HomeMy WebLinkAboutpitkin.eh.246314101001 (1976)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As-built Design
Engineer Design
Soil Information
Floor Plans
Water Permit & Information
Land Use Approvals
Second System on property
Third System etc
(All relevant older documents in the same order as above)
(A red sticker will be placed on both sides of the file tab when doc. is scanned)
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PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER
76065
Owner ~ /~ ,l ~' ~
Owner's Mailin/g/A/d~dress
Contractor
Phone No. ~/? ~~.X%~1f'~
Address ~-'"~ ;X ,/y [/l/U/1 ~/L
System's Contractor's Name ~~ - ~ ~ ~ ~-`~ L ~~TC~/~~~1-~~-~
Address
Legal Description
Lot Size ~ S~ ~~ -~ /~7Ci.~~ `i
Building by Use
Number of Bedrooms Type of Water Supply •~~ ~
Owner's Signature, ~ ~ Date ~ -~
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System
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RECEIPT NUMBER q
Phone No. ~~3 ~Z~ ~ /
_ ~C~ n~~~~ ~E-J7
Type of Soil or Soil Classification>J~ ~"~ J/`t^"' U r [ ,(./-r / / c ; 6 / Cr-/
Proximal Location of Bedrock ~°~/P'T 0~~f ~M~~-~~~ ~ ~%~~~~E~` ~~~TN,~Q ~~
Proximal Location of Ground Water Table ~~ ~ ~~F~ ~.P/I'1~/y~ ~ -~,~Ef)T~'/~~'/~ ~~
Percolation Test Date ~~~ ~ Minutes Per Inch 6~
Minimum Recommended Absorption System Size ~•'~' ~~J ~~' ' ~X~ /
Minimum Recommended Tank Size ~l~C~~ CfiLLl--w/~j - TGUG' ~~dl~~~f'TMEjy~
Special Con rtions of Issue: Nonce
When properly signed for issuance, this application
p~~~/!i becomes your permit. Application valid one year from
L/ C- data. If an individual sewage disposal permit is issued
for property on which no building permit has been
issued, the indiv itl ual sewage tlisppsal permit shall
expire 120 days attar its issuance if construction has
not been commencetl. Any change in plans or speci-
fications after the permit has been issued invalidates
the permit, unless appJJoval is secured from the Health
Officer fo~su h cha ~Qes.
Approved for Issuance By ' ~ ~" Date f~/=~~~
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FINAL INSPECTION APPROVAL Gr'~ e ! /' ~rl~;:`!7(G~
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(Drawing of System on Back)
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