HomeMy WebLinkAboutpitkin.eh.246721201006 (1976)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
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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
6
PITKIN COUNTY HEALTH
PERMIT NUMBER 76072
2 ( — to
DEPARTMENT
RECEIPT NUMBER '2 O
Owner (�i o,i /// C/ c% 6b'i`Sc)�) Phone No. Ie! -?VV/ 7
Owner's Mailing Address 20 Ln K 2 :5 Z Sfl L7 1, lei [. o
Contractor s lYI G 4s f%ir u P Phone No.
Address
System's Contractor's Name ct 1lzv X EL
Address
Legal Description Z ;7' yl
Lot Size G• %K QG2e Type of Building by Use
Number of Bedrooms
Type of Water Supply C c rt Ji e L 1— e //
Owner's Signature ��x Date d&�f�-
PLOT PLAN: ATTACHED AS REQUIRED
*#*******!**}*#******!*********}N***********************************
Type of Individual Sewage Disposal
Type of Soil or Soil Classification
Proximal Location of Bedrock
Proximal Location of Ground Water Table
}##N****#}#*##M}*#}#NNN#*}##N*#N!*!*##*#NR**^}*}!#}******#}!##******Q#N**N#!}#N#***!###NNR#
Percolation Test Date —/G Minutes Per Inch V ��
Minimum Recommended Absorption System Size / / �,/� C/ y " rr
Minimum Recommended Tank Size / ij �14zax '
Special Conditions of Issue: NOTICE
p When properly signed for issuance, this application
A/57— � 14 dV/�/Wl Al D` sO / becomes your permit sewage
lisp valid one year from
/ ' (// � date. If an individual sewage dhposel permit is issued
12ET F,Po�1 /��/�� �0� �7//�� for property di which ev building sp salpermit hes been
// U issued, the individual sewage disposal permit shall
expire 120 days after Its issuance If construction has
not been commenced. Any change In plans or speci-
fications after the permit has been Issued invalidates
the permit, unless approval is secured from the Health
Officer for such Chang". /
Approved for Issuance By 100 !G! �i Date ��7�6
NR# #*} #*eR###/�#eN*}*##N#e##
FINAL INSPECTION APPROVAL Date �D� �` 469
(Drawing of System on Back)
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