IPAC RHTE# t V, HaFrnett County Department of Public nt:alth 28942
Im rovement Permit
Gs.2P�F.
A building permit cannot be issued with only an Improvement Permit,�y
p PROPERTY LOCATION: Rar6�2 20
ISSUED T0: SUBDIVISION is vESA.G LOT # 3
NEW REPAIR ❑/�. EKPAI ION El Site Improvements required prior to Construction Authorization Issuance:
Type of tructure: 5�p Cyd � _
Proposed Wastewater System i pet `a—�"1a lZ6ovuCtC)a+ S axsC
Proj cted Daily Flow: ""qGPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes e No
Pump Required: ❑Yes ' No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t 0 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:��>
The issuance of this permit by the Health Department
site is subject to rev . I the si 'fir i
the laws and Rules for a aeo_ s enDis�sn
Date:
SEE ATTACHED SITE SKETCH
no way guarantees the11"f other permim The permit holder i¢responsible for checking with appropriate governing bodies in meeting their requirement. This
nded use changes. The Impro t Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
tions of this permit..
�
Required for Buildine Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .IM, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in actordanct
with the attached system layout. (�
ISSUED TO: =SMS �CLQN ye-IL—q) ) t4�c PROPERTY LOCATION: 1 ial 2
SUBDIVISION S G2�S4. noaz LOT # 3—
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ 1
Type of Wastewater System** awl o RLDV (7, d tJ x'75 �G— n (Initial) Wastewater Flow: `-M GPD
(See note below, if applicable ❑)
QL!��0L I `ems . SYS lRnnairl
Installation Requirements/Conditions
Septic Tank Size 1 OO d gallons
Pump Tank Size gallons
Number of trenches J
Exact length of each trench 133 feet
Trenches shall be installed on contour at a
Maximum Trench Depth cl ,IT inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover: r 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, / andemand the syrtem type rpedfed it different hour the type rpecifed on the app/kation. / accept the rpedbcatians o/ 64 permit
Construction Authorization is subject to
at or the intended use changes. The Construction Authorization shall not be tr inthri
the laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Date:
16 Con1sbqion Authorization Expiration Date: _
Date:
v
SEE ATTACHED SITE SKETCH
HTE# dG "b'3'IQ 6'a.2 Permit # �Ll� 1-0
arnett County 1> De artment of niblic Health
Site Sketch
PROPERTY LO(ATON: N tt mco t, �o
ISSUED TO: !! P`� ZP SUBDIVISION )-1GqZ-5>a 0 \ LOT # 3
Authorized State Agent: '� ,5�9� wFn i oL��rO Aate: $
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