Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
A29 122
09-30-1998 11�38AM FROM PERSON COUNTY HEALTH DEPA � , � i�mounti: pai•d �• �C� ; ���5/, 00 �� . ; 'g�ece•ipi � '��(n � i o�„ a.� . � . . . � � �I� � (ON FOR SE� . , i � � Impravemen�s Parmit(Fstatilished/R : �d I.ot) _ Fteins� � ;;� Im�ovem�e�ts Pernut (Unr+ccocded } ! .,. Rap . ��� � Impro�errients permit (Mob�ile Homc ; place) _.,_ ermi . �� � Improvemc�ts Pcrmit{AddiEion) � ._._ Repla - ; � . � . . , a e . �� ' _ Bacteria _„ G,haiiica} _ �'atroleum � : ;. � . .�_.. � ._.....� . 1. Perinit�r¢�iesttxi by: . { ! 7. Dime ' � wncrlprospd�tive owne�lagen�: � wi��� _ ' . � ddccss: . : t�c� jc . _ 1 �p�:_ � [4 i .. TO 9194798336 P.01 I —� � _ i ; � � Da te vf fvr New n or , �� �`- 8. What ryPe (if any, a � � ! cepiacement is anticip� ; •.� : ` ` ; that this scwagc dispo� � w ° � �, '`il��Lk_� ; :` ; � ; HomG itonc;#. �4J7 (p � � � � � �usinirss Phc�nc #:9i�-y71,����% � a� . . � ; ; . . . ;:;_ ? 2: I��ime:and a�ddt�css of cantii►t owner. 9. Water supply t}pe: ' , private�. pu�lic Q � ' ' � S •. .r � - ; ;. . �; -s � I � ,^_ A,re any welis on adjq�i �;j `` PF' 17 SI If so, identify locacio �; ; ,j �� �� cT` � 3:. F�roperty 17cscr�ption: Lot size: � ; �'��� :� I0. Type of sttuc f : � : Teix Map�: - ' r Paroct#: : ' Type o f dwe l l�ng: - - f: t ' �ownship� �`b.,,.��- � House:�Mobil�,: ::i � '��` � .� .. � 'i�r�e of busintssi_,_1 ;.,. , 5, I7irec�ions fQ property: State Road 8� Road : .. �. : �. � � 1�Iumber of Employ �,:; �.. amcs,,�ta �' i Number oi t�rco ,; . ,: �-�_ , J �►--I.� � �7. GC � ° ; � � ; Garbaga Disposal? :��.� � �.�i. : F" : . I Bascmcut? Yes O ;�. � :: � ,' t . �' � 6: I+lrtinber 1�f xCtti�ants oi p�opic to ervcd: ..� -" �. � .�.::: '. � ��LEA;k�I:'Y STAKE �iLL CO RS. O� THE P�tOP��t'x'I' AND� : ; � ! F�R4P4SED STRUC"�'URL�S. I ;;� �� Y hcreby niai�e appiicac�o,� co ihe Pers n� Cou�nty Iiealth Department� : �. sew�g� d�sposal s}�stem for thc above d:s�rtbed prop�rty• I agrx that the co , ;� ` and; r�pr�ertY ih� mauimu� faciiities.t ble placed on the pcoperty. I undarst� � ._., .: a �<:: int�cr4�ai us�:chatigea, the pe�,mit shall e�ome invalid. I undersEand that be � : is�ue� I� must pr�scnt a sucve�'y plat of t i propercy to tbe Health 1?cpt. I un �� , deliven:d 'a swvey plat of tho groperty � he Health Dcp� within 64 DAY9� _�� the s�te by ttie Hcatth Dept:, �is applic �t on shall become vo�d and all fees p ; j , .'