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HomeMy WebLinkAboutpitkin.eh.264320403004 (1974)PERMIT /�NUMBER Owner (rLLIP/L C2t Owner's Mailing Address Contractor Address PITKIN COUNTY HEALTH DEPARTMENT RECEIPT NUMBER A� 3 / Phone #-OZ,: = 32 2 9 # V2 -3-.20S,3 Systems Contractor's Namei1.�_ Address Legal Description -,e- -,e- Z Lot Size .7AL&a�—Type of Building by Use GE Number of Bedrooms �,3 Typeof Water Supply 60ELC. ' Type of Individual Sewage Disposal System �j e, F,4AJ<-X8—S—W21j7—QA Type of Soil or Soil Classification ZnAm --� k--/-,-6Cj Proximal Location of Bedroc11,4J ED 7 (� Proximal Location of Ground Water Table D"T% / S'e tF ©,A,0/d141A1- E'�PMi T Owner's Signature PLOT PLAN: Date Percolation Test Data �/� ' Minutes per inch Minimum Recommended Absorption System Size Q � J - Minim Recommended Tank Size ZCJ C?/`JLG!!/V !/L OLC /� "�" 8 b/�4 Pe it application valid one year from Date. Application to beco e permit and final only after lower portion is completed and signed by the Sanitarian. RETAIN THIS FORM AT THE CONSTRUCITOON ITE --� �`' '' Dat e Sanitarian/i (D awing of system on back) v -T, -L.-