HomeMy WebLinkAboutpitkin.eh.272904300005 (1979)PITKIN COUNTY HEALTH DEPARTMENT
PERMIT NUMBER f'7 /0AZ RECEIPT NUMBER _ z)/ q S
Owner B - E SQ H N'200 Phone No
Owner's Mailing Address
Contractor DE'"C-0 CONST R" 7-1DSU Phone No
q-145-6&5'-4
Address 30 1347- 64-fNw000 5do2m6's COLO
System's Contractor's Name .3013 e) S L TIE z f X C4 V 4r/ D dJ
Address G 11�- R ti D
Legal Description
LCA GOLOf2,q
- C K4---CL,E- Y
Lot Size &O t 9 C 2 e S Type of Building by Use P- e S t DE 1/G E
Number of Bedrooms
3
/ Type of Water Supply 5 P fZ i Uy
Owner's Signature Date !V 7` 7 q
PLOT PLAN: ATTACHED AS REQUIRED
PT►C IA,y,�–
Type of Individual Sewage Disposal System SCEPAGC B6-%, --
Type of Soil or Soil Classification Sl-fy _DAM 'TD Si�i/✓�i L��'''%
Proximal Location of Bedrock / ►'�T % SeFf4Z� 7W,441 R fr
Proximal Location of Ground Water Table.114r- r4r PE%F4,19,10 77i4d gFr.
�pSEE to r SPciT — ?
Percolation Test Date ��7�GQEIJ�tul edMMEA11S, 3� Minutes Per Inch
Minimum Recommended Absorption System Size 7-5-0 sa F7
Minimum Recommended Tank Size j000 GALC.dNS
S ecial Conditions of Issue: rvo
p When properly signed forr issuance, this application
becomes your permit. Application valid one year from
4� 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
Office1,71
to sunges.
Approved for Issuance By Date
g 29
FINAL INSPECTION APPROVA ate
(Drawing of System on Back)
✓rSo-j
p0rN+
1250 H r, C{f
`6)pejmo cjamcAETE S6PTic TA#IC L"51,
44
To H WY 133
71
A-22•
2 sTo+ty
� Nousr
12501 TO CR.YSTA r. /2,I VCe