Loading...
HomeMy WebLinkAboutpitkin.eh.273505100003 (1991) Barn-Gymzs �`I -06 oo3 ASPEN*PITKIN (65 ,\ ENVIRONMENTAL HEALTH DEPARTMENT 0 INDIVIDUAL SEWAGE DISPOSAL PERMIT NO. �I © E OF PERMIT: ( jTnitial Construction ( )Emergency Use or installation ( )Use Permit as a result of Sala ISSUED TO: Owner 6? 7 O AAJO , H44.11A�1i C. Mailing Address .21%6 1 DG,0L &6�- ( )Repair Work,(Previous Permit f .) ( )Alteration of an existing system, (Previous Permi I ) ( )Others C� DATE OF ISSUE. / Phone_7,,:� •14s'aa Business Phone 'oe Y/C,/ /, Agent//L] 5�i�! 'l/� y�� Phone �i1�L1 Mailing Address Sewage Disposal System Work to be performed by This permit valid only for premises location by tho following legal descriptions VOWS q45'�_/C Z[7 LOT SIZE / 0 aers- , WATER SUPPLY spy-ZdL AVERAGE PERCOLATION RATF.�7X(5 //VMf L" This Individual Sewage Disposal. Permit is granted with regard to the following uses 6 YM AD I -//IKON Number oft Dedreoms _ _ Lofts �' Garbage Disposals_ c' Dishwashers C Clothes Washers CALCULATED AVERAGE DAILY WASTE LOAD !� GALLONS. THE NATURE OF THE SYSTEM INCLUDED UNDER THIS PER11IT: PTl C.��I 7 yea of Tank or Treatment Units Tank. Ca a t ��0 _Callon Minimum athod of Final Disposals 4/35-, 4'0-r/OA �_6 Absorptiop .Area p � Square Feat Minimum cscrip=ion (including brand nnaame-�,-ilf ,any) of other equipment or appurtnancess C- )ther Conditions or Specificationes �I 23 P0 STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Refore Excavation ( )Upon completion of excavation and prior to placement of gravel Before cabsorption distribution ()Prior to backfill of any component ( )Other, specify: Plans nd specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Per misrJon is hereby gra;:ted to the owner or his anent to perform the work indicated above in accordance with the Pitkin County Individual sewa;e Disposal Re,:ulations in effect on the date of issue. In addition to general provisions set forth on the reverse hercef, this Permit ie subject to the following additional terns ant conditions: APPROVED FOR ISSUE BY (title)✓ The sb.tivc in:iividual se�:ago disposal system installed by' -^- lids b 1 ia::pcctcd for use ty a rcprescntativc of the Aspen Pic in Envicon hnta dealt. Dcpartmcoc. Tho uwnur a�:u os ari failure or Lnadcc(uacy of sewage di poral ystero. Completu as -built drawing attached. res,xonsibil>ty in case Of DATE F I 'AL ' P C ON---�,��� BY : l_ TiTLEi+C,P+jww 130 South Galena Street Aspen, Colorado 81611 303/520-5070 ASPEN*PITKIN ENVIRONMENTAL HEALTH DEPARTMENT I APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name o f OWNER 0' !S PHONE--- I HONE: 1 n Address of OWNER Mame of APPLICANT , PHONE q*X3 -Sct SH PERMIT TO BE: (')(}Picked Up ' (. )Mailed tot TYPE OF PERMIT: ( )New Installation ( )Repair ( )'Owner ( )Applicant d )Emergency use ( )Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM: Legal Description r].1 �a o C ret, J C � Lot �l� { 0 Block S Filing Subdivision Size of Lot 0_acres TYPE STRUCTURE: ( )Single Family Dwelling ( )Other: fr B corn Do you plan any further additions to the residence? ( )YES ( )NO No. of bedrooms f No. of Lofts No. of Garbage Disposals ® No: of Automatic Dishwashers No, of Automatic Clothes Washers 0 WATER SUPPLY: ( )Private well, Depth or ( YPublie, Name of System 04Spri ng ( )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 information will invalidate the application and any subsequent permit. Signature of Applicant DATE (This application becomes. invalid 1 mon hs 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. IN 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. The undersigned hereby acknowledges receipt of this individual sewage disposal permitapplicationand a p mi ee in t mour. o! $ ��© •Ofl __-_. Receipt Number 0Do $3 1 . Date Fee Received -L "l37'1 ( , •by Administrativ to 130 South Galena Street Aspen, Colorado 81611 303/920-6070 1 i 4- /6-1- ��� M, zI 05-