IPACHTE# t3-S -3�C�0 arnett County Department of Public Health
Improvement Permit 27441
A building permit cannot be issued with only an Improvement Per tt
PROPERTY LOCATION: NL,9 E ISSUED TO: C'w(,5 V)"o 1^1G 1N C. SUBDIVISION \� r�s-s L- PuoeeaC e; --- k S LOT# t
NEWA REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '5'F0
Proposed Wastewater System Type: Z -Saks 'TMF�UG1 O, Sy5'cn
Projected Daily Flow: (oO CD GPD
Number of bedrooms: -5 Number of Occupants: f max
Basement ❑Yes 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 100 feet Permit valid for: Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent:: Date: S SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees t e issuance Cher 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, .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: CPt; Es 12>0 LOA N3 G � N G PROPERTY LOCATION: N_e X$41 - 102
SUBDIVISION L.P,,y;n r_ @✓'�T�AC Son," 0\ LOT # tom_
Facility Type: SF0 (5gxL-x6: New ❑ Expansion ❑ Repair
Basement? ❑ Yes �K No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** c�7, -1C 9,E,ov�ns ON Syss�sm (Initial) Wastewater Flow: CO® GPD
(See note below, if applicable) -�-^
pu erC�^ 1 o a-S �r`c � tr N (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size 12-SO gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 45 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. '3,")"6 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: ' Feet on Center
Soil Cover: (o inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: / understand the system type speciled is different from the type specified on the application / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiecLto revocation if thLsite Dlan. Dlat. or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershin of the site. This
Construction Authorization is so�'ec`o compliancwi roes of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: M) Date:
Con tion Authorization Expiration Date:
HTE# Permit # a��41
Marnett County Department of l�tblic He4,rtjltlt
Site hetch
b
PROPERTY LOCATON: IL rz-
ISSUED TO: C-Gg� lr_s 9Z V X-0 N N c-, SUBDIVISION 4Q77Ar— Svmm c LOT#
Authorized State Agent: (OL-IML Date: 15 `)\)31
Q.0' r)(LP0l4;-.CF-
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:
Address: Date Evaluated: F�l)13
Proposed Facility: Design Flow (.1949): 60c9
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Methodb,,Au er Bor ng ❑ Pit F] cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
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
a
Description
Initial
S ste
Rep it System
Other Factors (.1946):
Site Classification (.1948 5
Evaluated By: O'�
Others Present:
Available Space(. 1945)
q
System Type(s)
S /
Site LTAR
r ��