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HomeMy WebLinkAboutpitkin.eh.264536100002 (1980)-3 (cI —CC) —OGa o PITKIN COUNTY HEALTH DEPARTMENT PERMIT NUMBER �Wlg RECEIPT NUMBER ✓� �� Owner COI ST-OpReAz SM IT OC Phone No. 92-7 322—] Owner's Mailing Address 0373 &PR I S CJLS�K CAR BOA/DA L-f--&/� 23 Contractor Whllie MOUConS+. Phone No. 927 3/4( Address System's Address Legal De Lot Size 35-/- ac - Type of Building by Use W6,kAe&kiQ' Number of Bedrooms ,9_111V©��Type of Water Supply well Owner's Signature ra F Date 612-612 PLOT PLAN: ATTACHED AS REQUIRED Type of Individual Sewage Disposal System Type of Soil or Soil Classification �)/L TV Proximal Location of Bedrock /lo1 ! �'� ����� > 14- 7— Proximal Proximal Location of Ground Water Table Percolation Test Date 7 Minutes Per Inch Minimum Recommended Absorption Minimum Recommended Tank Size Special Conditions of Issue: Vt')' ^V r Size S /7_ NOTICE When properly signed for issuance, this application becomes your permit. Application valid one year from date. If an individual sewage disposal permit Is issued forproperty 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 such changes. Approved for Issuance By —. Date FINAL INSPECTION APF ROV A L , ,�i✓L (Drawing of System on Back) U ,N J J In u I Ad% PROPERTY OWNER MAILING ADDRESS PITKIN COUNTY ENVIRONMENTAL HEALTH 11 Field Test Data Sheet on Percolation Test LEGAL DESCRIPTION OF PROPERTY A(� 7�6AOT LOCATION OF TEST HOLES Three (3) test holes required per system Test Hole Depths (24" minimum) Diameter of Test Holes Water remaining after 8 hour soak -36113 y i Z" 12- 11 1 Z' q 5 ff 11. / 3 TEST HOLE No.1 TEST HOLE No. 2 TEST HOLE No. 3 31 L- Drop Time 31 Drop Time SI L Drop Time /tel 2q3 2Y .51 -53 ,5_3 la Z� O I i s� 3 3 326 2 Z's 32 5e SS3 -33(, Percolation Rate Each Hole Average Rate Comments on soil or site: Date ✓ r �v Signature ! / STATEMENT City of 1pen Environmental Hea-ch Department 130 So. Galena Aspen, Colorado 81611 DATE .; 6 /24 / TO Christopher Smith ADDRESS 0073 Sopris Creek CITY STATE ZIP Carbondale, Colorado 81623 1 REDIFORM ®8S 88Z POLY PAK (50 SETS) 8PB82