HomeMy WebLinkAboutpitkin.eh.246717401031 (1978)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
PERMITNUMBER JT RECEIPT NUMBER
Owner-�rP�� Phone No.
Owner's Mailing Address
Contractor Phone No.
Address i
System's Contractor's Name
Address
Legal De
Lot Size—c? Type of Building by Use
Number of Bedrooms — -Z.0 P F4 Type of Water Supply � /�
Owner's Signature lit '� ' n / ��11 Date Z1• 7ce
PLOT PLAN: ATTACHED AS REQUIRED
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Type of Individual Sewage Disposal S /stem 1C /ANK
Type of Soil or Soil Classificati
Proximal Location of Bedrock
Proximal Location of Ground %
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Percolation Test Date dO—2,3Minutes Per Inch
Minimum Recommended Absorption System Size /72-0 is
Minimum Recommended Tank Size /" C ZILOAJS
Special Conditions of Issue: NOTICE
When properly signed for Issuance, this application
becomes your permit. Application valid one year from
O �G.. date. H an individual sewage disposal permit Is Issued
for property on which no building permit has been
Issued, the Individual o wege disposal permit shall
expire 130 days after Its Yuma If construction hes
not been commenced. Any change In plans or specl-
ficetlons afar the permit hes been issued invalidates
the permit, unless approval Is secured from the Heatth
A/K
Officer for m Zhangs,
Approved for Issuance By 144, Date
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FINAL INSPECTION APPROVAL ;ite
(Qrawing of System on Back)
P/
FT
11