HomeMy WebLinkAboutpitkin.eh.264308200004 (1980)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design I -
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.
age- oo -oos-
PITKIN COUNTY HEALTH DEPARTMENT 2
PERMIT NUMBER V�/�/� / RECEIPT NUMBER
1�c✓ ��9
Owner DAA/ 4 4�A4"72,4 ZZ I,' Phone No.
Owner's Mailing Address
Contractor L- zz✓z 5-7-% Phone No. :42 S—,
Address 2a
System's Contractor's Name ��� 7
Address QCIe
_
Legal Description % 93 2
Lot Size .9cieEs Type of Building by Use 6 ��1%fy �i✓�1
Number of Bedrooms Type of Water Supply
Owner's Signature ".;!A
T Date
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System
Type of Soil or Soil Classificati
Proximal Location of Bedrock
Proximal Location of Ground 1
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Percolation Test Date — — Minutes Per f-\ \
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?7<— (r --^C ✓i \ _ \ '
Minimum Recommended Absorption System Size—td1��
/
Minimum Recommended Tank Size 140gil LGA/V_
4
Special Conditions of Issue:
FjTRE,,,1ERU8
IF 4 NOTICE
When properly signed for issuance, this application
become your permit. Application valid one year from
date. If an Individual sewage disposal permit Is Issued
for property on which no building permit hat been
Issued, the Individual sewage disposal permit shall
expire 120 days after Its Issuance If construction he
not been commenced. Any change In plans or specl-
r.+ fications after the permit has been issued invalidates
TPJTKIN•COUMY the permit, unless approval is secured from the Health
I � �
� L,`�L �►,"•yQOfficer for such changes.
Approved for Issuance By Date 171 /if— t?L/)
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FINAL INSPECTION APPROVAL �/Date f ,� �'2—�4 6
(Drawing of System on Back)
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1 PITKIN COUNTY ENVIRONMENTAL HEALT"
Field Test Data
-Sheet
,on Percolation Test
PROPERTY OWNER I"iw / <[ PHONE
MAILING ADDRESS
L
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e
LOCAT
Three (3) test holes required per system
dplg DeZHoles
4"�imum) '
Diameter of
Water remaining after 8 hour soak �L—
Percolation Rate Each Hole
Average Rate
Qayd -7L �' V
Comments on soil or site: � — c
um 3 j 2 /,cw /
Signature
Date
Drop•
.. •
WP's-rLIW,r,
Percolation Rate Each Hole
Average Rate
Qayd -7L �' V
Comments on soil or site: � — c
um 3 j 2 /,cw /
Signature
Date