IPAC RRHTE# g b-14 o Harne__ County Department of Public Ya ,lth 29192
Li cn Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: -'5A /L/OI
ISSUED TO C— SUBDIVISION LOT #
NEW REPAIR ..�EIjPANSIO❑Site Improvements required prior to Construction Authorization Issuance:
� a
Type of Structure: 1 -4 -To
Proposed Wastewater System T e:
Projected Daily Flow: y G GPD`+z4I,.-1
Number of bedrooms: Number of Occupants: e9 max
Basement []Yes CS3'No
Pump Required: ❑Yes ❑ No R1 M e required based on final location and elevations of facilities
Type of Water Supply: ElCommunity Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
0' Five years
❑ No expiration
Authorized State Agent: i � < / s '—,,AzJ4s2SV Date: Z — F_� /D '/b •/7 SEE ATTACHED SITE SKETCH
The issuance of this permit by fe ealth 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 jW 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
Reauired for Building Permit
The construction and installation requirement 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. —7
ISSUED TO: OL%AICA6 0A)E � Gtr f. PROPERTY IOCATION 6i 1461 Y_G I 1=' F I
I Q SUB ILOT #
Facility Type: ��� �'I GO 1 Au� s, -.—Cad" New Expansion
n ❑ Repair
Basement? ❑ Yes Ed No Basement Fixture 7 ❑ Yes No \
Type of Wastewater System" %�{ l t/%S ZT ��w� 1 (Initial) Wastewater Flow: �O G-746 PD
(See note below, if applicable ❑)/,d 1" / /^ '/ �) /
Installation Requirements/Conditions / Number oettrenches .3 a L.Pje5 p
Septic Tank Size—,
Zd b gallons Exact length of each trench - r5feet Trench Spacing: / Feet on Center
Pump Tank Size Zen gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of: Z Z>/$ inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/•1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM — �(5 inches below pipe
Aggregate Depth: inches above pipe
Conditions: �� inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"'If applicable: / understand die system type specified is different from the type spedhed on the app&bon. / accept the sped6cadons of his permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revoadon 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 m the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State int��r—� �� — Date:
Construction Authorization Expiration Date:
HTE#/7-r- y67VO/Z
ISSUED TO:
Permit # Z5� / 9 Z
Y61AW70tt County Department of Public Health
Site Sketch
LOCATON:3'L1yU1 1011W5 Z4,4/ 140
►➢BION LOT #
Authorized State
=2:� /6 -/D -Z7