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Home My WebLink Aboutpitkin.eh.264334100013 (1973)PITKIN COUNTY HEALTH DEPARTMENT PERMIT/ NUMBER 7,20 0 7 / RECEIPT NUMBER �— Owner ��ir^G1�Hd GJ��'® C' Phone -�72-�_ 20�U Address Contract Aaaress Location of system �� /,�/�� 5©i�Sc� ��., Lot Size Legal description Date q/ , ,� Siganture of owner Percolation test data minutes per inch Minimum recommended absorption system size SQ y( 7 ) Minimum recommended tank size iSa �t� Permit application valid one year from date.Ap ication to become permit and final only after lower portion \is complete Ad s Retain this form at the construction site. 0 06S T DRA ING OF SY EM 61, <7' 3 5� ■ Date a ` Sanitarian 7 fj000 PERMIT NUMBER `4W PITKIN COUNTY HEALTH DEPARTMENT RECEIPT NUMBE Owner <, 4C /,1,� r ��r - Phone # �Z1 /71 7 Owner's Mailing Address 1-5� 41S//'7 Contractor Phone # Address Systems Contractor's Name rZ �- Address Legal E Lot Siz Number of Bedrooms Type of Water Supply Type of Individual Sewage Disposal System --j;dl G/ Type of Soil or Soil Classification_-/ Proximal Location of Bedrock1116-27— Proximal T Proximal Location of Grou d Water Table Owner's Signature i - r PLOT PLAN: f,,�jti° x , / '''' Date_1 / Minutes Percolation Test Data per inch Minimum Recomended Absorption System Size If Z- � CY Y14nimum Recommended Tank Size IOZ11-0 & ;4 erm i application valid one year from Date. Application to become permi and final only after lower portion is completed and signed by the Sanitarian. RETAIN T S.FO AT THE CONSTRUCITO SIT Date C� 7 5 Sanitarian (D awing of system on back) PITKIN COUNTY ENVIRONMENTAL HEALTH r Field Test Data Sheet on Percolation Test . PROPERTY OWNER PHONE 9 Z J — 1,79 MAILING ADDRESS LEGAL DESCRIPTION OF PROPERTY LOCATION OF TEST HOLES Three (3) test holes required per system Test Hole Depths (24" minimum) Diameter of Test Holes Water Remaining after 24 hour soak TEST H LE ill TEST HOLE #2 TEST rULE f1i Dro Time Drop Time Drop Time `2 r S i L . �� •FAN= IMS s � Percolation Rate Each Hole Average Rate Comments on soil or site: SICII ATURE DATE a q5 OOSC