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HomeMy WebLinkAboutpitkin.eh.264335108001 (1977)PERMIT NUMBER - Owner u-`' C� Owner's Mailing Addr Contractor �% 1,` 1 Address `S System's Contractor's PITKIN COUNTY HEALTH DEPARTMENT IL RECEIPT NUMBER 351- 6<6 -001 24i2-5- Gy-">ve,\/ Phone No. r) Phone No. me S �<6V Va, - G a- at -,- Address Legal Description -7 Z �aJw d I Lot Size �" Type of Building by Use S"`�'di�'��- Number of Bedrooms of Water Supply -Ty PP Y Owner's Signature - Date PLOT PLAN: ATTACHED AS REQUIRED Type of Individual SeWage Disposal System �CnT /C -/f AJI, - SrCPgCE &__Q Type of Soil or Soil Cl ssification Z024M _M -<!;A A) y e, Liq C le CD SAAJOS , L)A� Proximal Location of edrock C���T 7%H,l A F T Proximal Location of round Water Table C.eCAi_CX-' -r9/gA/ � Percolation Test Date. Minimum Recommend Minimum Recommend Special Conditions of I J) 7a RF / Approved for Issuance By Z!SL- Minutes Per Inch C' ;d Absorption System Size R�7�0 SO. R ,d Tank Size 1250 CA L L OA) (7, NOTICE le: When properly signed for issuance, this application S / L�G (� © Al �0A/ j Ci - j IC , becomes your permit. Application valid one year from C• / date. If an individual sewage disposal permit Is issued for property on which no building permit has been issued, the individual sewage disposal permit shall expire 120 days after its issuance If construction has not been commenced. Any change in plans or speci- fications after the permit has been issued invalidates the permit, unless approval is secured from the Health ORU s. Date ✓Date 7 FINAL INSPECTION AP ROYAL _. (Drawing of System on