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HomeMy WebLinkAboutpitkin.eh.264909400002 (1979)a ac���=oq�-ao .roc r PITKIN COUNTY HEALTH DEPARTMENT PERMIT NUMBER �`�' RECEIPT NUMBER X9789 Owner Phone No. Owner's Mailing Address n V f- 1ie,5 Contractor Phone No. yh 7 Address `-5 4-2, r p� System's Contractor's Name Eci Address Legal Description LE- Lot 1i't Lot Size �i�2 Type of Building by Use �& Number of Bedrooms -72,4) Type of Water Supply GG�ca �f Owner's Signature ) l6�-,� Date - 7 PLOT PLAN: ATTACHED AS REQUIRED Type of Individual Sewage Disposal System Type of Soil or Soil Classification &gY 40AV Tb SffN01� __ ^ r Proximal Location of Bedrock ( gCyre THAOJ 14 Proximal Location of Ground Water Table Cr&urex -rwAAP /6 Percolation Test Date �� Minutes Per Inch Minimum Recommended Absorption System Size *_Q S© Er Minimum Recommended Tank Size %SO 64",6^1_5 Special Conditions of Issue: l�iECo �E�U twyV ets- ta" x 1 i" x r01IDELOW INLET PIPE !N DEH 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 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 such changes. .S ApprovedDate for Issuance By FINAL INSPECTION APPROVAL ' — Date (Drawing of System on Back) o- I' s 9� H&JS6Aq 11 LRiAGS BELow ItJL6,r � �12 y 112W GAL"M "VCP" COMCOZTr SEMO. IrMr- .-A, , (-C.M IDP►v6, 7 APPgDxltAATr NC)g--FH-