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HomeMy WebLinkAboutpitkin.eh.264929102032 (1979)aU 41- aril -- Oa - 03�-- -v�� Swiss 4 vILLACE PITKIN COUNTY HEALTH DEPARTMENT r PERMIT NUMBER�v� RECEIPT NUMBER Owner Ai.,e5 W/10 Phone No. Owner's Mailing Address 3/5% /{1c , S (o h,,,d, /e F, /o. �iDa -CIR L- o Ca-i-�o h Contractor :e� An„ S (Jnr - Phone No. 9 31 Address SC, ,, Q Q s u �a ✓ r System's Contractor's Name Address Legal Description S .Ss U 47s Lot Size IOC ' X / SD Type of Building by Use SJn:y A Z-1AA, /y Q.=� J•a, Number of Bedrooms --Z (TV SE 3 rte �=�,,��ype of Water Supply S.,, 1/c Owner's Signature LJ 014 Date 6 /le S PLOT PLAN: ATTACHED AS REQUIRED Type of Individual Sewage Disposal System Type of Soil or Soil Classificati Proximal Location of Bedrock Proximal Location of Ground 1 Percolation Test Date _79 Mir�estes Per Inch >T� RE PEi2e, ow 7 ig AS SELM9 6_ r c EAS/ tF UcjE 72n 7-C,2,_-_.9/AJ. Minimum Recommended Absorption System Size OU 1 X 3� X 12 &C-L&W IML.E Minimum Recommended Tank Size / 000 acOun Special• • • of , z a ♦ / ' 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. Approved for Issuance By -LI -Date A2nK FINAL INSPECTION APPROVALDate 7-31-79 (Drawing of System on Back) PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER —� aPHONE MAILING ADDRESS LEGAL DESCRIPTION OF PROPERTY //,:�, 5'-6A 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 /2 d TEST HOLE No.1 TEST HOLE No. 2 TEST HOLE No. 3 Drop Time Drop Time Drop Time Percolation Rate Each Hole % Average Rate Comments on soil or site: c 7 Signature - // &Date / 0 ) ,q`LA PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test .� Na, PROPERTY OWNER ',j a'm-S u j©o c^-' 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 0 t - 14t 14A If I r% 3 3 Ul�-�1 TEST HOLE Noo.11 TEST ROLF, No. 2 TEST HOLE No. 3 Drop Time rv.A- "Ve- Drop Time Drop Time 1°► ►cC2 �a 0 S ro Wto lin 3 (b S OG r C> • a 'IIIb C> I o2 Igo ) '4 lb 33 3 i3 \9 -- - e Percolation Rate Each Hole � Jr 4 U w,,tJQyO w,� Average Rate ► /C Comments on soil or site: tza �� d-Qf = J""' "q- C -t -CY - Signature Date le - cL 9 i CN 22 12 peen I PWE-4 . , A VCP CmuzTe it' / 1�, Co PE 4t N 0 Gc�rur�.�r"E i 4ou S_ CX- C -A<-- EUgDIVISIoIIJ ROAD I