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HomeMy WebLinkAboutpitkin.eh.264322302004 (1979)till 3 PITKIN COUNTY HEALTH DEPARTMENT r` PERMIT NUMBER Y Owner *1-4l 0*0 Owner's Mailing Addres Contractor System's Contractor's Name Address Legal Description = Lot Size Number of Bedrooms Owner's Signature. PLOT PLAN: ATTA 0 ED AS REQUIRED RECEIPT NUMBER Phone No. 9a'r4)'�?/ / 1� Phone No. 9.17.-�'$J/ Type of Building by Use Type of Water Supply���1 Date J 'Z–'1 Type of Individual Sewage Disposal System Type of Soil or Soil Classification .4;W I_0/AAJ TO CAAWY &AYA4fA Proximal Location of edrock 9)&6_Arex 7W,4A/ /S i`r Proximal Location of Ground Water Table '' IIEW&C / %s jr - Percolation Test Date 15-3-7 Minutes Per Inch — Minimum Recommended Absorption System Size 26 VO SQ F1_ Minimum Recommenced Tank Size Ivo Special Conditions of ssue: When properly signed forr issuance, this application T ate. If your permit. Application valid one year from 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 Officer for suc changes. Approved for Issuance By Date FINAL INSPECTION APPROVAL a� �• ate (Drawing of System on Beck) PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER PHONE MAILING ADDRESS LEGAL DESCRIPTION OF PROPERTY LOCATION OF TEST HOLES Three (3) test holes required per system Test Hole Depths (24" roinimum) Diameter of Test Holes Water remaining after 8 hour soak J-7 it TEST HOLE No.1 TEST HOLE No. 2 TEST HOLE No. 3 '44 L Drop Time 9 � Drop Time s Drop Time � 7 i Percolation Rate Each Hole ' Average Rate ou Comments on soil or site: claod Signature SS cy i P1 `T'Kl?`� CO;.I1;`_"l: n� ".t,.�!' �' 0 ' P, -.D :�4,ri �'� L HEALTH Box V r.s;,-v:� C� t;y Iial.l Aspen; Colorado 925-2020 PFL27�iIT System I.,ocation. Contractor " Construct, ion, approval: Plans- and location are hereby applloveu. Perc. ral- inches in minutes= - sq. feet of absorption area j er bedoofl. _.� x_. 5=�`-teEtt l Lq.J feet Ali nim,_L require meat. I Su est _X0-1 �/.7 Date_'=y /_ _______ In Spec' 2.. Final approval of sy stcM: Pio syste^l s,-,all be dee-e-, to be in comol fiance :;ith the Se ;?. e DiS,�O z�_ La—,,s until t'Lie aSSc'!"i'JlE,� S;}'Ste::i 1S aD I'Vtred U:'1Ur t0 COVB' 1rig any -� $" septic ta.n- �- :� Proper materials and assembly %Adequate absorption area „__--- ---_� - _Ade_l'uate concre`.e cover '*dry t e17_s only) Ins. ecl, Retain '.;l.t';' perGlli rE'COr;a,; a t COIF �tructio;' site. 7f at any time this system fails a new permit must be obtained and repairs made immediately. Ew I l -a- 1115o GALLOA dva COOVETC SEPTle.-rAtJr-S OT I E S14oP 4- 6A 9d DaUxw nj C L)/j I T - \f A PACFMOk 13n3� le I t AOMPONED DOD CLFMDdr POA b