HomeMy WebLinkAboutpitkin.eh.264127301002 (1977)(1)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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PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER _774yS� RECEIPT NUMBER P
Owner 1121e2k6 STQwmAlA%I%> Phone No. gas -2-111(n
Owner's Mailing Addressk%ox k7k4- kJ3060%; CYL/ir\L (20 La I?
Contractor2 a e c 1•' R— ,1, A, 4t t� o t� Phone No.
Address
System's Contractor's Name
Address
A
Legal Description
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Number of Bedrooms P—Fj Type of Water Supply 'ad-� UJUDY Ir 9E_ EIS
Owner's Signature �.Iuo;A Date 'UM— 0 t 151D
PLOT PLAN: ATTACADANEQUIRED —NO is JvP-IEy EVER, DoAlfE
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Type of Individual Sewage Disposal System Ef!ne- X604 7EEPACE &D
Type of Soil or Soil Classification //4M G azeeteS
Proximal Location of Bedrock
Proximal Location of Ground Water Table
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Percolation Test Date IL Minutes Per Inch
Minimum Recommended Absorption System Size 40io =aQ FT 6,9 /X/:&, /�D
Minimum Recommended Tank Size /-5 Lr C3 /1 LL-62AI)
Special Conditions of Issue:
NOTICE
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A pea ♦
When properly signed for Issuance, this application
becomes your permit. Application valid one year from
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date. If an individual tewpe disposal permit Is issued
for property on which no building permit has been
Issued, the Individual sewage disposal permit shell
expire 120 days afar Its issusna If construction has
not been commenced. Any change In plans or specs
fications after the permit has been Issued Invalidates
the permit, unless approval is secured from the Health
IOfficer
Issuance By
for +uch cha-ng7es.-7
Date 5,y /
Approved for
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FINAL INSPECTION APPROVAL
Date. �-5ZWIZZ
(Drawing of System on Back)
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