HomeMy WebLinkAboutpitkin.eh.246315200003 (1978)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 prope.rty
Third System etc.
Floor Plans
Please See Building and Land Use Approvals Files for additional information.
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PITKIN COUNTY HEALTH DEPARTMENT
RECEIPT NUMBER =�J�
Phone No.
Owner's Mailing
Contractor
Address
System's Contractor's Name _:�% 10, —
Address
Legal De
Lot Size
Type of Building by Use
Number of Bedrooms ype of Wa r Supply
Owner's Signature / L Date2&4 fr
PLOT PLAN: ATTACHED AS REQUIRED
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Type of Individual Sewage Disl
Type of Soil or Soil Classificati
Proximal Location of Bedrock
Proximal Location of Ground 1
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Percolation Test Date , 139 Minutes Per Inch —
Minimum Recommended Absorption System Size 5-00 sZg )C-7—
Minimum
%Minimum Recommended Tank Size 75-0 GXLLdNS
Special Conditions of Issue: NOTICE
When properly signed for Issuance, this application
_ becomas your permit. Application valid one year from
/A/
date. If an Individual sewage disposal permit Is Issued
for property on which no building permit has bsan
Issued, the individual ravage disposal permit $hall
expire 120 days after In Issuance If construction has
not been commenced. Any change in plane or speci-
fications after the permit has been Issued Invelidetes
/����/A�/ the permit. unless approval is cured from the Health
L� .r//Ifi/t/Y-v_ Officer, for su h ch gas.
Approved for Issuance By Date
FINAL INSPECTION APPROVAL Date*********�a
(De- ing of System on Back)
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