HomeMy WebLinkAboutpitkin.eh.246717401001 (1979)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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PERMIT NUMBER I`I Q'I I
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PITKIN COUNTY HEALTH DEPARTMENT
RECEIPT NUMBER
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Owner ZZ, 711cr 111,4k,2hl- Phone No. " 74.;-.3ao19
Owner's Mailing Address P(* x iii `i F / %F E F / (°r /,., er do 6- AS
Contractor f�/ , �) / /3u, lar ys Phone No.' I43 3'pn o
Address —17.. f +ry fe ! Jy L, I 0"), a Ic. V t
System's Contractor's Name
Address
Legal Description 0 r ""1/tf {la//a ,era 7/r �u6d.-.,,-sI'd N
Lot Size <t ° Type of Building by Use A c Fa a,; 1-4
Number of Bedrooms Type of Water Supply Ce rX4-
Owner's Signature A��� Date Clo 7 241 1
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PLOT PLAN: ATTACHED AS REQUIRED
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Type of Individual Sewage Disposal System
Type of Soil or Soil Classification
Proximal Location of Bedrock
Proximal Location of Ground Water Table
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Percolation Test Date )/ ,F / Minutes Per Inch o2 Q
Minimum Recommended Absorption System Size & 3 0
Minimum Recommended Tank Size /&o0 t c
Special Conditions of Issue: Aa CJ7 �f 'COQ NOTICE
+ When properly signed for issuance, this application
becomes your permit. Application valid one year from
datfor o er individual vvel h no disposal permit Is issued
C��(� •_-C.L /�/{�(/!� _ for property On which n0 building permit hes been
/ expire
Issued, the Individual el mwsua disposal co permit shall
t—UNtw/rs otV G../i' f expka 720 days after In issuance If construction hes
o f
/0 50 yZ „/j�tfpijsp� ��sZC:O r �Q.y(�•� not been commenced. Any thenen in plans
Invalidates epec4
'l (/� �(/�� fications after the permit hes been Issued invelitlens
1n'v L41 the permit, unless approval is secured from the Health
l-tJ s%L- -a2s-t !/. tj r Officer for such changes.
Approved for Issuance ByO / , '� Date
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FINAL
//\\1IINSPECTION APPROVAL 1Cl�L L ��4�� Date /; � 7_2
(Drawing of System on Back)
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