HomeMy WebLinkAboutpitkin.eh.246720101002 (1976)Document Layout
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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.
v 20
PITKIN COUNTY HEALTH DEPARTMENT ,220YZ7
PERMIT NUMBER RECEIPT NUMBER
` OwnerL -rZCi/l/H Phone #
Owner's Mailing Address �O� �� C Rtk�)A)A4(E 6,z,o 91Z> 3
Contractor
Phone k
Address �Q(� f-rn. n.i�� Fig, i �L (J
flc AlA7 AP, N IA/
Systems Contractor's Name 9L.455/t/Z ,7e -,e z,/ZZ//.4
6o -y / 817,3
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Legal Descriptio NC
Description Lor �S S
Lot Size 1.16 Xc2E5
Number of Bedrooms
LLS
Type of Building by UsezvIAI p CE
Gc%,11,b
Type of Water Supply 127/c4 -
Type of Individual Sewage Disposal System Bey Tim ! -yx5TGI72_ xtf1K:Cfi
Type of Soil or Soil Classification ITAAJDY iQED CLAY LD/gN)
Proximal Location of Bedrock NOT DE7 7�- Ml NFD > 8 / A
Proximal Location of Ground Wateri.' e) A/OT DE7-F77PM/1VFQ >
Owner's
PLOT PLAN:
2raxpraa�*a*xa�*�*��+r*x���rx�*���e��rr+�«**+r��ra**rrwa*�r�
Percolation Test Data — Ja — Minutes per i/ncch p�
Minimimm Recommended Absorption System Size 82S = /-r (z X(00 S'EEPAGC ,RJP
MinimumRe o�mmended Tank Size 1V4X-,' Cs/`fZ-Z-ON ' - / u/v 117f --1V i
012
Pexll� application valid one year from Date. Application to become ermit and final only
after lower portion is completed and signed by the Sanitarian. RETAIN THIS F THE
CONSTRUCITON/?ITE.
Date �/ qZ7� Sanitarian '
TD-raw-ing of system on back)
APPRaK IMATf
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PR�oD ' POND
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SEPTIC TANK \
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
1
PROPERTY OWNER 61KL14Z64M�62� PHONE 74-3 � v
MAILING ADDRESS &X 822 1�31kgONDALE. Cy 81 bZ3
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOL
Three (3) test holes required per system
it
Test Hole Depths (24" minimum) X7(0
Diameter of Test Holes 1.2
Water remaining after 24 hour soak O
57
•
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7
L
TEST HOLE No.1•
•
VL
Drop Time
'• `,92
Percolation Rate Each Hole 51_
Average Rate 3—
Comments on soil or site: '1kD saA/D y���1,C-06T DEP71H 1Ns�o F/[. E 7J -07O LEC/.
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Signature��
Date