IPAC resubmitted approvalHTE# tr J_= g 6 Harntdc County Department of Public ~e~alth
Improvement Permit
2 6 3 3 2
A building permit cannot be issued with only an mprovemen~D Permit
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PROPERTY LOCATION: ,
i4
1,1111 V
d
ISSUED TO:
SUBDIVISION A47 Cf-g-0-t..4
LOT #
NEW
REPAIR ❑ e EXPANSION ❑
Site Improvements required prl r to Construction Authorization Issuance:
Type of Structure:
K Y
Proposed Wastewater System Type:2 5"~~4 e eT c
m fJr~
Projected Daily Flow:
6 0 GPD
Number of bedrooms:
Number of Occupants: L
max
Basement ❑Yes
0''~
l0
Pump Required: ❑Yes
12 No ❑ May-be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community L6' Public ❑ Well
Distance from well feet Permit valid for:
9-five years
Permit conditions:
❑ No expiration
Authorized State Agent:: _ ~/1"V s- ~ lCC`ftj Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by 6ol'Iealth 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 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 T0: PROPERTY LOCATI N: d ®x ~-r_ P_ Adl
SUBDIVISION 7a 0, -k Q r"adl:.c LOT #
Facility Type: w ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes 1:1 No
Type of Wastewater System** C ~v ~r v `%c -I J-!.®.(Initial) Wastewater Flow: GPD
(See note below, if applicable
let a,., t, -Cs4/4 (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size /000 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions: 14 l/ 0k=. l1' 1:CX
Q
Exact length of each trench feet Trench Spacing: Feet on Center
Trenches shall be installed on contour at a Soil Cover: t~ inches
Maximum Trench Depth of: ° k8 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
_ GPM f
'-P- JJV_fe'
inches below pipe
Aggregate Depth: inches above pipe
w` zl inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. 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. l accept the specifications 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 chance 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 SEE ATTACHED SITE SKETCH
Authorized State Age Date: t 7 ~V I (
Construction Authorization Expiration Date: 12 Za/C
HTE# Q 8 Permit # a b 3~-
arnett County Department of Public Health
Site Sketch
p / PROPERTY LOCATON:c,
ISSUED T0: 2 7s, f e SUBDIVISION LOT #
Authorized State Agent: Date: l ~7 /I
G
l
Department of Emrironmentill, Health p ' Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOHJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEX
Owner Applicant;
Address;
Proposed Facility:
Lc=tioa of Sits
Water Snpptp
Evaluation M dhod:
Type of Wastewater.
Date Evaluated: 2 ~ II r
Design FIOW (.1949):
Property Recorded:
'left:
_ operty ID:
Lot
File
Code:
Property Size:
U gc ❑ Imlividuat Well ❑ Spring
Auger Boring Pit . Cut
Sewage ❑ Industrial Amess Mixed
❑ Other
P
R
O
F
SOQ. MORPHOLOGY
OTHER
1
L
.1940
d
L
H
.1941
PROi•7L8 FACTORS
9
m
scape
an
Positiaa/
Slope %
air
Depth
(In.)
.1941
struchuW
.1941
Colwdeaoe
.1941
soil .1043
wetnaei soil
.1956
.1944
Prroflttl
Textwm
'Ninaela
Color DAMN
sepre
Clap
Redr
Hail
Ctuw
A LTA]R
c-
-
.
ww
Reps s3'~ Mar Factors (.1946)
Avsitabb s ea
,194!
Sydow
Site CtaWcadon (.1948) ~ r
9 ntem s
L
Evahuated By:
Site LTAls
, t-°-
Othas Present: 0
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