HomeMy WebLinkAboutpitkin.eh.246524201017 (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.
s .,.
�-T'" NUMBER / / 6f1 1, e
Owner
Owner's Mailing Address
•PITKIN COUNTY HEALTH DEPARTMENT*
V6 5- -rya -0/- oil
RECEIPT NUMBER /28?
Phone N 923 -,26'5/0
Contractor Z Cr Phone N ��2
Address
Systems Contractor's
Address bf-A V& 3 (Ali,014✓
Legal Description
N 24 %S 1,1P 8
�12
Lot Size a a,"') Type of Building by Use /f
Number of Bedrooms 3>o Type of Water Supply 1u2F /�
ll
Type of Individual Sewage Disposal Sysst�em Akf/irw Ami r/�YE4/'TT K- Se6eiK+E,�ff 40
Type of Soil or Soil Classification CtAy Imm TD G,PA!/£L r0 [ eAy To 68ez"
Proximal Location of Bedrock
Proximal Location of G� and Water Table MCA90eD Ar 90
wn" L
Oer's Signature / r 1`
PLOT PLAN: rl
�/ Thr
Date
-*14prpo✓cD L.EAeH F/ELOt DISTRiSun0,1 S , w /O�-2 R J
'CCEpp 7p SEE SF.w£.� NCS , C.(JJ/f/NG ANO�et TAN,r
ifMk#1E*** 3Fif iF3k#'iF iEiEif dF dE61EiE iE iE iE9FiF 9E iF3F iE 9F 3E iFdF if iE It iE itif dEdF 9E iF 3E3E 9E*iE3E iF iE 3Ei—r.4 ,, dF iE#'iF iF'ieia iF 9E if#iF iE iF iFiE iElE iE 9EdF if iF iF 9E iF dE it 9E iE dE dE jE9E iF'h 3f j: d'iE�
Percolation Test Data -0-/FJ Minutes per inch
Min R eked b or ion stem Size -540 A. • l 1O'xSG /SEE%1SE
Minim Ree mmended Tank Size ,) v eek /<Lo.�/ i7e.r eu / /T ��'��/r/
22%is F
Permit a lication valid one year from Date. Application to become j5efrmit and final only
after lower portion is completed and signed by the Sanitarian. RETAIN THIS FORM AT THE
-CONSTRUCITON SITE.
Date /L/2-1� Sanitarian
(Drawing of system on back)
a
\I
t•
-� ERCOLATION TEST FIELD SHEET
NAME OF OWNER Bt A Sp/J PHONE
ADDRESS
LEGAL DESCRIPTION OF PROPERTY
At least two (2) test holes per system must be run. They should be in the
area of the proposed leaching system and dug to the depth of the proposed system,
generally 2.5 to 3 feet deep.
The holes are to be soaked for a 24 hour period prior to running the test.
Test Hole I
Test Hnle TT
Reading
Drop Time
Reading Drop
Time
if
w
3%
g:zoe
:s -T
f.. Zr
3
¢:
3s
3%
z
4:¢r
2%z
S�
27s/0
1.Y8
4:Z8
¢:.r8
4: $18
4:sg
S••a$
PERCOLATION TEST RESULTS:
Hole I Minutes per inch Hole II /S Minutes per inch ` V
Average percolation rate: a Minutes per incl.
Comments on soil and/or site: / //� A
Name of person running test: hone: �/ S
3 Address: Signature: