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HomeMy WebLinkAboutpitkin.eh.272929304005 (1976)Owner �7�4-a93–aY-��5 PITKIN COUNTY HEALTH DEPARTMENT 76070 RECEIPTNUMBER 2137 MINIM WN 2 ME Phone No. Owner's Mailing Address - ' ^ C,,` 7 Ir Contractor �� -' Phone No. Address System's Contractor's Name Ar !E A1,yEAZ- Address Legal Description=—T p N L r Lot Size ,��"� Type of Building by Use tee_ Number of Bedrooms Type of Water Supply R Owner's Signatur Date PLOT P AC ED Type of Individual Sewage Disposal System &A y Type of Soil or Soil Classification DI IV _ T Proximal Location of Bedrock �����1/ ��C����N of /.– Proximal Location of Ground Water Table Proximal / 1'Q� Percolation Test Date A (/0 Minutes Per Inch Minimum Recommended Absorption System Size Minimum Recommended Tank Size 750 �2A L LORI S _ Tay 0-'OMPMTM EV� - NOTICE Special Conditions of Issue: when properly signed for issuance, this application t);ql i&rrAlAl MW l qUM H44, 1ZOA/TAL becomes your permit. Application valid one year from PISTMC E' F I_M &Vfi.r� / M' date. If an individual sewage disposal permit is issued /G`-'/�') IA for property on which no building permit has been issued, the individual sewage disposal permit shall <7 �el.4L T77%C72?jeo rZOA) /� �r expire 120 days after its issuance if construction has 1��� �/[ t (�/ AIIAII14LAM not been commenced. Any change is plans va speidat i- fications after the permit has been issued invalidates ©�ZO�^l C'71 / �j��- the permit, unless approval is secured from the Health I� �i{ 47 N� G Officer;ZI-7 fors ch changes. %3 1-c160V 7',� /' '� /J Approved for Issuance By Date FINAL INSPECTION APPROVAL !Date AZ 912 3 Z (Drawing of System on Back) 0 7s -o GALLW COAIC."7-c SwPnc. -m000c 00 Pkopc-IeTy 24, '�APW QTDR-y Ho OSC 16T 121 ,1'tl i o-5 750 CALLOOV 6e cow-ACTC Z&PrIC. TAA% I 15� FLSo 41vc �'J"IVISION WATE-R SUPPJV t.,INEr' V, ��CK Z' EG Leg - t STONE OD E-� WAI-ce ZE AVlc,%F' PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER L / C'-/%G,� 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 30 ri 2 Z,f )q f/ 0- - TEST HOLE No.1 Drop Time �37 TEST HOLE No. 2 Drop Time � 2s TEST HOLE No. 3 Drop Time 3 2� 3 -7 yq4 3 . Y ' _5�5 f S -57 Percolation Rate Each Hole Average Rate Comments on soil or site: 4 1 :::tt 7 _ �, TL) 7v -)� Date PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet on Percolation Test PROPERTY OWNER A42SA 7- G'T/ 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 2S11 '30 rr 02- u t 11 it 1 TEST HOLE No. TEST HOLE No. TEST HOLE No. 223 Drop -Time 2 23 /Z Drop Time 9- 2$ Drop 23 813 b Time y 30 y j511 137ns ii 0 r� 076 3 j Ilk I� 7 'S O Percolation Rate Each Hole Average Rate 7 Comments on soil or site: gaw Signature Date —,?—// 4 k PITKIN COUNTY ENVIRONMENTAL HEALTH Field Test Data Sheet own rPercolation Test PROPERTY OWNER RASA Vr A�,"''/ 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 24 hour soak -s TEST HOLE NLqa TEST HOLE No. 2 TEST HOLE No. 3 Drop Time Drop Time Drop Time 0 5D q f r-- _a 2 c7 .- �0 7 I S ►1,,n�la 6317 17 Percolation Rate Each Hole �� Average Rate Q Comments on soil or site: Signature i Date