IPAC RHTE# 1:3 -S d o'er / Har ctt County Department of Public ailealth
ImDrovement Permit 27319
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCH ON:
ISSUED TO: i-���. ( A ;rig, "-f SUBDIVISION �v f %�,�r 6,� � LOT # t �
NEW f' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S*F D S7 X d9
Proposed Wastewater System Type: c2r �, 9ed
Projected Daily Flow: -7 Sa G GPD
Number of bedrooms: —7 Number of Occupants: max
Basement []Yes 2 No
Pump Required: ❑Yes 2/No ❑�Ma} be required based on final location and elevations of facilities
Type of Water Supply: El Community L+7 Public ❑ Well Distance from well feet Permit valid for: ZFive years
Permit conditions: ❑ No expiration
Authorized State Agent:: / S�u„� '46f1[ • Dater `/ SEE ATTACHED SITE SKETCH
The issuance of this permit byte Health h Department m 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, .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.
ISSUED TO: S}-'All" ( 15 k/-r PROPERTY LOCATION: 'J .
/ SUBDIVISION ?—c, f- -f-G�r ��� f LOT #
Facility Type: 5-Fb L� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes ZNo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System ** d.3'- A Xt4 fV- (Initial) Wastewater Flow: 36 C) GPD
(See note below, if applicable ❑) u
LP
__ (Repair)
Installation Requirements /Conditions _ Number of trenches /
Septic Tank Size /0130 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench d r/y feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: /b'',30 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: % Feet on Center
Soil Cover: /Z 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
inches above pipe
inches total
* *If applicable: 1 understand the system type specified is different from the type specified on the app lication. / 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. SEE ATTACHED SITE SKETCH
Authorized State Agent: >� c,rac' Date: a l - ^
Construction Authorization Expiration Date: z ,' / 8 .J//'1,2.0
3 O�
HTE# Permit # a--7 e d-?3fy
Karnett County Department
Site Sketch
PROPERTY LOCATON: -771
ISSUED T0: e,. -r SUBDIVISION AI A LOT #
Authorized State Agent: Date: �3� °/ ° /S,
/zs-
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