HomeMy WebLinkAboutpitkin.eh.264328204003 (1974)r
PEF .F1T NUMBER
Owner /\F
Owner's Mailing Address
Contractor
Address_
6
Systems Contractor's Name
Address
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PITKIN COUNTY HEALTH DErARTMENT
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,�&q 3 .tTZ Oil 003
RECEIPT NUMBER171 d �
Phone # 2), — Z57V
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Phone # �)-J 3 - 7 Y Y
Legal Description �� �'U `-��- i
e
Lot Siz��
p /7LC'Type of Building by Use J/�✓tG�- 7`-%1`i7"I.Nfi!i-lam/n✓lam
Number of Bedrooms
Z. Type of Water Supply 64 / t- 11,4a L-
`, /�
Type of Individual Sewage Disposal System u�/lJ �7 �/ cJ�� A4 /► S
Type of Soil or Soil Classification�'—
Proximal Location of Bedrock
Proximal Location of (3r
Owner's Signature
PLOT PLAN:
W
97�y 13 A4 I
Date �//
Percolation Test Data �,7" J Minut s per inch
T111t�D 3 �UzrLt �2Q�ce�
Minimum Recommended Absorption System Size - lam' % �"K-YL
Minim Rec mmended Tank Size %-.�l' LC ��
Perm t a lication valid one year from Date. Application to become permit and final only
after lower portion is completed and signed by the Sanitarian. RETAIN THIS FORM AT THE
CONSTRUCITON ITE.
Date �
�C Sanitarian
% %�
( /awing of system on back)
I
ewzk� - 1 i
�
L
+ I OCOLORADO DEPARTMENT OF HEALTH
COUNTY • ��
PROGRAM %Z
LOCATI
REPORTED BY
REQUEST Pan SERVICE
CEIVED BY
DATE
DDRE SS TE LE PHO NE
ACTION" REPORT
ACTION BY DI SPOS I T10 N"),
(�/'✓/��� / C
DATE
SH -M -7t '(4-71-50).
Ivo. i 114 6 .
County Treasurer's Office, Pitkin Count$'
,Colo.
_ Aspen, Colo.,'
PfP ,UPS of 19
Account of ` DOLLARS
Credit
Fund.
Treasurer
THE C. F. HDECKEL CO., DENVER By
Deputy
` - COLORADO DEPARTMENT OF HEALTH *400
COUNTY ��j % REQUEST FOR ERVICE
PROGRAM I RECE I VE D BY DATE/O
LOCATION L,IaI �c .< ..
NAME t �AA, T 19 e3 M
f1
REPORTED BY R,.; -s oq<i J ADDRESS TELEPHONE
SERVICE REQUESTED Pry �P 7"t l ridr i Mor-n� /� /q I✓,�l – i( Or fly yy1 d.�CGtC�
Z or -4
.—� C
ACTION REPORTQ-
ACTION BYlVr DISPOSITION •�MrT /5s't/G�
DATE g J_37Y
SH -M-71 (4-71-50)
� J
Section
COLORADO STATE DEPARTMENT OF PUBLIC HEALTH
DIVISION OF SANITATION Code 12
ACTIVITY REPORT
FILE REFERENCE: �, }v��e-Sewage ;)S, �=
County57
INDIVIDUAL
OR
ESTABLISHMENT;a��s� m
ADDRESS:s@�i
NARRATIVE:
I went with Jerry Gerbaz to Ken Kallstrom's property in Brush
Creek to straighten that situation out. I explained to Kallstrom that what
we're looking for is two terraces witha serial distribution line, that the
botbom of the trenches has got to be level. Jerry and I walked the lot and
located them. Kallstrom had already installed a 1000 gallon concrete septic
tank.
LI 'l TER TO FOLLOW: () OTHER RECOMMENDATIO.1i'l-
DATE: �P=thPr19-7J4.-
ES: 7 (8-53-50)
REPRESENTATIVE: �`4
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