IPACHTE # /Lw'S-- 3oi- arnett County Department of Public Health
hDrovement Permit 27221
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION,- 2 � Jv>
ISSUED TTOE C SUBDIVISION j�t- -1� f " LOT # _L- 7
NEW i` REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: 4 }-..d
Projected Daily flow: i' GPD
Number of bedrooms: — Number of Occupants: max
Basement ❑Yes L7 No
Pump Required: ❑Yes ❑ No /Maibe required based on final location and elevations of facilities /Five of Water Supply: ❑ Community Public F-1 Well Distance from well feet Permit valid for: L.�}'five years
Permit conditions: ❑ No expiration
Authorized State Age -5 Date: 11-7-1 °- t Z SEE ATTACHED SITE SKETCH
The issuance of this permit by a dth Department in 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 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, .1957, .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.
(See note below, if applicable ❑) B-1; (Repair)
Installation Requirements /Conditions Number of trenches 21
Septic Tank Size 1Z�a& gallons Exact length of each trench ,(r5t feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z q — > /&' inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
e inches above pipe
dZ— inches total
* *If applicable: / understand the system type specified is different from the type specified on the app /ication. /accept the specifications 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. Xt Al IAl,t1tU JIIt JlMILM
Authorized State ent: Date: i 7-1 .- 1
Construction Authorization Expiration Date: 2 7�► 7}
HTE# /Z — ICC3 7 Z
Mu-nett Corint`r Department of
Site Sketch
Permit #
2-72-71
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\DA,
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: If'u `i Z
Proposed Facility: 3q4US Design Flow(. 1949): LQ-0
Location of Site: Property Recorded:
Water Supply: (Public❑ Individual ❑ Well
Evaluation Method: [''Auger 139ping ❑ Pit ❑ Cut
Type of Wastewater: EJ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.2.941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Hodz
t
(
Z
1- �
n 2r,
- yz
5 -c . G ,.
�'
� v�
J J �i I J41�
3(, 1
p
P
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948): i
Evaluated By: (� n
Others Present: L�
Available Space (.1945)
i
System Type(s)
Z
Site LTAR