HomeMy WebLinkAboutpitkin.eh.264309300014 (1978)Document Layout
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Permit
Application
Log Sheet/Notes & Photos
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As -built Design
Engineer Design 1.
Soil Information
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Second System on property
Third System .etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
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ADDRESS NOTIFICATION
Date: 11/30/2016
Effective Date: 11/30/2016
New Assigned Address:
182 Doc Henry Rd Unit B
Woody Creek, CO 81656
Former Address: N/A
Reason for Assignment: Attached CDU
Parcel ID: 264309300014
Property Owner Name: RUFFIN EDMUND C
Note: This address is being assigned for an attached CDU that was previously
unaddressed.
Please contact for any questions or Further Clarification.
Thank You,
Alex Durant
Public Safety GIS Analyst, Pitkin County Government I BITS
Phone: 970.429.6113 (0)
Email: alex.durant@pitkincounty.com
Address: 123 Emma Rd #106, Basalt, CO 81621
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PITKIN COUNTY HEALTH DEPARTMENT_ �j
PERMIT NUMBER � ( Z RECEIPT NUMBER 2k -7 v
Owner r�\ n G— A � -F t Phone No. C 1 1�- 1-\ V 1 1
Owner's Mailing Address 9IJ C� u^,t U v V - CSC .I C, 1 . 0 \ k. 5 6
Contractor 0 " ^ Q- /- Phone No.
Address
System's Contractor's Name
P.7,
Legal Description
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Lot Size Type of Building by Use ter 0-f -\ - Ort \f�)�-Zr,C V'r,'
Number of Bedrooms 1 Type of Water Supply
Owner's Signature - VE C Date
PLOT PLAN: ATTACHED AS REQUIRED
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Type of Individual Sewage Disposal System _-SrOr /C 7n/K �EE�i1�C
Type of Soil or Soil Classification
Proximal Location of Bedrock �RF�%��/���A ✓ O 17—
Proximal Location of Ground Water Table 7H—A ✓ E T
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Percolation Test Date FXISTIA/G —,5- Minutes Per Inch —
Minimum Recommended Absorption
-System Size FT
Minimum Recommended Tank Size 7�0 ��LLoNS
Special Conditions of Issue: NOTICE
When properly signed for issuance, this application
beoomn your permit. Application valid one year from
data. If an Individual swage disposal permit Is Issued
for property on which no building permit has been
Issued, the individual sewage disposal permit shall
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�expire n c mm after Id y ancilChang If n plans or q has
/ not been commenced. Any change in peens va idates
fieations after Ma permit has been Isaed Invalidates
the permit, unless approval is secured from the Health
Officer for such changes.
Approved for Issuance By C Date
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FINAL INSPECTION APPROVAL to
(Drawing of System i+ac itaJ.