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IPACr Aarnett 1 Department Improvement Permit A building permit cannot be issued with only an Im rovement Permit ` PROPERTY LOCATION: AP,ti.,S 9Q ISSUED T0: �uct� •+CS�d.P+HQ 1��UcnC:s ,9yC SUBDIVISION Nw,6r=oc,p LOT # QO NEWX REPAIR ❑ ANSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S%"' > QALN'7St', Proposed Wastewater System Type: ;) S o ?—C -p uc5 t 0%-4 Sy: , Projected Daily Flow: 1✓ 46 O GPD Number of bedrooms: _ 3 Number of Occupants: max Basement ❑Yes �No Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well L® '�i feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: 13 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance er 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 ermit 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: Curve- en,t —y- o )rAt3rces `Nc PROPERTY LOCATION: 4ZD SUBDIVISION LOT # �O Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Figures? ❑ Yes �No Type of Wastewater System ** �S dl s c-9w C;--- , Q A � T 5 16r-(N (Initial) Wastewater Flow: GPp (See note below, if applicable ❑) 4ZC',q y ON N Uij 'S (Repair) Installation Requirements /Conditions Number of trenches 1 Septic Tank Size tca (!> a gallons Exact length of each trench a©d feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: 1'*a 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: (M inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe inches total * *If applicable: l understand the system type specified is different from the type specified ofl the application. / accept the specifications of this permit Owner /Legal Representative Si nature: Date: This Construction Authorization is subject to revoca a site plan, t, 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 su pliance the p the nd Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: _ Construction orization Expiration Date: HTE# k :L- 'S 3:034� , Permit # a' "�Z-15 Mrtrnett County Department of iblic Health Site Sketch ac "(- C--s M 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: Proposed Facility: .5 mU6 ^LC, v� Design Flow (.1949): Location of Site: Property Recorded: Water Supply: °gPublic❑ Individual ❑ Well Evaluation Method] Auger Boring ❑ Pit ❑ Cut Type of Wastewater: ❑. `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 .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz ! Sy 7 1 rc O i lC1 (c VRA its N x L G 3 5LC' �4 14 -3 6�,e- semi Description Initial Systerry Repair System Other Factors (.1946): Site Classification (.1948): P Evaluated By: Others Present: Available Space(. 1945) System Type(s) a — Site LTAR '