� (iW.. i � . � 1 � � i z � ii ncc� 4wna or Authorizcd Ag�nt ; � �3 1g Syste�u (Loaa Closing) u ,g Septic System � ` ide _. �d ;ed Struct�c%: i': . iitions, exgansions, or ;d co cha streictur� or faciiity � syscom is iiitcridod to ser�rc? ,, .. inity l�� sgring��7 r��nY?r�s❑ Naq. Q .: '�� ;omc: Q i�iness: 0 � �. �.....: � . k� sD No�, �'. '�,If so; # af basemenc feztuc�es: I� QF ALL a siu cvatuation �for the ptrsite ;s.of [his a�PP�icatiott ace true if tt►e siteii� alfcced vr the an Impa��et�ents.Pec,mit can bc an� that' in ttie �vent I have not r�thc date o�f the evatuatian of forfeited. �': TOTAL P.01 � 1 ,�l _ /.0� � .. , L,O�� / Z IZOLtslllGLC: IZ/D 6C r � f2 � I • 279 AC. 13 � �6+ o ��� � N 10° I 9 W �11 T-�� 1 2�°5g� 96.39 63. � � SPRING � j � 1 \ 1� �N 2. 4�� �� � N 3° 35' 25" W 145.00' � L' b , \�6,`O . R 52.G � , ���0\.50,�— -- �' 1.619 � (� � 1.309 A�. 22 232. 21' � N 3°35 29 1.609 A,C. __ N3�35'29'�W 377.25 -- tN N �o �-� ,? 2g8 C:► I. 7 � 2 At __ N3°35'2 416.�5 �� .763 AF�. N 3° 35' 2 9" 335.07 ,� l.76� AC. N 3°:,5' 29"tiy 350. I8T— O i.527 AC (V3°35'29'�W �15.0p — 'L �.� �D -!�"i9 pT6 io�� 1 S 1 5 Ta i4a PLEASE SEE ATTACHED PLAN FOR SO1L AREA AND SYSTEM LAYOUT Tax Map #: %¢'' 2� Parcet #_ I Z Z Zoning l���v�n/¢L Township �`�VE !�/L�- Applicant � //�°,� G� 1y�� Location: �C��U�L� �/ � � � �2 Subdivision: lC����LLF Sectlon: Lot: �2' Improvement Permit A buildinq permit cannot be issued with onlv an Improvement Permit New`�Repair^ Addition _ Type of Structure��Water Supply�l!!�1 � w�L� # of Occupants b�� # of Bedrooms J� Other Basement? �JO Basement Fixtures� Projected Daily Flow:� g.p.d. Permit Valid For: �e Years ❑ No Expiration Proposed Wastewater System Typ� l%��✓��ONF�L ��-�� _ Pump Required? Yes �No Permit Co Q� �.� � / s/ N (�vcwl �v�v . Owner or Legal Representafive Signature: \-1' Date: 1 I- 9-`� � Authorized State Agent: ..S Date: �� � c The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate goveming 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 Systems of the North Carolina Administrative Code. Authorization To Construct Wastewater Svstem (Required for Bui{ding Permit) Type of Wastewater System�l�+w��l�� A'' Wastewater Flow: c� g.p.d. � Facility Type: �7l�S� New CY Repair OExpansion ❑ �� Basement? 0 Yes i�1Qo Basement Fixtures? 0 Yes �I�o �o �� � � j'�Y Wastewater Svstem Reauirements ���, Septic Tank Size: �i� gallons Pump Tank Size: �,� 9a ` �$,, Total Trench Length: '7� feet Maximum Trench Depth: '� mche Aggregate Depth�►?' in. M�Iimum Soil Cover: � inches Trench Separation: �„ Feet on Center Other: p'�S�"�.