD-/ UNIDER THIS PERMIT: %
Type of Tank or Treatment Units Sepri� �" '/v� ��i Sr/�G Sank. Capacity �C� _Gallon Hinimua
M' thod of Final Disposals Absorptlotl Ares . Squacc ert minimum /-00-L
Description (including brand name, if any) of other equipment or,appurtnancess %Y i � � a �d�%�Sto
Vq 1 v v-0AJST�LlC!'
JE-e,Sl0ljLU6-'7b /�L '/i�i7 L ,�-(��4� C�fiC H rD
UN A nV AIVAI LIA L PAS 1-5;
Other Conditioni or specifications# ` �-
0O3eT/-lia DMiN F/FTY �50 UPI//L� �� %' t OS" /S /E'EC'D� DGU
��nr�.oL_ J,�I�A7M� ATEe ��-(� ��RNAPJPCS Nd3'r -K- IA[�LLCD iN WD5,
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STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
( )Defore Excavation ( )Upon completion of excavation and prior to placement of gravel ( )eyforestem coveringof distriibutiion
( )Prior to backfill of any component ( )Other, Specify%
Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Pernivsi.on
i:r hereby gra;.ted to thf, owner or his agent to perforn the work indicated above in accordance with the Pitkin County Indivi;ua.l
Sr:wa;c Uinpcsal Rcvnlations in effect on the dr,tc of insue. In aa!ditton to general provisions set fort; or: _.r+. .averse her-oi,
this P.-rrnit is subject to the following additional terms and conditions:
Aspen/Pitkin Environmental
rPPROVED FOR ISSUE BY4. � wl�' i (title) health Officer
The ahove inSividual nevago disposal System inatallcd by TS /v LTi`
has been in::pCCtcd for use by a representative cf the A3(%Cn 1':t in Cnvironnanta
reaonstbilLty in case of failure or inad,-quacy of thtu 'ewa.�e disposal system.
DATE O1' F NAI. IPISPECT 0 I Q /
BY: /
)Ica to Department. The uwnur assurnos a
Completo as -built drawing attached.
TITLE
13 South Galena Street ( Aspen, Colorado 81611
12
-Aspen/Pitkin Environmental
Health Officer
303/920-5070
_�*
t ..
ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT
Bill
Name of OWNER Bernard Stapleton PHONE
Address of OWNER Bill Stapleton 2298 Owl Cr. Rd... PO B.ox 3252 Aspen, CO 81612
Name of APPLICANT Bill Stapleton PHONE 923-51,95
PF.R.MfT TO BE: (X)Picked Up I )Mailed tot TYPE OF PERMIT: ( )New Installation (X)Repair
( )owner kAApplicant ( )Emergency use ( )Alteration NOT due to failure
LOCATION OF PROPOSED SYSTEMt
Legal Description inerAgfhnnrrlc Pit -kin County Owl CrPPk Ed. -
Lot Block Filing Subdivision Size of Lot acres
TYPE OF STRUCTURE: (XSingle Family Dwelling ( )Othert Do you plan any further additions to the
residence? ( )YES (X)NO
No. of bedrooms No. of Lofts 0 No. of Garbage Disposals 0 No. of Automatic Dishwashers ()
No. of Autonatic Clothes washers 1
WATER SUPPLY: ( )Private well, Depth or ( )Public, Name of System
4X)Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
(X)Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound
(')Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Othert
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 information wi 1 inv lidate the application and any subsequent permit.
Signature of Applicant # DATE /0 -�� i
(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.
{. 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.
She unde��rrs/signe hereby acknowledges receipt of this individual sewage disposal permit ,application and a permit fee the amour.[
Of S J31L? , Receipt Number , Date Fee Received � _3 //moo---- y
Administrativo officer
130 South Galena Street Aspen, Colorado 816111 303/920-8070