HomeMy WebLinkAboutpitkin.eh.264321302018 (1978)PERMIT NUMBER
Owner �G
Owner's Mailing Address— Z-0
Contractor v
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System's Contractor's Name
Address
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PITKIN COUNTY HEALTH DEPARTMENT
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Legal Description I-- L -'i ,! 1 ,.ZL C. G,
Lot Size 2
Number of Bedrooms
Owner's Signature
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sev�age Disposal System
RECEIPT NUMBER .2705-0
Phone No. = 0
Phone No.
Type of Building by Use
Type of Water Supply
-.. Date `l v ^ Zd
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Type of Soil or Soil Classification �L TY S/
-SLC LOAM Td 0,LA V 4AID SIAL
Proximal Location of OedrockL &ZE[? '�
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Proximal Location of
round Water Table
Percolation Test Date Z*z
_13M inutes Per Inch
Minimum Recommended Absorption System Size
Minimum Recommenced
Tank Size
NOTICE
Special Conditions of �ssue:
When properly signed for issuance, this application
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A `'/� n
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`^) �/ �/ ` becomes your permit. Application valid one year from
DIS Tet �V(/f�/� date. o e 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
O�ffjicer f r such than s.
Approved for Issuance Byl
Date
; -FINAL
INSPECTION APPROVAL
Date
(Drawing of System on Back)
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+, + -.r 3PEN*PITKIN
ENVIRONMENTAL HEALTH' DEPARTMENT
REVIEW AND LETTER OF /OPINION REGARDING WATER. AND SEWAGE SYSTL:IS FOR EXISTING DWELLING.
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Date Received 8 g 3Date Forwarded ��� %/ .F -3 _ Receipt No. 4'�'1 % y 6
Requested By /i1 S� ��J ucl� o/olo LerTZ- C-,glc 6yu5�r GF-ct llll��
Memo to be sent to: �uJ DLA/UNI S�ii� 2/0 S -j6
Dwelling Location
;4, - ;41
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Sec. , , R W;
Lot No. /0/ , Block No. Z _, Filing No. 2 -
Subdivision
Subdivision i3{-(d-�4
Address 0/0% -T'i, I &e Coue- C"fe 61 //22eff
Property Owner (�r%1, Sc , 4 �lxrcl
SEWAGE DISPOSAL SYSTEM REVIEW:
Copy of Individual Sewage Disposal Permit Enclosed IC�� No record found
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Our records indickote a 1000 gallon and 6OQ square feet
of absorption trench �, bedi. pit
Visual Inspection; of Premises: A. Not feasible due to weather conditions = ,
B. Apparently functioning satisfactorily
function satisfactorily as well evidenced by
WATER SUPPLY SYSTEM REVIEW:
C. Not functioning or expected, to
Not known 1-1-1 Public Water Supply Tap (Name) _
Inspection Report Enclosed = . Approved well construction and location
Unapproved well. construction or location because —
Standard Bacteriological Test Enclosed
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Acceptable Not acceptable
DATE et
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130 South Galena Street
5"wm,osSCrJfiT�d end Sk . Lab # Fp c I I
.DISTY�c.-r L�-b
Result Inconclusive E —1 , Reason:
e-cU`S Fora m_P� o"z4T SGLt o�SP ccc«rivco�UJ
Aspen, Colorado 81611
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Respectfully Submitted,
Environmental 1lcalt h fficer
303/+®25-2020
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