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A35 145„The District Health Department Orange, Person, Caswell,. �Chatham, Lee Counties Water Supply and Sewage Disposal-:;..: OVEMENTS PERMIT No. °� Dat � Owner: � Location: . � �� ^�'W yt. ��:. /�� .. �... . Contractor: ��;o� `.� Water Supply: Private � Public � ��= .7: ewage Disposa cililies:. No. bedrooms Dishwasher, Disposal, > � ashi in ther auto �- atic appliances � ize of tank: ��`.Nitrification line: � . � . fl %li l � - . -, . - ._. Other disposal facility: Water supply and sewage disposal facilities location, insfallation and ' protection . must meet state and local regulations. Septic tank should be pumped out every 3 to 5 years and shall be main- tained by owner in such a manner as not to create a public health hazard. Septic tank and nitrification line MUST BE INSPECTEB AND AP- PROVED BY A MEMBER OF THE DISTRICT LTH DEPARTMENT STAFF BEFORE ANY PORTION OF THE S ALLATION S COV- ERED AND PUT INTO USE. . /� i �` Date approved: � Sig` Sanitarian Well: Sewage Disposal: � Counter- By: CerYiiicate of Com Sio •' Date Approved: � � � By: his representative) (OVER) Location of weil and sewage disposal facilities sketched on back. NOTE: Make sketch of installation showing lot size and shape, location of house, septic tanks, privies, water supplies, etc. Note pecial problems existing on lot. Write in measurements in order that installations may be located at later date. Note�location of water supplies on adjacent lots. (1� ` (z) � Application Date: Amount Paid: Receipt#: _ Tax Map: Parcel #: ��,�f �� 7�'�+ ' —,-- cC � ��L'7i � i��7' 1L�i �ca-a> �► u¢a gb T•-,•-„ <c3 ga �aza. � �IL "J� ae" an ��Ca Applieation for Services (Septic Systems and Wells) Services Re uested ❑ Improvement Permit (Site Evaluation) ❑ Construction Authorization $200.00/$300.00 (if > 600 d) Fee is de endent on the e of s stem ermitted) � Mobile Home Replacement or Building Addition ❑ Permit Revision $150.00 (if site visit re uired) $75.00 ❑ Well Permit (New/Replacement/Itepair) ❑ Repair of Existing Septic System $300.00/$200.00/$75.00 No CharQe 1) Services uegt by: S Name: Address: L e � o �� 7 Phone # (home): 33 6 �s9 9 � �3 �� (work/cell): �J � 0-- a3 7� S' 3�' 2)Name and address of current owner (if different than applicant): Name: Address: 3) Property Description: Addr and/or dire tion O � � M � �� Lot Size: �� C� Ci a Property: __ .S �Q ,/ 'o rv� f� �. iA �� Lot #: 4) Proposed Use�n d Type of Structure: � Residential ✓ B iness/Type: Other ►'e/�0�' a! �� e`� "�'' Number of bedrooms � / Number of eo le served seats/em lo ees : � /� P P � P Y ) i L✓eaSc � Basement: Yes No �/ (with plumbing: Yes No _� p,�� ' �� n .e�c� Garbage disposal: Yes No � S' �e , r 5) Water Supply:� Private Well ✓ (Proposed Existing _) Community Well: Public Water System: Are there wells on the adjoining properties? No Yes (please show location on site plan) Note: A completed application must also include: ➢ A plat/site plan of the properry that shows property dimensions and the size and location of all proposed structures. ➢ A signed copy of the `Lot Preparation' form verifying that the property is ready to be evaluated. I am submitting this application to request services from the Person County Health Department. I understand that if the information provided is incorrect or if the site is subsequently altered, or if the intended use changes, all permits and approvals shall become invalid. ' n r e ative : ..