IPAC RRHTE# ii-�- a-���I arnett County Department of Public wealth
Improvement Permit 26746
�Et� ► L P�Nt•11,�6 A building permit cannot be issued with only an Imprament Permit
PROPERTY LOCATION: ` o
ISSUED T0: NJU SUBDIVISION 5ur-nSL'y-\ttz LOT #
NEXX REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'S
Proposed Wastewater S stem Type:r'
Projected Daily Flow:G GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes >< No
Pump Required: Dyes--- ', No El May be required based on final location and elevations of facilities
Type of Water Supply: Oun,ity Public ❑ Well Distance from well � C00 feet Permit valid for. N-o ive years
Permit conditions: expiration
Authorized State Agent:: Date: 1'.), `1 It SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health DepartmenY in no way guarantees nce of other permits. The permit holder is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intende es. vement 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 nd Dis osal a itions
to
Construction thorization
(Required for Building Permit)
The construction and installation requirements 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.
ISSUED T0: tvAt 13 PROPERTY LOCATION: o y 6 J�Lo VLO
����', �� SUBDIVISION Sv M m�z. -�� u—. LOT #
Facilit y Type: 15ob`�` 5 o'%d [ New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes �No �� U
Type of Wastewater System" �* �scll d V C-;� } cl y1J (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) �3 S °lam V �,� >. v a!
ezi is (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size } oE5 o gallons Exact length of each trench lS-0 feet Trench Spacing: c! Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: 6 inches
Maximum Trench Depth of: yq 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: '�. inches total
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.
* *If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subtle rte - evocation if the site elan. olat. or the intended use chances. The Construction Authorization shall not he transferred when tharo is a rhanaa in nwn—hi f ,ho .;t, Th,
Construction Authorization is subject Lo complia Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent Date: '7 i
�)Co tion Authorization Expiration Date: e a
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