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Home My WebLink AboutPitkin.EH.272904100001 (2020)3/5/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permthid=thread-f%3A1660269676228654496&simpl=msg-f%3A16602696762…1/3 Bryan Daugherty <bryan.daugherty@pitkincounty.com> Online Form Submittal: Property Sale/Remodel Use Permit Application 1 message noreply@civicplus.com <noreply@civicplus.com>Wed, Mar 4, 2020 at 2:15 PM To: schuyler.clay@pitkincounty.com, ehapps@pitkincounty.com Property Sale/Remodel Use Permit Application Please Note: Each OWTS System must be submitted individually. If there are additional systems on the property, additional applications are required. Job Parcel ID 2729-041-00-001 Physical Address 14418 Hwy 133, Redstone, CO Residences 1 No. of Bedrooms 3 Square Footage of each Residence 1349 Purpose of Use Permit Property Transaction Closing Date 4/10/2020 Lot Field not completed. Block Field not completed. Filing Field not completed. Subdivision HOT SPRINGS RANCH (UNPLATTED) (Section Break) Primary Contact Information Primary Contact First Name Sharon Primary Contact Last Name Boucher Primary Contact Email Address sboucher953@gmail.com Primary Contact Address PO Box 700 Primary Contact Phone Number 970-379-4489 Primary Contact City Carbondale Primary Contact State CO 3/5/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permthid=thread-f%3A1660269676228654496&simpl=msg-f%3A16602696762…2/3 Primary Contact Zip 81623 (Section Break) Owner Information Primary Contact is Owner?Yes Indicate Preferred Method of Payment Debit/Credit Card Payment Contact Email for Debit/Credit Payment sboucher953@gmail.com (Section Break) Licensed Inspector Information Primary Contact is Licensed Inspector? No Inspector First Name Carla Inspector Last Name Ostberg Inspector Email Address carla.ostberg@gmail.com Inspector Mailing Address 33 Four Wheel Drive Road Inspector City Carbondale Inspector State CO Inspector Zip 81623 Inspector Phone Number 970-309-5259 Inspector Fax Number Field not completed. (Section Break) Uploads Pitkin County Inspection Form 14418 Hwy 133 - OWTS Use Permit Inspection Form 01.17.2020.pdf Site Plan 14418 Hwy 133 - OWTS Site Plan.pdf Floor Plans 14418 Hwy 133 - Floor Plan for OWTS Permit.pdf Additional Reports, etc.Field not completed. Comments or additional information: Field not completed. PLEASE READ BEFORE SELECTING SUBMIT: By selecting SUBMIT, I certify that I am the owner or representative with the legal authority to agree to the conditions of this permit, the above information is complete and accurate, and that I have provided complete and accurate information in all of the documents included in my application package. I acknowledge that this 3/5/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permthid=thread-f%3A1660269676228654496&simpl=msg-f%3A16602696762…3/3 department may revoke any permit I am issued if my application is found to contain any inaccurate, false, or misleading information. Building Permit Instructions If this application is part of a building permit application, please bring a copy of this application to your building Pre-Submittal meeting. To get a copy, either enter your email address to receive a copy of your application, or select "Submit and Print" below. Email not displaying correctly? View it in your browser. Owner's Name: Address: Parcel Number: Inspection Date: Pitkin County Systems Inspector License Number: QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION: Is the home currently occupied?YES NO If NO, how long has the home been vacant? How many bedrooms are in the home? RECORDS: Were system records available from Pitkin County?YES NO If YES:Permit number: ___________ Date of Final Approval: _________ # of bedrooms permitted: ___________ Was an as-built drawing available?YES NO Is the as-built drawing accurate? YES NO If NO: SITE CONDITIONS: Proper grading, no evidence of erosion?PASS FAIL Improper vegetative cover?NO YES Evidence of compaction such as heavy machinery or livestock?NO YES Improper discharges such as straight pipes?PASS FAIL Evidence of high ground water?NO YES Snow cover present?NO YES Any question marked FAIL will require correction before an OWTS Use permit is issued. If secondary treatment is used, who is the maintenance provider? Complete a drawing of the system on last page of this form as accurately as possible. Email: Inspector's Name: Business Name: A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by the Licensed Systems Inspector within 60 days of the inspection regardless of whether the system passes or fails. Onsite Wastewater Treatment Systems (OWTS) Use Permit Inspection Form Inspection form for continued use of an existing OWTS Website: Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Phone Number Page 1 TANK: Tank capacity gallons gallons gallons Tank material # of compartments Date of last pumping Lids/risers in good condition Risers to grade Riser height Riser condition/watertightness Inlet sanitary T/baffle Outlet sanitary T/baffle Effluent filter (if part of design) Condition of tank material Tank was pumped for inspection If YES, list the pumping company If NO, when was the last pumping Scum level (1st compartment)inches inches inches Sludge level (1st compartment)inches inches inches Scum level (2nd compartment)inches inches inches Sludge level (2nd compartment)inches inches inches Backflow (if pumped) Midtank baffle Watertightness PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present?YES NO If YES, is the pump/dosing siphon functioning properly?PASS FAIL Does the pump/wiring/dosing siphon appear to be in good condition?PASS FAIL Is the high water alarm working, both visible and audible?PASS FAIL SECONDARY TREATMENT: Is a secondary treatment unit present?YES NO UNKNOWN If YES, does the unit appear to be in good working condition?YES NO Does the owner have a current maintenance contract for the unit?YES NO UNKNOWN Maintenance Provider:_______________________________________Phone:________________________ ABSORBTION AREA: Effluent surfacing?PASS FAIL Evidence of past surfacing?NO YES Surface dampness?NO YES Excessive odors?NO YES Field location verified by observation ports or probing:Ports Probing Liquid in observation port?NO YES If YES, record depth:inches Distribution Box or ADV part of original design?YES NO UNKNOWN If YES, is it accessible from grade?YES NO Is it level and in good condition?PASS FAIL If there is no maintenance contract, a contract must be in place prior to occupancy of the home. A copy of the contract must be submitted to Pitkin County Environmental Health Department. Tank 1 Tank 2 Tank 3 Page 2 Any problems with the system that were not addressed in the inspection checklist? Please list any recommendations for the continued use of the system: Were any repairs done as a result of this inspection?NO YES If YES, please describe the repairs. Licensed Systems Inspector Signature: Additional Notes: To the best of my knowledge and training, the information collected in this inspection is accurate as of __________________, 20____. Clearly label any pictures and attach them to this form. Page 3 HOT SPRINGS RANCH PrMN COUNTY. COLORADO 682 SF OF W LTRATIVE AREA IN 4 GRAVELLEW C AMBER-TRENCHEL EACH TREM04 HAS I ROW OF II CHAMBERS FOR A TOTAL OF 44 Pe 11, F14 TEST PIT 2• PVC CH POMP LINE PVC LINES \ / ❑ CONCRETE DISTFaBUTION BOX oNE HMSE TAN lEFFL NOTE: LOT IS SERVED BY A SPRING 114 MILE SOLIM 54' SETBACK FROM RIVER OWS AS-BULT DRAWING JOB NO.137134W TAW FIGURE 1 -,'