HomeMy WebLinkAboutpitkin.eh.273504401001 (1991)ASPEN*PITKIN
ENVIRCJiNMENTAL HEALTH DEPARTMENT (oaf
�y n
•INDIVIDUAL SEWAGE DISPOSAL PERMIT NO.
RPE OF PERMIT: L°99e� �1414191
Initial Construction ( )Emergency Use ( )Repair Work,(Pi�evious Permit / .) ( )111teratlon of an existing system,
or installation (Previous Permit / )
( )Use Permit as a result of Sala ( )Othor,
ISSUED TO: DATE OF ISSUE 7
tiJBusiness PhonL3J/ )OR— L Z _
hollerHome Phone_ /,�-���
Mailing C 1
Address a A ILLS
Agent i1�'1� 5 , /V Phone
Mailing
Address
Sewage Disposal System Work to be performed by ASPS 61k'FH&UJA ' /I
This permit valid only for premises location by the following legal don ription
Lo'r SIZE ( I. 1-1—A -• WATER SUPPLY
AVERAGE
This Individual Sewage Disposal Permit is granted with regard to the following uses CCitil/;/yt
mraber oft Dodicoms _,5— Lofts C' Garbage Disposals_ Dishwashers^ Clothes washers
14
CALCULATED AVERAGE DAILY WASTE LOAD '?'070 ALLONS.
THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PERMIT:
of Tank or Treatment Units (�G/ f ��iK Tank. Capaciu
� C% Callon Hinima
Y.o-
,
ethod of Final Disposal s.46 p� Absorptiop Area Square Feat Minimum
ascription (including brand name, if any) of other equipment or appurtnasCA
""V
uS c -/1/ L ET S "7U B l�
ph—s
07
Aher +:o�/s or Specificationes 1
�F � / � � �M � Ldrel
STAGES REQUIRING INX
SPECTION BY THE HEALTH DEPARTMENT:
( )Refore Excavation Upon completion of excavation and prior to pinpement of gravel A:ystein ofefore verindist,
absorption field n
kP
rior to backfill of any component ( Other, specify, _ - —
Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Pernissl.on
ihereby granted to tt•c owner or his agent to perform the work indicated atm %e in accordance with the Pitkin County Indivi.;�al
-
Sewa;e Disposal Re•rulations in effect on the date of issue. In addition to general provisions Set forth on the reverse iter-�ei,
this Permit is subject to the following additional terns and conditions: -
Aspen/Pitkin Environmental
APPROVED FOR ISSUE BY
f (title) Health Officer
Thr a x+ve in:iividual scwago disposal system installed by ---
c tur use b a rcprescntacive of the AsS:en pit to L'nvironrti•nta Lica07VpTruncllt.llt drawing'~attachod.As a
has b:en in::pcctc 1 Y
rvns�onsibility i ase of failure or inadequacy of Chiu sewage disposal system. Complete as- u
Pi
TIAL _ I `� — 9
DATE OF FINAL INSFE TI N — Aspen/Pitkin Environmental
TITLE Health Officer
130 South Galena Street Aspen, Colorado 81611 303/920-6070
ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT
t C �• u,r : tt �L PHONE
Name of OWNER
Address of OWNER C r � �t h �`� �' '
R
- r n PHONE
Name of APPLICANT jet pnJ /c
PERMIT TO BE: Picked Up ( )Hailed tot TYPE OF PERMIT: ( ew Installation ( )Repair
( yowner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure
IpCATION OF PROPOSED SYSTEMt y
Legal Description Al d w r -c S.. �✓ v/ AG' ✓r
Lot Q �J J� Block
Filing - Subdivision�cl1-to)-L Ck ize of Lot
Do you plan any further addi ns to the
TYPE OF STRUCTURE: Ingle Family Dwelling ( )Others residence? ( )YES
No. of bedrooms
S No. of Lofts - No. of Garbage Disposals No: of Automatic Dishwashers /
No. of Automatic Clothes Washers /
WATER SUPPLY: ( rivate well, Depth G) or ( )Public, Name of System
( )Spring
( )Stream or Creek
TYPES OF INDIVIDUAL SEWAC:E DISPOSAL SYSTEM PROPOSEDt '.
( eptic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound
(')Recycling, p t )Vault Privy ( )Other:
potable use ( )Recycling. other use
She initial site inspection must be arranged with the Aspen/pitkin Environmental Health Department (925-20201. canObe.30 obta-M-)
before a permit can be issued. The individual sewage disposal permit must be issued before a building p
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 dis 1 DATE .�^ 3permit is hereby susubsequent permit.
bmitted. The undersigned acknowledges that the above information
is true and that false informat n w nv idate the application and any,i
Signature of Applicant
his application becomes. invalid 12 months from the above date.
V - -
NOTE: PLOT PLAN must be filed with this application.
Please locate the following items by measured distances:
1. Property lines and dimensions.
Z. 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.
She undersigned„)pereby acknowledges receipC of this individual sewage disposal perm t nPP cat on and a permit fe in the amount
Z g�L iF�/1'71�j Date Fee Receivedby
of $ ✓ , Receipt Number (40 �dministrativo Officer
130 South Galena F -et Aspen, Colorado 81611 303/920-5070
ASPEN*PITKIN
ENVIRONMENTAL HEALTH OEPARTMENT
FIELD TEST DATA SHEET ON PERCOLATION TF
Legal description: all Z_-
�(°1wel
Address of Property:
Name of Owner:
Address•
(# & st. / p. box) (city) (state) (zip)
Name of Agent:
'
Lot Area: Water Supply:Public Utility Subdivision_
Private Well Other
Distance to Nearest Surface Water /4Z>/ Typ "
Dates Observations Made: Soil Borings: W1 7 by
Percolation Test : by !�
SOIL .BORING TESTS
PERCOLATION TESTS
Total
Observed Depth.
Estimated Depth
Character
Depth
to Groundwater
to Groundwater
of Soils
P-3
Drop Time
��'
Depth of Water
(left after 8 hr. presoak)
B-1
PERCOLATION TESTS
L'- ..rv�
P-1
P-2
P-3
Depth
p-1
Drop Time
P-1
Drop Time
Diameter
P-2
Drop Time
P-3
Drop Time
��'
Depth of Water
(left after 8 hr. presoak)
L'- ..rv�
p-1
Drop Time
P-1
Drop Time
P-2
Drop Time
P-2
Drop Time
P-3
Drop Time
P-3
Drop Time
ily—
�� c2
Rate P-1 hY-A Rate P-2 Rate P-3
AVE GE RATE: minutes/inch
Plan of the site and location of test holes on the7back _
Co ents on it • S ' to%Wf
*)4j772
Date Signature
930 South Galena Street Aspen, Colorado 89611 303/920-5070
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