HomeMy WebLinkAboutpitkin.eh.264335108002 (1979)Dic43 35-1 Cb _0aa--
PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER f �( ` RECEIPT NUMBER/
Owner 1 }}OM AS • ��►•I L16o� Phone No.
Owner's Mailing/Address {-�pL�odD t1�IV E , }-ic.l.Ei
Contractor r ��*�E"JIM CRAVE3 Phone No.
Address
System's Contractor's Name 113-333Z
Address WI>�D,� 00?
Legal Description t.•o'T �•'�) STEP-a..scst?� ft -E d��
Lot Size Z•'2S Type of Building by Used
Number of Bedrooms
Type of Water Supply
-Sy�31��J�S.o� �PR��i�-•
Owner's Signature P—&tn:�JQ�Date 4/6 �7QL
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System �����' ��/� �EEi� /��i(✓C'/���
Type of Soil or Soil Cl_alssificati
Proximal Location of Bedrock
Proximal Location of Ground Water Table LIoT r)CeZY/NE,L/— G�i� / I T�iE' 711AA1 8 FT.
Percolation Test Date i5�- Minutes Per Inch
Minimum Recommended Absorption System Size Z.2_5-0 �Io , l ge��,V ZCe- e�
Minimum Recommended Tank Size 500 CA L-LONS — 7—v( r6AOIVT1'4CA 1S
Special Conditions of Issue: rvo
p When properly signed forr issuance, this application
becomes your permit. Application valid one year from
�FNcuE-S 7-O BE
/w / TIl s , co oA) date. o e individual which
sewage disposal permit is issued
l✓G �V �.% �l �C.- 1/ for property on which no building permit has been
/j D� ��� �t I , �� ACJ/� /� ��j, /AA issued, the individual sewage disposal permit shall
l> n 1 A% ��/) expire 120 days after its issuance if construction has
OF V JDIS7 �Q��t O /,'eoi 1 a R� QE7�6� not been commenced. Any change in plans va idat i-
c� / (//C (� Ir.� l'�✓` QJ�V C/ fications after the permit has been issued invalidates
the permit, unless approval is secured from the Health
Officer for such ch gas.
Approved for Issuance By Date /
FINAL INSPECTION APPROVAL Date 1/ ���
(Drawing of System on Back)
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