HomeMy WebLinkAboutpitkin.eh.246514102018 (1977)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.
�] PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER —L/(' RECEIPT NUMBER &R
Owner r %�r Phone No. —32,3_
Owner's Mailing Address
Contractor—�/Qn/l E _ Phone No. 5A AftAr
Address
W
System's Contractor's Name J;PAV AL
Address
Legal Description Ler at 4ftm
Lot Size 4 &-r- it 41 coos Type of Building by Use eAX
Ib !O
Number of Bedrooms %7 Type of Water Supply 664" -wooftles
Owner's Signature Date aaa� & --Z7
PLOT PLAN: ATTACHED AS REQUIR I
*k******►►►*********************w****k*************Y***++*******k**k***************aa****►
Type of Individual Sewage Disposal
Type of Soil or Soil Classification
Proximal Location of Bedrock /yDT
D SAN
le
"L
Proximal Location of Ground Water Table G�F4725�—p 7W,4 1- �S�r
+++++*****w******wwwa**k* wwk***k*+**#*w*****#****a a a a**#******www****akw***►►►►►ar Is
Percolation Test Date 34/0 Minutes Per Inch
Minimum Recommended Absorption System Size J/ �Q `�J / x /0 1,�FLOLt) INLET)
Minimum Recommended Tank Size lS-rl ET yl AWATF0 7REATMFA1T- PtAndr"
1-2,SU C,ALL0
Special Conditions of Issue: NOTICE
When properly signed for issuance, this application
/D I� becomes your permit. Application valid one year from
date. If an individual sewage disposal permit is Issued
for property on which no building permit hes been
issued, the individual sewage disposal permit shell
expire 120 days after its issuance It construction hes
not been commenced. Any change In plans or speci-
fications after the permit hes been Issued invalidates
the permit, unless approval is secured from the Health
h 8
�jIi Otf��ipSuch ZZZ
Approved for Issuance By Date
****e*****►*********************++*+****+******+*+*+*+***************a*********►**►►►**Is
FINAL INSPECTION APPROVAL -��f Date IdI/'17
(Dawi�g of System on Back)
W I d
Y (2.Do JErr Az2 rwo
T(,L.-ATME/JT -tl-A T
104
.41
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PITKIN COUNTY HEALTH DEPARTMENT
Owner
Address
Contractor
Address
Phone
Phone a
Location of system err��sc,:i;,�S 7- Lot Size
r
Legal description
Date L. 7 17 Z
Siganture of owner
Percolation test data /. "eZ�ZyIYAxper inch
Minimum recommended absorption system size
Minimum recommended tank size / ') .[~n
Permit application valid one year from date. Application to become permit and
final only after lower portion is completed and signed. Retain this form at
the construction site.
DRAWING OF SYSTEM
l dT /F
Plea
Date SaniArian
3