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HTE# os- s"-zo7~-7s~3ar`nett County Department of Public`-oealth 24836
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:-X111.5
ISSUED TO _ (}/J/4/b /~Jpi7,2I SUBDIVISION 7X-., c e- _ LOT # 7-
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 F tom.
Proposed Wastewater System Type: jL,52o t7ez 7,~JCJ7.as>`1
Projected Daily Flow: 3 6 o GPD
Number of bedrooms: 3 Number of Occupants: L max
Basement ❑Yes ANNoo
Pump Required: ❑Yes ❑ No Mae requiredsed on final location and elevations of facilities
Type of Water Supply: ❑ Community 9 Public M Well Distance from well /ae e feet
Permit conditions:
Permit valid for.
Lr! Five years
❑ No expiration
Authorized State Age %v Date: SEE ATTACHED SITE SKETCH
The issuance of this permit b the 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 i e 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, .1951, AS& 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 T0:
PROPERTY LOCATION: J17-1811 1360 4Jk- /?-b
SUBDIVISION 77te,,.,&.r
Cl C> LOT # Z
Facility T
e: 5 F
(J✓ N
E
yp
ew
xpansion ❑ Repair
/
Basement? ❑ Yes No Basement Fi
xtures? ❑ Yes
No
Type of Wastewater System" ZS% !7~
➢ ZY1~J
(Initial) Wastewater Flow: (od GPD
(See note below, if applicable
A,4,,t fi ,r
!r, Ls7., n-4 /ivy t (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size /006 gallons
Exact length of each trench Z Q feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil cover ~P inches
Maximum Trench Depth of: Z- Y 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
Conditions:
Aggregate Depth:
inches below pipe
Z inches above pipe
/ Z inches total
**If applicable: l understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
Thia renew„ri- d,A,,d„d,,.. ,..,,u.........,,.,.•~.._
°-1 - r..,, - -allg- tilt -1-ULu011 numOncaOUn snan nor oe transterrea wnen tnere is a change m ownershp of the site. This
tonstrucnon 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 Agen : ~ Date: 1777- 7 _ 7.0~
Construction Authorization Expiration Date: 9~~---f -7--7-
/
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HTE# 09- 5-- 707&-75,-"> Permit # Z y vs((,
narnett County Department of 1- ~ blic Health
Site lk ketch
PROPERTY LOCATON: JZ /ht,~k-= /IAA
ISSUED TO: A~/y/~/ /yID,tZlLIS SUBDIVISION LOT # 7_
Authorized State Age t: Date: '7 - E)1-
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