� W� Date �"-�C �o�Q� S i� a t u r e (� w n e r/ L e g a l R e p c s n t ) 10/08 Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790) � � � � C � 0 < � cvr� (:UF JAMES A. WATTS p, B. 173, P. 516 fIFtC�TE OF EXCEPTION �E) HEREBY CERTIFY TNA7 I AM CWE ARE% fHE ER(5) 0�' THE PROPFRTY SHOWN AND DESCRIBED EON, WHICH 1�IA5 CONVEYEO TO ME Cus� �Y DEED pR0E0 [N 800K `____,._ � PAGE ______� AND T SAId PROPERtY QUALIFiES AS AN EXGEFT[ON TNE PROV1S10N5 OF THE PERSON COUNlY DIY1510N REGULATlONS UNOER 5ECT10N 16-1• __�wriER _-_____nnT� � � ` owrieR _..________ pase ""� bATE i------------'-' tNNLN AG ND ZOt��' � AOMINISTRATCIR t50N COUNtY, NC �� WOODSUAL MAY 1990 NI o, so• � _� P1ARY W. WATTS �� . � \��' � / /" ' c,� / ' �O ' \ �i ,✓ . i" � i � /, � �, ' V` � % / �� / � � I �� / / O � � � �, i' / � � j�J /" / / \�� j/ /. / �� -� G�rFC) � � �� / .. s/ i / ConnectGIS �� _� �� Page 1 of 1 ,.. �'. P '.. � t �. � � �. .. .. . �� .. ��. ro �� . .. . . �� . . .... . , nw . �. � �� — — _ _— _ g � ..� � „�.�;.��-� � . �� — � _ -,-r--� .,�� _�..----�-r� � 1:38 feet �5� �U�TF'c•� � � q�� -�FF`�. �'� �' � �i'1 ,�,► �, , � 4 -�.,,, � �, � �t j' �,.� � i �� .-.e.,... .av, '� ^-�'.�� ' . 1�� 5 . G ,,,,,,,.� y ''.t. �— . ��-y .. .A', 1 t' \ } �� , �6 , o"" .n,th � �P" ��`S h . ... f � � �� f?UtdTY 51 �� Thl: 1 G'. Fa ° khe �n � r r al �� i� 'a �7�in �.Ih .�r .ctio^ ar T� _m rctc �- t�rc c �t� � S 3n: ��lld Ef fYt�C '� f Y��C U' 7'� ;t.r �- rr r c rvati � . fi ai9 Gz [�� u � a sl�> t tna 3'L Rt3h� .�Zt3 P 71 V'� ] P�'1jGf slf'!;: s:.i�e: rc �� ai �.,Gcm.Ea i.: t. ihz inf,rr �.c�'�. c��rai�r�i cr'��, mac http://gis.personcounty.net/connectgis/Map/PrintWindow.aspx?Map=http://gis.personcoun... 3/24/2010 Aaalication Date: �� Z Tax iVlap #: 1�' 3� Amount �aid: 1 �.� •OU Rec�i� #: ,2 G-7 D ti Parcxl �: �� y� � �--��`�� .� �� t ac�,�e,c•�' � � � �J1�T�L"�Y"' ��f ��a-�,-.- --- m�.�.a ��.a�. � G I 1 APPUCATION Ft3R SEitVICCS 'IF THE INFORMATIOM IN 'THE APPl:1CAT10N F�R AN IMPRO�IEMEAIT PERMIT 1S INCORREL'""1'. FA,LS1FiED. Ct-IANGED OR THE SITE IS ALTERED THE�1 'ti-!E 1NIP4iOVEMENT PERMIT APID AUTHORIZ14T10M TO . CONSTRUCT SHALL BECOME INVALID, - �- , 1) Permit requested by: e agent/pros�Ctive owner): kEi+% �t�0.�r5 Home Phone: - 3 t�� Address: �55D McG►hees N►�\� fl. Business Phone: � � T�oYl�cxo�, NC. 2h5'73 2) idame and aldciress of currer�t owner. �G.t�e . 3) Property �escription: Directions to the prope 4) 5) C� �Townshlp: �°`Me �a�� Proposed Use and 5lnictut� De�cripfion: answer eacll bi the follo�ing q�[estions: - - a) Prapased . Existing ✓, Type of Structure: Width: � Depth: b) Number of Bedrooms: Number of occupants or people to be served: �_ � c) Basement Yes . N� Wiil,th/ere be piumbing in the�basement? d} �arbage Disposal: Yes . No _ Water Supply Type: Private �� (new _ or existin4 �), Publi , Community� , Spring _ Are any welis on adjoining property? Yes_ No �,/�yes, please indicate approximate locatiori on the � site pian. 6) Does your property cantain_previousiy iderrtif'ied jurisdlc�ionai wetlands? Yes,_ No� PLEASE NOTE T9�IE FOLLOWING: ➢ A Pl.i�T OF THE PROPEi2TY OR Si'i� PI_API iNUST SE SUBMRTE� W17N THIS APP�ICA�'tON. ➢ PROP�TY LINES AND CORNERS MUST BE CLEARLY MAR4QED. �, 9 THE PROPOSED LOCATION OF ALL, STRUCTURES MUST BE STAI�D OR FLAGGEi3. 