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HomeMy WebLinkAboutpitkin.eh.246725400007 (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. se s- • PITKIN COUNTY HEALTH DEPARTMENT PERMIT NUMBER' I` RECEIPT NUMBER Owner S (Lawwil-Cc- C 9E- � Q� Phone No. q 3 X,/6// 6 �/ Owner's Mailing Address BpA "Fqp ,/ / 1J nf u- � . (OL -0, X,/6// Contractor Z TkW e�)DS),-ko Phone No. Address 'f�;F)X _Ly 3 System's Contractor's Name Address Legal De Lot Size Number of Bedrooms Owner's Signature PLOT PLAN: ATTACHED AS REQUIRED Type of Building by Use zalp&iV 14 L Type of Water Supply . /j4jt;-L L Date a*aa*a a r*****r*aa*aaa**a a s a*aaa**a as a**•*a ra a a*aaa***a**aa**a*a*a**a*a a a a a a**********}a ars Type of Individual Sewage Disposal System Type of Soil or Soil Classification SUOY fnr- F .s'Xit 0S719.✓F `-P,01C1W1FAdT3 Proximal Location of Bedrock G,eEATee THAI/ O FT. Proximal Location of Ground Water Table GiQEATCX THAA/ 8 FT. ***aa*4**aa*a**aa*a**N*a*aa*a 4a N4*44N}a*4**aNNa***aa*a a * * a a a a a a*4Nt a a 4*a**aIs*****}**aY*4}* Percolation Test Date 4,3T/9 Minutes Per Inch Minimum Recommended Absorption System Size //00 .547F7- Minimum ©FT Minimum Recommended Tank Size 12—.rO CAu-oAIS' Special Conditions of Issue: NOTICE When properly signed for Issuance, this application `QOM %/ov3E Ta �ANIr �(��Tra a� U becomes your permit. Application valid One year from D�X data. If an individual sewage disposal permit Is issued /'K/WO� �� /� for property di whish no building sarme hes been ( ✓ /ISEME.JT issued, tins individual "wage disposal permit shelf expire 120 days after Its Issuance If construction het not been commenced. Any change In plans or specl. fications after the permit has been l+wetl Invalidates the permit, unless approval is securetl from the Has" Officer f r mch changes. Approved for l4uance By Date aaaa3w as*.w*wa*•*a rrr►ar♦aa#aarrw*wwaaa a aaaa**•****w***aa*a***r aw a a •*ra*aa*r Is*Is Is Is *a FINAL INSPECTION APPROVAL �� f Date , 71 (Drawing of System on Back) 10 ROVSE 2—'750 GALLC J SEPTI`, O N EAcm MRISo`o5- OS LtAWoUT$ 64 /fie$ DEE P i71 r 13' y ��dac BSB ,,. � Popax PUMP 114 SCALE 1'1=:30/ (�pwo By I - 8S s trE IAISF>6�C-T-/oti1 F/j CfAA�L ulA&1< 0 ARAE AND oNf 9v-DROM 14 Wrmdr PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER �q ca( -e PHONE 97a 3 -'IWJ 2 MAILING ADDRESS PZ) 6f&� LEGAL DESCRIPTION OF PROPERTY !.B•f (P 1M� LOCATION OF TEST HOLES Three (3) test holes required per system Test Hole Depths (24" minimum) Diameter of Test Holes Water remaining after 8 hour soak Ail Ahase . _30 Lds �ro rn .ra , ( rod d n ii li 5 . TEST HO o. TEST No. 2 TEST HOLE No. 3 Drop Time Drop Time Drop Time l M'f/6 5fl 5 a /S7Air :3,2 6 =So q(141,15r.191.�q 0 S 13 4"//(. :oo (42Ka lb : D I i3 :3 Slit, 4 4 b 1 vi sI ((a I -'s f Percolation Rate Each Hole 3oZ =n in Average Rate 3 5 rm.- .. ,,,c L Comments on soil or site: d foJJ y'G Ef [ QOtJ `4 I [t Sa � w/�k 3 Signature Date