HomeMy WebLinkAboutpitkin.eh.264335101006 (1977)PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER 77012,
Owner Joe E. L
RECEIPT NUMBER
Phone No.
Owner's Mailing Address
Contractor ��)���"rn A/ PF Phone No.
Address _
4 it l? 5_ �) , - � n rg
System's Contractor's Name
Address
Legal Description ill
Lot Size S;- A r -E5
L06t0
7 Srf1R wcso irk
/S/0
/2.o /
Type of Building by Use Si,;CtE
Number of Bedroo a of Water Supply
Owner's Signatu ^ Date
/AXW35,6 7
�4Z S -
PLOT PLAN: ATTACHED AS REQUIRED
7
Type of Individual Sewage Disposal System - 0EF '#%;-
# t- �r'^'� - `-'� �'„� I"
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Type of Soil or Soil Classification 4AYEy
Proximal Location of Bedrock '> OF
Proximal Location of Ground Water Table
EA/G/A/E&l/AIG
Percolation Test Date . - Z Minutes Per Inch �EPD�T
Minimum Recommended Absorption System Size 1250 �� ��
Minimum Recommended Tank Size i�or, A L LD
Special Conditions of Issue: nioTlce
p When properly signed for issuance, this application
becomes your permit. Application valid one year from
date. If an individual sewage disposal permit Is issued
for property on which no building permit hes 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 uch changes
Date
Approved for Issuance By
3
NAL INSPECTION APPROVAL
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