9 THE SiTE MUST BE DiE�1DILY ACCESSIBL� F�R AN EVALUAT]�N BY THE HEALT�-f �EPARTMEiVT STAF�. f hereby make applicatio� ta the Person CouMy Health Department for a site evaluation for the on-site sewage disposal system for the above-described property. 1 agree that the cantents af this application are hue and represent the maximum facitities to be plac�d on the property. I understand if the site is altered or the intendesi use changes, the permii shall Cwner or Legal �epreseritative � 9�-a3�-�a Date PCND, rev. �6127102 �� l.J �� 11 . ��.�-o-n-,,,.,�„ ��.IL IF��e�,.Il�7�. � WEI�L PERMIT� Pa.EASE SEE A'1'I'ACHED PLAN FOgt WELL SITE LAYOUT Tax Map #: � 35 Parcel #� ti Township ��m�'�mh� APPli�� +�, In�oJrl s Snbdivision: `01 A Section: �-- Lo� — Location: � ��wb 1.�. ' i.z > Y�� ►�.� r�..: � � `�� d o.��s ��-;�.� (�-� � •a� -�l� �� 5�'Z� tM�C,�.,�.�.� �'V.;�� iZ� �rs�S rs�. ho �F�. 9 i�.s.s o F �UZ - Tvne of Water Sunnle: Reauirements• v TI1diVY�l1� Site Approved by 5� e, -a�- o Gzouting Ap ved bp � l-0� Well Log �� . .,. n..,., .vJ� t � - - -- . . . Air Vent � Hose B� Concrete Slab W� D�: �1�1k�� COriliritlilltj% P11b11C '- �u�� o��c.+�. �:s�-� �u4 \ �� si � s�-c�, We11 Approved By: Date: '�°5ee Attached Site Sketch'k* Wells must be 10 feet from property' liaes. � WeDs must be 100 feet from septic systems. Wells must be xt least 25 feet from aap bu�ding foundation. Other conditions: �� 1 �„� �� ac s�4 � L. � l.� i 1 n� kti z w; i�- � �I [iS. Cd�a'r�2.� PC�ID, xev. 09/07/01 �� .di. �.ii. �� u u � �_��.—�..—.-- � uwt� uv r,� , � `'`� � �� f� � ��T�7�'�'�t`��t� �C�°� � -S'1►ef-Eor� �c1�ll__t��=' 1 �r �� !F.i1�xa-•e-7i'ft^-rAR�.'I•lx�s.�_.1t73.'�:EA.:L �Ji�C7.l71.'1.�lY1a. {�J($J{�q � o /O'+/V °Oa� � T� �Cci Wt Sc�r ✓�c. r � ..�..r... ,_.. . fTroui �og Owner_ __._ r �i� !�%Ct�S' �'ax Map �� Parce! # �,� � Lacation: -�- G�(ce..� !'YI; oi � � cro S rl r.� e... t�- �� o►� � SubdivisiQa: Lot # SSd rn.c �e.es m,'t� 1 is'c( tiVeil Co�shvc�ion Ui�tzn_z Frorn nearest Prvvecty Line (Minimuin IQ feet) _/OO �L i�istarttic from Septic System (Mtnirt�um 60 feet) /� � Totai Degth_ �'� 6O . ft Yield: rl GP�VI Static Water Level: 3G� ft Water Bearii�g Zones: Depth /�'� ft �� Qft ft _�_______ ft C�esing: Depth� From E to,.,,,_„ � J . t't. Diamccer. �� in `�"ype: GalvanizedSteelT� 5 . �V�ig#�t: �13 ��' _�...� ickrtcss: /�� Fieight above Groun�: .��. in / Dri�rc Shoe: ✓ Yes No .��ny problems encountered while seuing casing? �Yes r! ri�u If `�es" giv� t�eason: � Gr�ut: • � . . h'�at: ....._____ SaricUCement Goncrete �,,,__ Gravei/Cement � � AnnulZr Sgace Wicit� �_ inches Watec in 1�nt�u1 r 5�Sace Yes s! I�o �Ieshoci of Gro�sc: Pumped . P:ess�re Pourec� � Dcpth �Q,_ io B:S��t. hla�erials L�sed: I�To_ Bags Poriland cem,er�t �_ � . 