HomeMy WebLinkAboutpitkin.eh.246717401022 (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 2 /�a
PERM NUMBER p VIP �M868TEIECEIPT NUMBER 23Z5%
Owner — Phone No. `1 ? n a�
Owner's M
Contractor
Address S g (Yl
System's Contractor's Name 51`4/nl
Address
Legal Description
Phone No. C% 23 — yo -)7
Lot Size 0-39 Type of Building t
Number of Bedr L ype of Water SuF
Owner's SignatuT- Date
PLOT PLAN: ATTACHED A4"ECjyJI{RED
r
4#4**N*#*****#*****N%*%4*%*****#***%*N***#***R***N*#******##*f4#**#**f*******R R**#**44*%##
Type of Individual Sewage Disposal
Type of Soil or Soil Classification
Proximal Location of Bedrock
Proximal Location of Ground Ii
****4%**NN******************1
Percolation Test Date
Minimum Recommended Absorptiol
Minimum Recommended Tank Size
Special Conditions of Issue: NOTICE
p �: f G'E BES/ When properly signed for issuance,tiovalid
d o application
�tj,s� o /I date. If your permit. Applisewage
disposal
salitl one year from
LDl..fr t date. If an individual sewage tlispowl parmlt is Issued
for propertywhich no buildingpermit has been {uuetl, theheindividual sewage disposal permit shall
expire n c tleye after Its issuance if construction r s hes
Ly L c� not been commenced. Any change in plans or apaci-
fications after the permit has been issued invalidates
the permit, unless approval is secured from the Health
Officer for such chane n.
Approved for Issuance By Date 17
FINAL INSPECTION APPROVAL
II (Drawing of System on Back)
14 ate
Im
0
9aO-V
i PPROA I MAIC
RI -44
�L
Hou
-E-
i
WATE¢
PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER �6 yzr PHONE
MAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES /
Three (3) test holes required per system
li ri
Test Hole Depths (24" minimum) -37-
Diameter of Test Holes
Water remaining after Mhour soak / 3
TEST HOLE
TEST _No. 2 TEST HOLE No. 3
Drop
y
Time
Drop
Z9
Time Drop Time
Y2-
6
8 X6
b
2
3
7VIL 4.1
3
'
L
93
84
I
7
1 Y4 qqg
?9
q5L
s
q
5o(v
6
7 /
SI le
$ Y8 512
Percolation Rate Each Hole _ 27
Average Rate l''/
Comments on soil or site:
Signature
y
Date /4 kt,
33�
S
Tb PAr-A
J�, c N /A
ol
PO
,1x-a�
73
5F