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HomeMy WebLinkAboutpitkin.eh.272909200025 (1978)%b��7�� - z5 "lZ -66 - o aG Q PITKIN COUNTY HEALTH DEPARTMENT PERMIT NUMBER RECEIPT NUMBER �O� k� Owner � � �--� s Phone No. 45F W Owners Mailing Address _ i Contractor �Rctl ' Phone No. Address �J Llr�jCp i T.. 1Z S�) %J L C CC S I G2 System's Contractor's Name Address Legal Description `�C E�- �'� ' C � RE u Lot Size 45 '1�4'C Type of Building by Use Number of Bedroo Owner's Signature Type of Water Supply WEU— (Drawing EU - PLOT PLAN: ATTA Type of Individual Sewage Disposal Syste Type of Soil or Soil Classificati Proximal Location of Bedrock Proximal Location of Ground Date z5-) - ^ �� S EPTI C 7—AWAA* ,- Percolation Test Date V Minutes Per Inch Minimum Recommended Absorption System Size FT: Minimum Recommended Tank Size -75-0�/-T � � _&pq �� Special Conditions of Issue: IvoTlce p � When properly signed for issuance, this application :>/s rQ becomes your permit. Application valid one year from 1date. If an individual sewage disposal permit Is issued !.:1A%4EAJ1-7P,qL C-n C`) ©� �, for property on which no building permit has been ,v ^/issued, the individual sewage disposal permit shall /JTj' % UAL �G� f7©expire 120 days after its issuance if construction has not been commenced. Any change in plans or speciTIUA. fications after the permit has been issued invalidates the permit, unless approval is secured from the Health Officer for such changes. lall-7 IFI f Approved for Issuance By Date FINAL INSPECTION APPROVAL "� ate****;; (Drawing of System on Back) rogig, .1 a !� y too squoa K-LAOD SATE V S TI r OK ^,orracted,'. ilctcber 29, �S/TU�9j-;6--D /N