1Neight of I Bag �_, poc�nds If mixture (sanc� grat•e;, cuttings} - Ratics �,,.,_ co � ID��ates: ✓Xes _ho ' 4 z 4 stab /�Xes _ No Dti�li�lg I.O�,►, I.t�c�tinn Ilra�i„Q i her�by r.�„rtifS t�tat the abave infc�t�mai�on i; correct and thAt this wel� w�s eon�tnteTed in accord3nce t�it I o , s�t fortii bv che #'ec�on C:c�uqry ��e�ith D ' SStfnCl�t. Pl LC.'r..ill,ttinns I �i�nai�rQ ot' Cor�tractor _ �C,��/./�-L�� !n �� f /,� ,!/ . —..�^.--..�_ # �fJ Date I.c�/ l7� `C��„� PCHn rev U�)l;trurY+ id Wd8Z :80 Zd�� bi '��0 L9IS-$$£-9££ :'ON Xd� �JITII2�Q ��f1 NOl'l-�3HS : W0� Agplication Date: �y Amount Paid: 7 Q ° Receipt #: 70 3 �v2 � e��GG�O Ci Improvement Permit (Site Evalttation) � Mobtle Hame Reptacement ar $1 so.00 if site visit requirt eII Permit INew/Reulacemec �`�?.�� 1. V Tag Mapt �"r- � � ��T Parcel#: IE�-��,..,.... �.�.Il 7C-�t�.�.,.9 � for Services L� Constructian Anthorizatioa (Fee is dependent on the type of L� Repair af Existing Septic System Application: No Chargel CA 5150.00 or $300.00 1} Applicant infor.rmaiion: NS3T1C: s.lG�1� � � �.t� � 2G.r� � Addtess: �'ti f:r : �irr�. � �� 2} I+Tame aad address of current Qer (if differeut than applicant): Name: i` GJ �' Address: ' 3) Praperty Description: Lot Size: Address and/or directions to Prope : %/� ,�I'Ic�«� �i// /1� , Phone (home): �33�) �22 ' 1J�.LL (wark/celI): �'~�3�Z �;s3z -- �,/,13G Phone: % Z' %j�� 'y��) / r,�a•k � #: 0 yes G1 no '� Does the site contain an}ijuri�dictional wetlands'9' � yes � no Does the site contain any existing �vastewater systems? Ct yes ❑ no Is any wastewater going to be generated on the site other than domestic sewage? ❑ yes L1 no Is the site subject ta approval by any ather public agency? Cl yes ❑ no Are there any easements or right� of �vays on this property? (if `yes' is checked, please provide supporting documentation) �) Proposed Ilse and Type of �tructnre: l�Residenrial ❑ New Single Family Residence Maximum number of bedrooms: [� Expansion of Existing System If expansian: Current number of hedrooms: ❑ tZepair to Malfunctioning System Will there be a basement? Cl yes ❑ no With plumbing fixNres? �Non-Residential Type of busuiess: Total Square footage of Buildin� Maximum number of employers: Maximum number of sea#s: c��,,�6,1a'.�►� � ��f��r � � yes ❑ no s'") 'Water Supply. ❑ New �veil 17 Existing Weil ❑ Community Well � Public Water ❑ Sprina Are there any exisEing tivelis, springs, or existing waterlines on this property`1 O yes � no 6) if applying for `Anthorization to Conshvct', please indicate preferrecl sys#em type(s): ❑ Gonventional � Accepted ❑ Innovarive ❑ Altemarive Q Other ❑ Any I cernfy that the information provided above is complete and correc� I also �tderstand that tf the ft2for'm[uion provtded 1s inaccurate, OP I th� site is subsequently altered, or the intended use chcmges, all petnrits and approvals shall be irrvalid. e (Owner! ��f! Representative'�} � Supporting documenmtion required. /t� - � 2o�y � Date Permits are valid for eiiher 60 months or are nan-expiring when aceompaaied by an approved plat A completed �Lot Preparation' form must accompany aay applieation requiring a site ev2tuatioB. nnn �\ Do.ti..,.. l�...,..s�, MMtI�MT�MYTf+O� NOOl+I, 17� Q i►A'..