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A29 113� a w � a . • � • • PERSON COUNTY HEALTH DEPARTMENT WELL AND SEWAGE SITE, LOCATION IMPROVEMENT PERMIT Not for waste water system construction. No permit(s) for Construction Location or Relocation Activity shall be issued until Authorization for waste water system construction has been issued. ■ Tax Map # � �`i Parcel # \�� Zoning Township ,�}1; V� �'" f Owner/Contracto�,-��/ 1�t�2 S IP�,� � Da�t(�e � ". i ♦ � � � � /1 �. � _ if i � i. � � �] � �' \�I .� r��� (�// Subdivision Name �d� J ► l ( � `J� �G-�a � SE E SYSTEM SPF L ea � • 5Z7 Sizd VI ile Home Size # o edr s � Nitri Permits may be voided Well and Septic Layout 1 ���.�.���� ��� � � Date ,�, � � .: iL� � ��J�_ � �� IL . � G!i .t�L1 llnp T�k � on Line :h Trenches � � PvG changed. � � - ..� � e Permit Pai WELL SYSTEM SPECIFICATIONS 3ividual � Semi-Public Required Slab iblic Replacement Air Vent te Approved Required Well Log _ ell Head Approved Well Tag 'outing Approved .�.�,.«�... _ .-, ., %� I—Q-- � ,M _ �� �.� Date Installed by. Approved by G S.R.# � This report is based in part on information provided the homeowner or his/her representative in the application submitted for this permit. The environmental health specialist is not responsible for false or misleading information contained in the application. The environmental health specialist is also not responsible for concealed conditions on the property or for statements in this report that may have resulted from false or misleading statements provided to him in the application. Neither Person County nor the environmental health specialist warrants that the septic tank system will continue to function satisfactorily in the future or that the water supply will remain potable. c:\amipro\permit.sam O1/95 rev.l.l / �.�i,r �, .t '' ' Y .�j i� �'� . � ..��.C. `' . •4 � ..*� f:s� �l y 4 .i- � Y . �i� � - * � . .1� , _ � �� . � �- . . - � � (:�53���kC. � ' �% , : ; 3�5:2 1N _ .. . . \ . � : ..: .: .+. '�. . • � . „� 5 } � � 1 � _ ' .�FtO�i< - M�dUP�Acf�T ;,:- - °��.291�t � , : \ :\_� � . � , �3i�`�RC�;, �.C,�f2tdER - �` r�� 00 ► � N 3° 3� 2 9' W �` � � � '.y'' • "' `M i � . - 389.fl7. � . t�1 .� _�.., ; f 1 _ �: �i , �'� 5 -l� � 4-� ~�'t � - _ _ � �� . n. . . ,; � . � __ 5 ' i' � � ,. :. " _ . . .. � s. °.�� : � i� . . � � � ' .7 • F . � 1 , _ /�., Y' �, r ,��� �.�4 ` .' �-. � `v' ' � �, _ } r , : �' . ��� t ^ + � � � �. . �... . � .. ^ y�- � , �' ! 7 t � � 1 � � ti � \ : � aK it �, . � � J�. z .r t � ^ • .. . /�� - . . �i (i� 1.F1, ... � 4 , i v_�, i ' � _� � �•�y�C �_,� . � � V F , . ' � �. �fI - .f'� � . {W "r � �" •� �i v . �. � . . . ' , r 'T � . .. � Y ' .` � �5.: '.{. .. 23�.� o t- - � � - �� ,� � � _ `; s� � N 3�f '.2-9"W " ' ` '� 'r � , �� •.� �� � tb ;.; � ` �, * /� }. • r. '�,�, F ° * k � ��,1 ��� /'i� •�� r � .�� � : KT j �' ' ,• �� . . .: t .ta` _ �� t � -.as yZ' � . i " � ...i. -� 1 .� ;Y.a t aF j � F r ^��. . 5 .. � L.,� L :J�. \ . '! w il 'l : f4 ` .. _ _ � ' ..1 i - ' .h j .�. t.�'�Ll{ �: '} �/�_j ���.� •4i• M �. � ' . -. . . � � � �� � � . J� �f . Jsh ,�1 Y F .�O . ���t r Y 1 y �.; � �!_Q `,i�'' . _ �. , ... '��'V -� � f � ., s..�� �� � � t ^• �- - � '�. �. �� � �. � ... - -. t..52 A . . c n` � ; �: . , �a ns: o�::�, . ' - ' .. " 3 7 7: 21 • . . _ • . . � ,� � . . _ _ . . . _ , � . . : . ..:. . . ..: . . . .. . . . _ . :, .. .. . :�.. �.' . .. . :.. �.. . _ . ..- . _ _,: _ :: - . � . � �� t_v��3�' „W. .. � 16 . . . � � .. _ � �` ,.�, � I _ - � , - �' .� � � . v - . . . . . p v. . � ��� .. � .. � � . n . . - . . � (� : . . �. ., .. �• ` �• - � � � � � - . _ � ., S` . • � �so S?5'' .:� �, m � _ �. L: � iJ�l;9 _ ' ` �.; . • � .S /... .��i.;� . W �.. . rn . . . . . .� �t, � ' �, .. _ . ,� - - : � � . � �. .��� �c . . � _ C's .. �;.� _ . , .p �� ���wt� rl. �o' . � �, : Z,,l � `�:. u'. � �,_, _ �. ,' � 1 . �� , � . � � . � "t� '. � � _ :�t' `_U ' :�. � .. R.,�h � � House � � —�� '� _ , .� . � �1.��0.AC. �'oz g / '� � o � . � � ►?� . ' ; . � � 1 �. � �o� . ��� i �� i � : ' o � �N 3°35: 29 W ' 1 5 / � �. , � 1 � �' ' � . . . ' . . . �./ � .Y . . .� �G� -�� � , f , . . , • . 2� .. � - . . . � . :l . j . • , �� . ,�0 4��, �c�g: �,;/ � _ . � ,. . .�5�}�s, � . ' : / . � 1� �R� y . - � � . . : S ' . • . ' ;�. . . . t� . . . • �c• . � � . - -�� . t c�a � ' :. � . . . / � . �. .;: ,; : �' ` �rn . - - . _ � . �� . . j . .� .. . . ,: �, C .. ' : � / .. �: 1 � � . •�Q . • / . : - . • . : � . �� • : ' ` � . '� • . ' . . : '� . - 1 �J� � . . � ' . . . . . � ''nt . -� . �� . . . _��. � ti *� � r . �- � � . . , � � � �:� � . �. _ . , . . . . .., '• .45� ! . ��. � . ���j ��� ' . ' . • . . _ � . � j� . �� ` t � ;' f ����5 � Wr .�! /: � , . . . . _x ���. . ...�s�,.� _ , .�> n. . ., �n,7� . s.... �� � M'ti.d.a'�:• ..t; �. . ., , . -./. -�,.�. _. � . ' i . � • � � • • • • �•'I IY]