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IPAC RRHTE# ~02 "5-A 6 IS-Zt2A arnert County Department of Public nealth Improvement Permit 2 6 7 8 6 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: s. c- L xd- ISSUED TO- y 4 a SUBDIVISION o f f e f ~Q ; c( y~ NEW Type of Structure: REPAIR ❑ LOT # EXPANSIONr ❑ f Site Improvements required prior to Construction Authorization Issuance: 37 X </Z P d W J- ropose astewater System Type: a Projected Daily Flow: 6 o GPD N b f b d um er o e rooms: Number of Occupants: max Basement ❑Yes Z No Pump Required: ❑Yes Ind' No ❑ Ma be required based on final location and elevations of facilities Type of Water Supply: Permit conditions: ❑ Community Public ❑ Well Distance from well feet Permit valid for 2- ive years ❑ No expiration Authorized State Agent:: Irt`~,y~ '_6Z2/' Date: ©Z__ SEE ATTACHED SITE SKETCH The issuance of this permit by the ealth DOH e art no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout. ISSUED TO: f y4A C' a ~.r~r-uc~ PROPERTY LOCATION: X d. SUBDIVISION ✓ of~ r 2 i d Facility Type: < r~ 2/New ❑ Expansion ❑ Repair LOT # Basement? ❑ Yes 0"'No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System' ?f'rG ,,P- vck u 4 ,l, (Initial) Wastewater Flow: ~ 6 G (See note below, if applicable (Repair) Installation Requirements/Conditions Number of trenches V Septic Tank Size Zoo o gallons Exact length of each trench 0_ feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: / e'~7G inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: 9V GPD Trench Spacing: ? Feet on Center Soil Cover: 6-16 inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: /understand the system type speciled is different from the type speciled on the app/ication. / accept the specilcationr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent 'I Date: % K~7 Z Construction Authorization Expiration Date: /oy~a 5~/.7/1 "j> NTE# / -r a 8Ir4 iCk Permit # a 7 8 Q Site Sketch PROPERTY LOCATON: ISSUED TO: ~/r1 co SUBDIVISION LOT # 9Y Authorized State Agent: 4~1~ Date: Z d~ srt 140,rf;r- C~ )h Rl~'ert? r L/L,