IPACHTE# VI -53 a� ar ett County Department of Public Health
Improvement Permit 27523
A building permit cannot be issued with only an Improveme Permit
PROPERTY LOCATION: �121cz
ISSUED TO: Yy) cX —q, W M -S LL C SUBDIVISION Q N 4,K--,0 vl"� LOT # _
NEW-K REPAIR [--] EX ION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �J F� Q I] L4 "i Xs �
Proposed Wastewater System T pe: J cry � o � 1 a
Projected Daily Flow: L-� ® GPD
Number of bedrooms: LA Number of Occupants: max
Basement ❑Yes No
Pump Requirets ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well C)d feet Permit valid for: � I Five years
Permit condition --- ❑ No expiration
Authorized State Agent:: Date: t .y ' � 5F SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss'2 other permits. The permit holder is resp nsible 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 Improvem rt,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: i Gc��S )� PROPERTY LOCATION: c�
SUBDIVISION C LOT # ZD
Facility Type: �F� � xs� New El Expansion ❑ Repair
Basement? ❑ Yes - No Basement Fixtures? ❑ Yes{ XNo
Type of Wastewater System ** U �e-`a � f 0 ZCD vC;� I eJ G (Initial) Wastewater Flow: L"iN Q GPD
(See note below, if applicable ❑) d
CG} . IRenairl
Installation Requirements /Conditions
Septic Tank Size f ® ® b gallons
Pump Tank Size t ®a 0 gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: t"i -�� inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: C° 1 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING 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 specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authoriiauon ' o 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 \o complia�,Rr ' " ns Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Constru ' Authorization Expiration Date: _
HTE# Permit #
fl-arnett County Deptarfinent of IlUblic Health
Site Sketch
Q,
I
L-a, �- �
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: �3�\3
Address: Date Evaluated:
Proposed Facility: l-\eCQ rcN Design Flow ( 1949):
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method: A er Bori g El Pit ❑Cut
Type of Wastewat r: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
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
-
5 �L
�i25 S
�LSS
Description
Initial
System
Repair System
Other Factors (.1946): �7
Site Classification (.1948):
Evaluated ByQ( e
Others Present:
Available Space (.1945)
System T e(s)
0 U tom'
c U0
Site LTAR
1 a,'S
-