�i Q� i,,Di� r UUi� . Permit Expiration Date: ( + � �L _ Authorized State Agent: � Date: � 6-1 The type of system pe itted �f does ❑ does not differ from the type specified on the application. I accept the specifications of this permit. Owner/Legal f2epresentative Signature: ��Date: � �_�"�� PCHD, rev/ 10/12/99 0 Application #: 207� Tax Map #: /� 2�I Parcel #: /�Z Person County Health Department Environmental Health Section SITE SKETCH �'M� L. �lt..l.. �OSF�r�� l.�7`�Z Applicant's Name Subdivision/Section/Lot# � /� lv f Autho ed Sta Agent ate System components repsesent approximate contours only. Tlie co�:tractor must flag tlie system rior to be innin t{:e installation fo insure that ro er rade is maintained � bo' MIN�MUM sEil��ck F�onn W�Lt, TD S�IG r�b�-. � S0� FROM WEI.L ib }{puSc FO U N� ft'`l O IV . /ro' � P R 30, yy' v LUT ,�r WELL PKoPUSEn �z3 E �,� �2� WUu3G f ILS,ob �� 5p' 35 x5o� _ F 35' � � � � � Miry'. � � �5, . f 45' Scale: / ��_ �6 � SR //(Z- /�67, 06' 30� PCHD, rev. 10/12/99 2� , s , � PERSON COUNTY ENVIRONMENTAL HEALTH .. � � PLEASE SEE ATTACHED PLAN FOR WELL SITE LAYOUT Taz Map #: j'�1 �� I Parcel # !�� Zon(ng AppUcant� ��/�'iOGJ "' ' V ` LocaUon: Township �/� � � �� ► �� - 6 �� �fyI P � Subdivision: � 6 ls� v Section• Lot: �.._ Well Permit ype of Water Suppiv: � ividual Community Public Requirements• Site Approved by �- Grouting Ap roved by Well Log Well Tag ,� Air Vent Hose Bib Concrete Slab Well Driller: �G(/U�,�1 Well Approved By: Date: D' 7�Q� - �� �� 5��� �� �,,- p�� � -to �� � **See Attached Site Sketch** Wells must be 10 feet from property lines. Wells must be 100 feet from septic systems. Wells must be at least 25 feet from any building foundation. Other conditions: PCHD, rev. 11/29/99 0 � c:�,i�r•rr�� i�:rvvi.�tc�tJr; � IJI•:i.l. i.(1(;' DaL�:_�` _!.-._._,J-a�� . Owner: " � Z..oc��ion --��-.J. (,� � / /�i�-cctions: _....--�os��,. �/t %� L � ---._ J �i•��i. ii�,ni,ri� � _ _ ....._.r �J.[t� • ' . . a-f� /� -�---_. ---_ ... ... . ��.���visior� .Na����c:--- .... - - . Dri1li,�g Con - -----_ _ , . . ...__ c��acco�-_ _----�'�.-�-ns..... l,J� �� � ._ , . . �. _._.`,Lot �� .. r..... 1'y l : l . ( � �'. --�_ � --.— Distance fxom Nc:u-cst ���- � ....--,,,�: _---�(:)N:ti_I,.It IJC._!1 [(�� . Po]lution v �����y I..� ,� iS�/_�_c.__. 1�i:,i:i,lcc �i-om Source o,f ' Total �Dept}i:. . Watcr $earin �'�- ��ic:lcl:_-.3 �-- ---_.. --- a' ' g:Goncs: U�p�l �' M ,5 ttilic Wa[e �y�a c � � . a�._.g. l�►. z ���: ������: • F7'011l ... .._ .____ .('�. r-�. �� 7 ._._ _—_._��. T�'P.C: Steel - . ---.t<>...._ . �--- --�'�- ll;•u . . ��cic:��: �� � Znches Xf S[c:c;l, docs own� a���rov,; C� ��` ;inizcd Stc 1��--� Wc�� -�_ `� hic . • 1i[�. __ 'o �x•v k,�c,:;: .