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Home My WebLink Aboutpitkin.eh.264320406002 (1974)l 2 k� PITKIN COUNTY PERMIT NUMBER HEALTH DEPARTMENT �7 0 RECEIPT NUMBER .//,/ Owner Phone # qz5--31 6 Owner's Mailing Address ox 2 b5-7 A5 pen Ccs V Contractor Phone # 9Z S 7 / 7 to Address Systems Contractor's Name L Address Aa.ndo -2,2,-:2 r/ Legal Description Lot Size '3,7 aorCs U I Type of Building by Use SinFa P - Number of Bedrooms 2. Type of Water Supply WZe- Type of Individual Sewage Disposal SysteCPAC C Re b - Type of Soil or Soil Classification J CiAM y - Proximal Location of Bedrock^y'i%��/V'F1� ` — Proximal Location of Ground Water Table a Owner's Signature s Date 3-7# -T PLOT PLAN: Percolation Test Data Minutes per inch O X56 - Minimum Recommended Absorption System Size Minim Re ommiended Tank Size�� 6 Permi a plication valid one year from Date. Application to become pe it and final only after lower portion is completed and signed by the Sanitarian. RETAIN THIS FOT THE CONSTRUCITON Date 77�'i Sanitarian 06 P 1 b;�l (Drawing of system on back) 3 K' • + f �..� �S { e�4� c \ •i t k y r 20 o To wZL j_ 2o� 60 © COLORADO DEPARTMENT OF HEALTH COUNTY 7 REQUEST FOR RVICE PROGRAM RECEIVED BY LOCATI TE / REPORTED BY ADDRESS v TELEPHONE SERVICE REQUESTE ACTION REPORT ACTION BY DISPOSITION DATE SH -M-71 (4-71-50) 7i �rZ /V3 5 //.4< it :1�> * (1 1 j F --f-- � ZL�S (Co 1—) 4 0 5(l 70 >y 1�31 3 > Y4 x te