HomeMy WebLinkAboutpitkin.eh.246733402001 (1977)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.
IA + 0 247-33j�-OZ-0011
!j%� PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER /" RECEIPT NUMBER 6'M
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Owner • n i.n Fl ti _ nn t PhoneNo. { z j - '38, n
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Owner's Mailing Address `1! 5nl ., �v.�
ny')MASS 0 C �l01--n , X16S`f'
Contractor ') l Phone No.
Address
System's Contractor's Name
Address
Legal Description Lal 1, may 2, 3gL> �z-I�—c'5f nor 6F !sA1DIjkV6:& M
Lot Size i Ac_ems Type of Building by Use
Number of Bedrooms Type of Water Supply lffmaj±�j 45,4
Owner's Signature Date 6(F7 P= qi )CI
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System
Type of Soil or Soil Classification
/�--)/I- 1 7 L -U/ /riy.Cc�/(�tOGfINyy/7Gy//i1Gc �c//(� ie
Proximal Location of Bedrock Nor oF-7- �1 mCD' � CCATQ ��AAJ 19 �T
Proximal Location of Ground Water Table / OT- PE�M0JFD - ge6gT'�e T-HAd 8 Fr.
Percolation Test Date —Minutes Per Inch _21�6 2
Minimum Recommended Absorption System Size
F.
Minimum Recommended Tank Size 1000 GAIL -61 VS — T -U/0 (7AA4PR,0e'MEAIT3
Special Conditions of Issue: NOTICE
When Properly signed for Issuance, this application
li SYS EM fl BSORPiIon/ /{�tA TG �� bacgmas your permit. Application valid one year from
/� �j
Gate. If en individual sewage disposal permit Is Issued
LOCAE-(? To4 (.L p<,-T-t7CAI Pne-1 loiJ OF uuW°M� on
vwhichidual no builge ding pesal permitshallhell
L -Q j — I /r 501 I A&_C- Z61L A MO A espke 120 days after Its WuMd If construction has
not been commenced. Any change in plans or specl-
MIN IA4 Um OF 9-5- F%. r)OA1 GU,47-E.e fications after the permit hp been Issued Invalidates
- / the permit, unless approval Is secured from the Heslth
L1 ry E 1111_ Officer for such Chang". g
Approved for Issuance By Date Date `/,5 -17 7
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FINAL NSPECTION APPROVAL
(Drawing of System on Back)
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1000 CAL LOAI
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'No. •24553
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County Treasurer's Office, Pitkin County, Colo.
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Account of
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Credit to Fund.
-� Treasurer
3 By Deputy
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER �/O PHONE
MAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after $4 hour soak
L
3,
TEST HOLE No.1
TEST HOLE No. 2 TEST HOLE No. 3
351-
Drop Time
3 5" 1- 3 SL
Drop Time Drop Time
7
35
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1
(0 l6 s Z01
'ZW14
I
Percolation Rate Each Hole
Average Rate 3s�_
Comments on soi' --
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Signature
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Date