HomeMy WebLinkAboutpitkin.eh.273511300002 (1989)k ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
INDIVIDUAL SEWAGE DISPOSAL PEMIT NO.
P27.`3-S-//-3'� . --X2—
W
E OF PERMIT:
nitial Construction ( )Emergency Use ( )Repair Work,(Pievious Permit 1 .) ( )Alteration of an existing system,
or installation
( )Us(- Permit as a result of Sale ( )Other:
ISSUED TO: DATE
(Prowl us Pct it 1 )
OF ISSUE. 0
O -,mer A 1 nu� �� sane Home Phone Business
Tlailing Q
Address p'v
Ag en t___j
rIa i 1 in g
Address
Phone
Phone — 2 5790
Sewage Disposal System Work to be performed by / T n
This permit valid only for premises location by the following legal description:�f
s 1 z E /0 AI? of 290 At SITE WATER SUPPLY iukL L AVERAGE PERCOLATION RATF.
T1is Individual Sewage Disposal Permit is granted with regard to the following use:� L Ak
Nt.r..ibcr oft Ledreoms Lofts— Carbage Disposals_0 Dishwashers Clothes Washers
CALCULATED AVERAGE DAILY WASTE LOAD r
> L cALLONs. .
THF_: NATURE OF THE SYSTEM I`:CLUDED UNDER THIS PEP:iIT:
Typ.: of Tank or Treatment Units of r i'4- �
Method of Final DisposalsA Q�/�, ,� ► 9 r RDJCAE � Abeorptioa
Dcacription (including brand name, if any) of other equipment or eppurtnanceas
.Other Cundition9 or Specifications
-
STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT:
Tank Capacity_Callon Minimus
Area ISquare Feet Hinimuan
( )Ficfore Excavation ( )Upon completion of excavation and prior to placement of gravelBefore covering distribution
system of absorptioti ficid
( 7rior to backfill of any component ( )Other, Specifyr
Planes \and specifications of the proposed sewage disposal system have been reviewed and are ccnsidcred satisfactory. Perninnion
iK hereby gra;:ted to tl:c owner or his agent to p•^rform the work indicated above in accordance with the Pitkin County Indiviaual
Sewa,c Disposal Re•{ulations in effect on the date of issue. In addition to general provisions set fort.h on t,,o reverse her' -:!of,
this Permit is subject to the following additional ter ras and onditions;
Aspen/Pitkin Environmental
APPROVED FOR ISSUE BY __ (title) H%- lea th Officer —,__ _
Tho t`.Kwe- in.iiv(dual s,'. -a90 disposal system installed by-_—__—_-�—
i Ass been in.:pected for use by a representative of the Aepcef ':tr.in L'av:ron:>.•nt.a Hcal( llcp�:rtmont. Th )wnut aq'iu:T.os a
.'cc;>onsiLili!y in ccae of failure or inadequacy of this 3ewe11e d13p0431 uystcm. Complete as -built driving attached.
DATE OF FINAL INSPECTIO;t
LY :
Yi
TrTL�
Aspen/Pitkin Environmental
Health Officer
130 South Galena Street Aspen, Colorado 81611i 303/920-5070
ASPEN*PITKIN
ENVIRONMENTAL HEALTH OEPARTMENT
APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL• PERMIT
Name of OWNER l ,E / PHONE > S 3 L2 '7
Address of OWNER
Name of APPLICANT P144
PHONE S
141W 1- ?0.61V 7
PERMIT TO BE: tAPicked Up ( )Mailed to: TYPE OF PERMIT: (New Installation ( )Repair
( (Owner ( )Applicant ( )Emergency Use ( )Alteration NOT due to failure
LOCA?ION OF PROPOSED SYSTEMiAy
Legal Description
Lot Block Filing Subdivision Size of Lot 98,0 acres
a Other: Do you plan any f"(ehoe /�a t o
dins t�t�/Jc,,
TYPE OF STRUCTURE: (.Single F milt' Dwelling g ( )
residence? ( ) YES ( N0% %E)
No, of bedrooms No. of Lofts No. of Garbage Disposals [? No. of Automatic Dishwashers
No. of Automatic Clothes Washers /
RATER SUPPLY: ()4Private Well, Depth .2 7 or ( )Public, Name of System
\ ( )Spring
TJ- ( )Stream or Creek
TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSEDs
(.)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 w Ll invalidate the application 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.
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 acknowledges receipt of this individual sewage disposal permit F 1 ion and a perm fee i/t the amount
��CC// _ ��/�/
of $ `J o _ , Receipt Number , Date Fee Received by Administrative Officer
130 South Galena Street Aspen, Colorado 81611 303/920-5070
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