HomeMy WebLinkAboutpitkin.eh.246734301011 (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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40AG7-343-01--011
PITKIN COUNTY HEALTH DEPARTMENT / q
PERMIT NUMBER C)( RECEIPT NUMBER '22693
6 3
Owner 5F-l2C F a -
Owner's Mailing Address
Contractor
Address
System's Contractor's Name
Phone No. 9_�3 - a)5,3 -
Phone No.
Address -1-11-3 � 'ti'f �RVILIL4
eyl- Woo'o _-.,R« v -Ill 7 U
Legal Description Ar // ,Fl ee r / / Zee / ai-rFkM'y 4-- ,Lou/�tRss lfv- A-
Lot Size / - )- g &2 r- f__5 Type of Building by Use Z f-510'-eV(772Z 'S/060L
flC D/s�o58g.
Number of Bedrooms `3
Mb 0f sfdtURsdygType of Water Supply e o `I�/M uulP�i pfd L
Owner's Signature Date /9 / 9
PLOT PLAN: ATTACHED AS REQUIRED
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Type of Individual Sewage Disposal System /OA/ jVA/Ca' &5
Type of Soil or Soil Classification 91t," LOAN — SHALE F.Pi9GMEn1-rg
Proximal Location of Bedrock 6)eEA'rF4 7 -HA P.) 8 FT.
Proximal Location of Ground Water Table C EATEG -rMAP/ B FT,
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Percolation Test Date�-39 Minutes Per Inch
Minimum Recommended Absorption System Size W Sr.7-
Minimum Recommended Tank Size /ODD G'ALGD^/S'
Special Conditions of I ssue:1BSOi2M_.1eA1 Sys% /✓� NOTICE
When properly sipnetl for issuance, this application
✓ data your permit. Application valitl one year from
/o86 //s,AtieJ //I Oe_ dereIt an individual sewage thisosel
permit Is Ivuatl
�Al�� TiE'FiV"C-SA140-7-
40 / for property di which n0 building permit hes been
T/l��l N issued, the individual "issu disposal permit shall
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expire 120 tleya after iv issuance If construction has
gx� ' Gje TNAA) S FT !d/ H To not been commenced. Any chang4 In plans or speci-
fications after the permit hes been Issued invalidates
�a /7 (� the permit, unless approval is secured from the Health
T7cA1 27 0 Szz^. Officer for such changes.
Approved for Issuance By Date � z
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FINAL INSPECTION APPROVAL Date Y
(Drawing of System on Back)
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER 9-1ALL U77 II -� 4 PHONE 9I a 3 3�i�35
MAILING ADDRESS —11 S1�I Y AS \_ CQ (6II
LEGAL DESCRIPTION OF PROPERTY C-O34-;orA. kcm� S-_ k=-3A.n-4-4-- �
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LOCATION OF TEST HOLES �IO 06 LU
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 8 hour soak
30"
l5"
2'�'
TEST HOLE No.1
TEST HOLE No. 2
EST HOLE No. 3
DropTime
R
Dro
Q!JR
Time
Drop
,a Time
.5 911
3:tO
513
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3 /a
S 16 'Y (
0
s Ib
b t
4 iy
53 -4 (6
3 3 a
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6
5I1b 3: 41
ib
lit,
3'. 4 D.
I 4
3'.60
5
'O 1b 3.5
3 19 Itb
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Percolation Rate Each Hole 3 1 m 3 a 53 „� C
1�3
Average Rate
Comments on soil or site: 30iIS AtRCO'np0Sed/ S.tAJ'e Int 3v�dtnn std{, I1i�moS�
0.n Lovo�' �
Slope : ao I5 k ,
Signature rA�p C l CkA d ti't
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Date _ 'T-ao -T9