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HomeMy WebLinkAboutpitkin.eh.273512300001 (1986)2-3 - 00 -©o ASPEN4bPITKIN ENVIRONMENTAL HEALTH PARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT N0. 7 s TYPE OF PERMIT: ( )Initial Construction ( )Emergency Use or installation ( )Use Permit as it result of Sale ISSUED TO: Owner Mailing Address_ Agent f��� L-jQ 4e. Phone q2!.; Mailing Addressd/1/`� �_ _ Sewage Disposal System Work to be performed 1) A40- �J 1M S9YDEle== Xepair work,(Pcevious Permit 1� t )Alteration of an existing system, (Previou. Perm t i ) ( )Othors / ,^ n DATE OF ISSUE r Home Phone Business Phone— A This permit valid only for premises location by the following legal description: LOT SIZE , WATER SUPPLY �i6 TTY . AVERAGE PERCOLATION RATE This Individual Sewage Disposal Permit is granted with regard to the following uses ,410rKAIANCL. Nu:aber of: Dodicoms _ Lofts_ _ Carbage Disposals__ Dishwashcrs---4�?— Clothes Washors . CALCULATED AVERAGE DA?LY WASTE LOAD horn CALLONS. THE NATUP.E OF THE SYSTEM INCLUDED UNDER THIS PERMIT: Type of Tank or Treatment Unit: &Prle r !trv< Method of Final Dispo9alsSCEOA-96-A--j— I Absorption Description (including brand name, if any) of other equipment or appurtnances: _0 R V ///i V, IAI Tank Capacity _Galion Minimum Area square feet Minimum Other Conditions or specifications: App, VAS FD4 OEPi"I e.1 431AL-LA roA� STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: ( )Acfore Excavation ( )Upon completion of excavation and prior to p�aCement of gravel SJSfnystem ofvabsorptlon fieti ldon (Prior to backfill of any component ( Jother, Specify: — Plans and specifications of the proposed sewage disposal system have been reviewed and are considered satisfactory. Pernission iK hereby granted to tte owner or his agent to perform the work indicated above in accordance with the Pitkin County Indivi'lual Sewa;c Disposal Rc,:ulations in effect on the date of issue. In addition to general provisions act farth on the reverse hereof, this Permit ie subject to the following additional terms and conditions: A-4APPROVED FOR ISSUE BY 1 (title) The above individual seva.le disposal system installed by Ana been ln::pcctcd for use by a representative of the As responsibility in case of failure or inadequacy of this/ DATE OF -FINAL INS BY: e Q 0GG/AJC/ Jit[-h--w-W-LiC i Lnvlronr�rital Ilea . Dcp.%rtmcnt. :tic ownur eve+a�noa a 0/disposal aystcm. Completo as -built drawing TITLE 130 SoutA 'Galena Street Aspen, Colorado 81611 303/925-2020 D'O'D 0500 im rPEN PITKIN AS � ENVIRONMENTAL HEALTH. DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL•PERMIT Name of OWNER C �,La�' PHONE,>� i y Address of OWNER Name of APPLICANT PERMIT TO BE: ( )Picked Up ( )Nailed 1(.� ( fbwner ( )Applicant PHONE TYPE OF PERMIT: ( )New Installation ( )Emergency Use U ( )Repair ( )Alteration NOT due to failure rs Legal Descr pt on Loc Block Filing_` Subdivision Size of Lot acres TYPE STRUCTURE: ( )Single Family Dwelling g[Jotheea-- Do you plan any furthe( ditions to the ��/ "`... �jresidence? ( ) YES QO NO No. of bedrooms=; `No. of Lofts::2122=d No. of Garbage Disposals GGA No' Of Automatic Dishwashers+.- 42i= No. of Automatic Clothes washers WATER SUPPLYs ( )Private well, Depth or ( TPublie, Name of System ( )Spring ( )Stream or Creek TYPES of INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( iSeptie Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound (/ L )Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Other: The 'initial site inspection mus[ 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 AN•I PORTION OF THE SYSTEM. Application for an individual sewage disposal perpi is hereby submitted. The undersigned acknowledges that the above information is true and that false informs Son wil n lids a the application and any subsequent pe mit. 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 hereby acknowledges receipt of thi individual sewage disposal permit application and a permit fee in the amount Receipt Number � , Date Fee Received by Administrative Officer 130 South Galena Street Aspen, Colorado 81611 303/925-2020 fly XSPEN46PITKIN ENVIRONMENTAL HEALTH DEPARTMENT FIELD TEST DATA SHEET Legal decription: Name of Owner: Address: (# & st. / p.o. box) (city) (state) (zip) Name of Agent: Water Supply: Public Utility Subdivision Private Well Lot Area: Distance to NeareWs:-A ce Water ft. Dates Observations Made: Soil Borings:by �4/ Percolation Tby' SOIL BORING TESTS �k�g3k ' T(ET MUMSER TOTAL OCOTN FEET 011TH TO SPOVND WAt(R, I[CT $:i CHARACTER OF SOIL WIN THICKNESS IH F[ET y, OS![RY[D ESTIMATED HIGH � Agog 10 Agoggoggo CILL 2,5 B-1 ���rt/ nl µ N041R1 WATER 1-1 TIME, OROP IN WATER LEVEL. INCHES B-2 SECOND TO NEST TO LAST TEST DEPTH CHARACTER OF SOIL SINCE NO PERCOLATION TESTS Average Rate:.; minutes/inch Plan of the site on the back Date D Signature BOB NELSON ASPEN/PITKIN SANITARIAN 130 S. GALENA ASPEN, CO 8 ; 6 1 1 Agog 10 Agoggoggo 919]g9ggo N041R1 WATER 1-1 TIME, OROP IN WATER LEVEL. INCHES MINUTES SECOND TO NEST TO LAST TEST DEPTH CHARACTER OF SOIL SINCE NO IN HOLE INTERVAL TO FALL NUMBER INCHES THICKNESS IN INCHES ST WET OVERNIGHT N MINUTES LAST PERIOD LAST PERIOD P[R100 ONE IN" P-2 P-3 P-4 Average Rate:.; minutes/inch Plan of the site on the back Date D Signature BOB NELSON ASPEN/PITKIN SANITARIAN 130 S. GALENA ASPEN, CO 8 ; 6 1 1 a 4W gym. r GA LLOI 1 r..; 140 P =� Aayen+yt.�N€ ScPnc ?A�1 K D►Q W �- ��'ME)li'i"'S romm 44 A y i +y. f � ter.. .* •� Of lw f � TVA �4kk U.Apr 1 w will •�------�-- �s. sest1; 10- N 7y Alp