��„ cf e,,;+e n v....ti.,...., t.rr� ��c�� i�� e�� t�nm Tax Map: fl3S Subdivision: ��.sf ��.�� - �- � � �� I� �rav�nu-a� �n��na�.m.Il IHC � �.11�1ia Parcel: I'i'S WELL PERMIT (New_ Repair�) Lot: Applicant's Name: K�rn� wa�S � 1�r�,'R. t�.►r-�tAS Mailing Address: SSv Yr�t�� v� Ri� R�ocw �J� .��S� �l Phone Numbers: 33i, - '� - �►a '33L- 3� - �^►� Location of Property: SSa MC �,t�,ES M�u.- RO Permit Conditions: 1.) See attached site plan for proposed well location. 2.) All applicable State and County regulations governing construction and setbacks apply. 3.) Permits expire S years from the date of issue. 4.) Issuance of a permit does not guarantee a potable water supply Other Conditions/Comments: Permit issued by: �c.t�, /4- SMS1-�1 �New Well: EHS/Date Location: Grouting: Well Log: Well Tag: Pump Tag: Air Vent: Hose Bib: Casing Height: Concrete Slab: Well Driller: Pump Installer: Approved by: Date: 10-L,-1a Certificate of Completion �iner: EHS/Date Depth: i3 ` Grout: 4stc.,�� c.Ewc,��-t- � o�b � o-- a3-�� DAbandonment: Date: Method/Materials: License #: License #: Date: Addi[ional Comments: Lt�0., h�p 't%l w� W��+RO� Aw� w�� r��w w Eu.. k�'S) P�sser.c�� Date Sample Collected: EHS: Person County Environmental Health 325 S. Morgan St.,Suite C Roxboro, NC 27573 Date Results Mailed: Phone:336-597-1790 Fax:336-597-7808 11/26/13 WELL CON5TRIICTION RECORD 71�is toim canbe uscd tar sin�c or mu16{ilc vvdls 1. Welt Contractor Iaformation: 1��,.� ��kr► Wdi ContractorNa� _ 30 2.�� ^/� NC Well Contracta CectiScation Nwnba wa�,r � i ��r� �i?G Compaay N�me Z Well Cnustrnctton Permit #• List o!1 applicobie ��1! eonrtrruxlon pemrltr (La Coun� Stvte. Varfanc4 etc) 3. WeU Use (check well nsc): OAgcicvltural OMunicipaVPublic OCzeothecmel (FieatingJCooling SaPPiY) q�idential Wata SvPFtY Esu►8k) �Indust:iuUCommercial �Residentiai Wata Supply (shace� pAquif�rRaharg,e �GroundwaurR�ediatian OAquifer Storage and Recovery OSalinity Batrier OAquifer Test �Siomswater Drainage OExperimaatal Txhnology OSubsidcnce Conuol OGeothe�aI (Gosed Loop) O'Tracer ftC'�enthermallHeatinaJCoolin¢Retutnl OOthetieXD�atIIundCs#il i 4. Date Well(s) Completed: � � ' �� " � � � S. �YeU Locatloa: �CU ��. d��vt c� l.�c.r�%S FacilitylOwnerNa�ne Fac�lity 1DN (iFapplieable) ��.Z i%�l� � �, � /`yf %l �� Physicat Address, Ciry, d Zip 'y 7�T y �ir�n.-� County Pmxl Idcntificatioa No. (PII� Sb. Ladtude and Longitude ia degrees/minuteslseconds or decimat degrees: (ifwell ficld, we IaUloog is s�cient) il�� .3lv -`�S�?'!D y rr u17� -%9- U/'�Og w 6. Is (are) the wei!(s): i�ermanent or C1Temporary 7. Is tWs a repair to an eristiag welI: � or ONo ljthis is a repair, fi!! out kno�rr+ tive!! constructio» fnJormatlon and aplaln ths natum ojthe repatr aeder #2/ remar� seuton oron rhe back oJth(sjmm. 8. Number of we0s constructed: � For malttple injectiar oraan-tivatertupply rvells ONLYxtith lheutmecoasf�rrctiou. }rou avn rubm!! onejornt. F�Intemat Use ONLY: 22. CerHticatton: ��'�� —.�J�� s� occ�w� � n�,� By stguing d+is jornr. t hereby aery/y tlwt dre w+el1(sJ uas (wne) constnicted in aaordance �vtth /SA NCAC 02C.0100 ar !SA NGlC 03C.0300 Wel! Conrnucdon Standa+ds and that a rnpy o�thEs rravrd har beat provided mlhe »rJt orw+er. 23. Sits dtagram or additional weII details: You may use the back of this page to pmvide additianal well site details or well consauction detalls. You may also attach adfiiNamat pages if na�ssacy. 