HomeMy WebLinkAboutpitkin.eh.264903300007 (1978)PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER NO RECEIPT NUMBER ak)�91
Owner P 0+24 i6l" I Phone No.
Contractor - v Phone No. q0 - D qq
Address 0 (� 3 ` �,a ��., �- A �- Q l6 J 3
System's Contractor's Name 7t.96vr62 Q&,A^»
Address
Legal De
Lot Size -.'� /' C;x AA ,
Number of Bedrooms I�*-�
Type of Building by Use YJ U &142"Q
Type of Water Supply �� A�;�� 6 Am?Z4llo+�
Owner's Signature Date C 7
PLOT PLAN: ATTACHED AS REQUIRED
Type of Individual Sewage Disposal System tpe7pnWK ✓A�p6�6P6 �0 5
c
Type of Soil or Soil Classification 4pioy AC-0aLAy AID k1V�dA16')�4A46Vr5
Proximal Location of Bedrock //p, c>,F TuAAj f�
Proximal Location of Ground Water Table 2 V4rr C) 67 -6e
Percolation Test Date 4' �32Minutes Per Inch
Minimum Recommended Absorption System Size — uo —S - F
Minimum Recommended Tank Size 75-0 --1A L"Aig -
S ecial Co ditIons of Issue: Nonce
I� When properly signed for issuance, this application
Q/V G . 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
Ojc for suc changes.
Approved for Issuance By
Date 71
/
FINAL INSPECTION APPROVA ate
(Drawing of System on Back)
2 �s�
Ta DITi
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PITKIN COUNTY ENVIRONMENTAL HEALTH
Field Test Data Sheet on Percolation Test
PROPERTY OWNER / �i// PHONE
MAILING ADDRESS
LEGAL DESCRIPTION OF PROPERTY
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
• • •
l�►�LIl � -�► /fes ' % - __
Percolation Rate Each Hole
Average Rate
Comments on soil or site:
Signaturelt-Z4
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2 Z/O
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Date
$ °6
,No.
County Treasurer's Office, Pitkin County, Colo. ���
Aspen, Colo.,_ 191—
Rrrrueb Of
C ¢- z;, 1�C�LLAR
Credit toFund.
�e / 3� _ � / Treasurer
BY::: Deputy
THE C. F. HOECKEI CO., DENVER