HomeMy WebLinkAboutpitkin.eh.246334101004 (1975)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design
Soil Information
Water Permit & Information
Second System on property
Third System etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
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'19 9 j U ofU PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER
Owner
Owner's Mailing Address Aft 1244 County Road 106 Carbondale
Contractor
Address 7G? elA,& AW
Systems Contractor's Name
Address
Syr- ��-
RECEIPT NUMBER 19o49
Phone # 963-2745
Phone #
Legal Description Lot 11 Seven Oaks
Lot Size 1 acre Type of Building by Use Residential
Number of Bedrooms 4 Type of Water Supply Central (7 Oaks)
Type of Individual Sewage Disposal System
Type of Soil or Soil Classification
Proximal Location of
Proximal Location of Ground Water Table
Owner's Signature
PLOT PLAN- E—
�0
3)
0�
I "Op
Percolation Test Data r� / Minutes per inch
Minimum Recommended Absorption System Siz
Minimum Recommended Tank SizeC5 C)
Permit application valid one year from Date Application to become permit and final only
after lower portion is completed and signed by the Sanitar' ATHE
CONSTRUCITON S TE. /% �✓
Date Sanitarian
Drawing of ystem on back)
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER c00-1--1 /� PHONE
MAILING ADDRESS 12-`I c4 C0 (COQ O C� L J(s
LEGAL DESCRIPTION OF PROPERTY c1Q�-�
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum) 3 a
Diameter of Test Holes
Water Remaining after 24 hour soak
G000110001
G3 -
I. Drop Time I Drop Time I Drop Time
Percolation Rate Each Hole C) lU
Average Rate CitiN U4 `
Comments on soil or site: `
SIGNATURE
• — — - — DATE
C + COLORADO DEPARTMENT OF HEALTH
COUNTY REQUEST FOR SS VICE
PROGRAM Z/ RECEIVED BY
LOCATI
REPORT
ACTION
SH -M-71 (4-71-50)
DISPOSITION
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