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JAN.23.19% 3 :0BPM CITY OF ASPEN NO.eo P.1- <br />.A <br />COLORADO DEPARTMENT OF HEALTH.. . <br />Water P0l1Ut16ri Control -DivJsion <br />4210 East Ilth Avenue <br />Denver, Colorado- 80220 <br />APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS <br />Applicant (Owner): &D— CD/+�7`7Al �7` �¢a. . CdK1�' <br />.- V� <br />Mail Address: C/Q j- JS city: e01W Phone: <br />A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: <br />Attach separate $hosts or report showLng ent_i re area wl th_-respett ta- s-urround ft <br />areas, topography of area, habitable buildings, location of potable water wells, <br />soil percolation test holes, soli.profiles in test holes. <br />1. Location of Facility: county /'j'�/ % —, C 1 ty or Town <br />Legal Descr.i.ption ,8F91S_C'. CQ? AIAIR VrgRb Lot Size: - <br />2..,,T.ype of area and facility - Number of persons served: <br />Subdivislon Motel Restaurant Trailer Court <br />Other: _ /NF_ CH/Midi g 14,0g F _ <br />3. Source of domestic water: Public (name). A/CJ/V <br />Private: Well . Depth Other � Depth to first ground water table <br />4. is facility within boundaries of City or Sanitation District: ill D <br />If so name: <br />S. Distance to nearest sower system: 10 All-ES <br />Have negotiations been attempted with owner to connect: <br />If rejected, give reason: <br />6. Rate of absorption in test holes in minutes per inch of drQp In water level after <br />holes have been soaked for 24 hours: _ j <br />7. game, address and telephone of person who made soil absorption tests: <br />�+l n1 s I q' 68 <br />8� Name, address and telephone of person responsible for design of the system: <br />.46 0qA✓ 7'u>�ar �6? 1-Jc_A1 1X/00 0 SefLly S 1.,0 OT900 <br />9. Est. bid opening date: Est. Completion Date: Est. Project Cast; <br />Date: <br />//A <br />Sign of Owner <br />i <br />