IPAC RHTE# /357- . ar, -d County Department of Public _,ealth 27707
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 4'L/gg1i JJ � PO 5
ISSUED T0: eZ ' ' SUBDIVISION 6? .rl/5 6ceZC- ° LOT # 2-,t)
NEW 2'' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -5 >
Proposed Wastewater System Type: ZS-1-76 12zai y
Projected Daily Flow: 149,0 GPD
Number of be_dr000 s: -I Number of Occupants: max
Basement ®Yes ❑ N
Pump Required: ❑Yes ❑ No Lw_f Mae required based on final location and elevations of facilities �, •'''''
Type of Water Supply: ❑ Community IJ Public ❑ Well Distance from well feet Permit valid for: 2 ive years
Permit conditions: ❑ No expiration
n
Authorized State Ag ° +�°° Date: 1 °� �� I —Z K-1 `I° SEE ATTACHED SITE SKETCH
The issuance of this permit b e 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,
Jpifrsite revocation, 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..
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: / understand the system type .specified is different from the type specified on the app lication. /accept the apecificationr 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 Jtt All 11ALHU) 311t Null,
Authorized State G-- Date: �— 2�—f �
Constructiod Authorization Expiration Date:
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: e -
PROPERTY LOCATION: , ,WQ
a � 5
SUBDIVISION
LOT # 2�+
Facility Type: —
w ❑ Expansion ❑ Repair
��N
Basement? C� Yes ❑ No Basement Fixtures? L�'ffes ❑ No
Type of Wastewater System ** 7S ".lv
V C-i- s ��' !1S'k-
(Initial) Wastewater Flow: —!J 3Q GPD
(See note below, if applicable ❑)
t--p Z'> -'Va V(- � {Repair)
Installation Requirements /Conditions
Number of trenches
Septic Tank Size 1100 gallons
Exact length of each trench %� � feet
Trench Spacing: �— Feet on Center
Pump Tank Size a Z gallons
Trenches shall be installed on contour at a
Soil Cover: ~ , inches
Maximum Trench Depth of: Z4 ' 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
tc inches below pipe
Aggregate Depth: inches above pipe
Conditions:
`F- C-A 5"r r,- Jaez'ii,-,_
I Z— inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: / understand the system type .specified is different from the type specified on the app lication. /accept the apecificationr 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 Jtt All 11ALHU) 311t Null,
Authorized State G-- Date: �— 2�—f �
Constructiod Authorization Expiration Date:
PROPERTY LOCATON:�
ISSUED TO: IQZje,.35 SUBDIVISION LOT #
Authorized State Age 4L—,—,:���. Date: IT
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