24. Snbmfttal Insuvciions: 9. Total well dept6 below Jand snrface: /� (ft,) �a. For All WeUs: Submit this form witlim 30 days of completion of well For multip(e nYlls Jist d1 deptTis ifdifferutt (um++plc-3(r�.i�1'md 1@100� COnstnu[i0II to the f011owiag'. 10. Statte water tevel tretow iop of css(ngs �� {fk) Divisloa of Water Qaality, Informa8on Processing Unit, Ijxnterleve! ts above casin� use "+~ 1617 Mail Serv[et Center, Raleigh, NC 27699-I617 � 24b. For inieetlon Wetls: ln additioa to sending the form w the address ia 24a li. Borehole diamtter: _. (in.) %� ' - above, atso submit a copy of this focm within 30 days of complaioa of well 12. Well canstrnctlon method: 1/ y�f N consuuc6on to the followin� (i.c. auger, mlary. cabl� direet push, etc.) DIviston of Water Qaality, Undergrnand Injecuan Contrnl Program, 13. FOR WATER SQPPLY WELiS ONLY: 1636 Ma1 Servtce Center, Raleigb, NC 27699-1636 13a. Yteld (gpm) %' Method of tes� Lt� ��- �Or Water Suoalv & Geothermnl Wells: ia additioa to sending the form W � the address(es) above, also suhaut one copy of this fotm within 30 days of 13b. Disinfeetioa type: _� Amnun� y �P�� of well coastxuctioa to the counry hrrlth depattmeat of the cotmty whero constructed. Form pW.l Nmth Carolina DcpaRmeat o[Envitonment andNawtal Raomm-Division oriYata Qualiry Revised Jan. 20I3 � . y q { % ;! �� =� � �' � I, } � � , � \'� I �. � � d , � '� � �� • i � �:�I �> > . �� , � � �.�� 9 d � �� , � �� , , �:-( � �L'.�/?L'l:`y""L.1I."�f�:�i��l.<C.'.�i^itl{:..�11.� .1� 1'1�t�<211..� '•.�:, ":1. �a��1�� m��/ I�'��ob�� -I�a�a� 3��a��is Ta�Y IVIap #: 3S Parc�l#:� Address: Approval Requested for: bile Home Replacement �lding Additicn Applicant Name: �P i`� �it _ _ Address: � G- L Phone �'s: Permit Located: �/ Yes T10 Installaiioi� �ate: - - -j Desi�n flow: 3(�Q (gpd) Curreat Centract with Certified Ope:ator on file (if requireri): Water Supply: _�Well Public cr Community Wastewater system shows no visual evidence ef failure on: -��ID ate) l�pplicant's signature if site visit is not required) . ��r1�ds��/��a� ��p�� ,— zy—�� Enviro ental I iealth Spe�iaiist Date PP:son Co�nri Environmental=Teaith, �� . y:or?an �t., Suite C; RoYboro, N� 27�73 Fhcne: ��5-�97-??9C/ ra,�: ��6-�9�-;�0� � iv�:�-�,�i.�ersor�countv.ne� Id :��;�� I��,T _ ._��°� 7��a-�� .11 ]E-�Z�.�.Il�. SI'I'E. S](�'�CH i�;�h (�,.ti�s r�r��.�,, ,rti.; � 1 ►2 Authorizecl Staxe Agent System components re�resent approxsmate �cont beginning the instaAation to i'tssure that j�s�oper \� j +�o�FM�2' ' �^ -'� � ( i�nQ. 5 � �— _�. .. t,.��l :s m cr ic.cc� �, ; }�, a o�c�e �Ic�s 0'� Lu�C�O�I �9F1'?lh� V • �10�� c,oszl i no�c � / -Fz� �� i��c:r-,�.c,�� .�wQ' ... � c.�cv-. � �,.�a.�'� c c� , -- Ck.\o��^�e _ ]]o,c�;11 �c.;�; �t, cl.o�-► Clo.�.y cr �.�.n,�.�-, Scale: � � �E Ta.g Map # �►35 Pa:rcel # � �15 Section/Lot# Q �- a � - o'� Date The contractor must, flag the system�irior to —�Q �"�'� C i 5 Mcr��u�.c� t�i ��. Mcfo l�a.� �`" i \ ��. PGHD, rev. 09/12/01