��. ----� : . z � Slloc: �'cs--�- _✓ ��`•j 'bl��� bovc Ground: . Werc: Problcros ,��icoun�c • Nc>_._ _.._... ___ . ; ..,—�.�_:'Yrlche;s� � "„ �, IC:(� 1C1 ��.t:��111Zi �t1C �:�� J11I ��� r � ------�.., Grout: ;�� Y �,zve rc.�sai:`.__ - _.---�- _ ,� • � cs__��� No - . . YIx Ne a t � 5, _....- _._�_ � ------._.., ..11C1�(.'c:1]1Clll . . ' ';�;t �rZnular.�Spacc Wielc�� � --- .� _ —._rCoricxete • . . _;.:• a Watcr in �.ruii�l. ------�. - --..._:j�ichcs . ' �:f...� 'lr S��:icc:: � �::: . . Mctliod:� I'w��lix;c�;;� , - _..... __.�._._. No,_ - . . . � t1�: .... . _ I r��.�::�,r ._.. ---- , , , ., �P .��rom � �: . J '� i �rccl r�- �1'Ia�ccz-i�� Uscd:. N _..--- _._ ��� �v_..-�.._j'[. ---------____ � . , • •`1' : : o. Z3:i1;s 1'c�c�.l:utcl Cc� . Z,Fmz:�[wc (sz1�c1, j;r:i��c] cui.�ins�ti .. �icnt`_ _ Wcibli[ of1•ba�' .�� .�•,y.j�. Z� 1']:itc. - ' ,. ) IZrt[ic�: � ---�—'—.-1"`� s. �'cs � IVc� —.—_ __ co ( .,,., `� � �� ;.�a� �rC� `--•- ---.... _ .._ ' .. ' •,;;�`i `./ :' �. __ Nc� , •� ••� - __..__..._._. - . ._ .. � ��._ —_..__,__.�__.---�� ..... I�) l� I I.I .1 iU(-.' I.�) ... DC�t)�� "' , --{! _.. ., _ ....._. , _ . .. -__ __... _.... .._._.-.--____._ ----.----._ l�urr,aatiori llctici - ------���. �� ---_____.._. �L�._ —�_ ------�----�'�.n. c�.� _�_='��C�_..�.. - --�-- -___..._.�5.'�r�� �-���X' --�.-_ -�� � S_•--�s __ . _______._ � -; • — Y.. _ � .... _ f- _' - . ��- �� �c _ '-.�-----� .Y..�. ...� 1��2_t..�_...x _jLt z H����x cE�xzrY ����,�•�..�:�zL .. . �'�S W�L�, w�.s corrs ���� uc��L�� �� L.�rvr-UzzM���i�xo ��RT� �y.T�I�.P,�RSON CnU.N 1'1' t•IIn.CC.ORll�,T(CL . . n r .�r-1 z� � �n i;'rt ., .. iori L ,'''� � , .; . •�';�•i ' ,: •'r' j� � - �'�� ., ZS CO�ZRECT AN '��TI'i REGULAT'ZC �N'1'. � � �� = �,-G��� � � . . �_ _ �j,,�.ilutc. c�l (.or���,�.:lc r :;a ; ;�, - �.�- �,,a,�td , � Da cc :� :'�� ► �,� � , ,� :. 0 . Person County Health Department � � . Environmental Health Section Tax Map #: � � Parcel #: �a o�' Zoning: Township: Q�' � �" H � ' � Subdivision: �05 � u�� �(C �� d T� Section: Lot: � Applicant: ��►��S � ` � � Location: ��-S�r�S ,�-�or�- �d �' Q eration Perm it System Type (In Accordance With Table Va): � THIS SYSTEM HAS BEEN INSTALLED IN COMPLIANCE WITH APPLICABLE NORTH CAROLINA GENERAL STATUTES, RULES FOR SEWAGE TREATMENT AND DISPOSAL, AND ALL CONDITIONS OF THE IMPROVEMENT PERMIT AND CONSTRUCTION AUTHORIZATION. Authorized State Agent C�k.'c� Sc�ruo�. a8 � 3 0' � � t - �a-os -S� s � �. �`� % �n�ds � �;�.c � ,, �h�v�; a9 0. . �t���oa �� �, �� � �.�a�Ha ' � � '� � � - � r : � �'� � �n �� � > �, �� y� +N�� r`O . •� �` ��t�� Tax Map #: l�l�� Parcel #: �a� Date PCHD, rev. 10/12/99