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A29 239��}�pll�it'soi� fl�ie: q— 6-05 i ax 1Aao �: ��mount c?�ii�� .UO �. 2U�)�t# �v2D f�ea$i t r�_ 7� Parcai �• : ,..�,`�-,� j. �" ��I�.� �1� . ' .�--�-- �, � � �CT1�"'Ic' � 7i�u_-va.�a��ra••,-*�++ ��a.�.c�Il. �3Ca�.9.�1.+�I�� (mpravements provemeclt5 Petmit- 3i50.W obifa Nnme Rep4acemer�Additlon) �pairlRepiace Existing System Perm dPPI.iCAT10M FOR SEi2VIC�S Fem,it $�so.oa�oa.00 Permit Revisian Fee - ior - �za.�.00 ��} Pe��r�il, rec�u�sted by; (Ownmrlagen�l�pr�spsciive awnerj: ��� J,:Z�. Horr�4; ?hane: �` Address: 3�0 li _ Bu_�iness Phane: o S ;�j Na�ria� and a��fr�ss of current owner: ,��-m� 3) Pr�a,��ir�yy Descriptian: Lai size: cre� Township: ' e �1 � DiFacfians to the prbperty (Inciuding road namesand numbers)T �'igrm 5�v � / e.- Lot # g 4) Pru pr�sed Us� ar��i Structure Descripti�n: answer �aci� of the foilowing questions: a} F'r�posed ✓; Existing ____; Type of Structure: �s id��i�j47 Width: Depth: b} �l�.imber of Hedrooms: _� Number of accupants or people to be served: c} B.asement: Y�s�; Nn _ Will there he plumbing in the basemerrt? dl �ari�age. Dispasal: Yes , No � � Ff��u4�r Stapp{y Type: Privaie �(new „ or existing�, Public� Community� , Spring � Are an y wetls on ad joining property? Yes� No T If yes, please indicate approximate locatian on the 'sit� pian. 6) D�ac� your �reperty contain previously lslentdfec9 �ur3sdictional weNands? Yes� fNo r/� P��E AIQiIE THi� FQLLOWtNG: ��, Pl.r'�T t�F `C�E 3�R�PERTf OFi 5i?'E PLAPI OflUST SE SUB�AlTfE�D W1T�i THIS :a►PPL9CA�'i�DPl. 5� ���ROPER'i"�f'LINES �1ND CORNERS I�UST BfE CLEAR�.Y MARKED. �, 9 i'�iE PRt��.t3S�D LOCATtOM OF ALL STRUCTURES MUST 8E STAIbED OR FLAGG��. ��'HE SiTlE� �iUS`i' BE READtL`l ACCE591BLE FOR Aid EVAL.UATlOP18Y THE �IEALTH �E�ARTIHE�IT :�TAFF. f her�:.:r� ma[ce appiicatiorr ta the Perso� County Health Department for a site evaluatio� for the on-site sewage disposai sys#ei~�.fcsr the abave�iiescribed property. 1 agree that the contents of this eppiication are true and represent the ma�cimum facilitiE.:a to be piaced �an the property. l understand if the site is aitered or the intended use ci�anges, the permit shall �ecorr�a: �nvalid. % �' or i.�gal q, j�l O.� Date �cs��. re�. o�r27toz � ��� ��i �1.�.Ld�C�.J �� �. e > � ,, �ti.� �� � � �J � Jl � ��.���,� � ���.�.]t IL 33C ��.71�1�. Applicant: Location: T�x I�1ra� � • ��rc-el = • � S��i;bd!ivi�si�on '� �' ' i ��h�:s�e�Sect+i�am�'Lo�t � � Improvement Permit � P�rmit Valid for � Five 3leaa� No �apiration Type of Facility: New i� Addition Water Suppiy ��� # of OccupantsM� 1C # of rirooms � Projected Daily Flow � g.p.d. Proposed Wastewater System: C! CZ � � Type: Proposed Repair: Type: Pemut Conditions: �e S( d� 5��� � Owner or Legal Represe Authorized State Agent: Ya.��.r. Date: ZL D The issuance of this peimit by the Health Department in does not guarantes the issuance of other permits. It is the responsibility of the applicant/property owner to in sure that all Person County Planning and Zoning and Building Inspections requirements are met This Improvemeat Permit is subjecf to revocation if ttie site plan, plat or the intended use changes. The Improvement R�rmit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina `Laws and Itules far Sewage TreQtment and l)isposal Svstems' (15A NCAC 18A .1900). Neither Person County nor the Enviranmeutal Health Specialist warrants that the septic tank system wi11 continue to function satisfacton7y in the future or'that the water supQly will remain'potable. � Authorization to Constract Wastewater System (Reqnired for Building Permit) * See site plan and additional attachments (�. �Z ��� �r . Propos Wastewater System: C( � �Q �i� Tjip� Wastewater Flow �g.p.d. M New Repair Expansio \ Soil LTAR: � O g.p.d./ ft 2 Type of Facility: � `'���'�,�,�PS - _ Basement _ Yes �, No Wastewater System Reayuire�aents 'I'�nk Size: Septic 'Tank: � gai Pnmp Tank: iu � gal Grease Trap: gal �rainfield: 'Total Area: �� sq ft Total Length 4c� ft 1V�affimnm Trench Depth 'Z 2 in Trench Width � ft Minimnm Soil Cover. Y� in Minimum Trench Separation: �, ft �•%� �istribntion: Specifications: Iiistribntion Boa Serial D' tribntion � Pressnre Manifold �P_t� � i�i //1� D -�— ✓�'ICI�`'1 i � U.'� (�oSr�'tn ��S Authorized State Agent: � Permit Expiratio Date: The type of system pernutted is permit. �wne`�//I,Egal �iepresentaiive: Date: � -.1� —� !-�' Conventional � Accepted Alternative. I accspt the specifications of the Date: PCI� rev. 11/10/OS , .��,j� )�� ����'lJ� �1.. �l � "' . `L �� �l.J 1V �� ]Esava.a-o�* � �a�.�.Il � 33Cm.�l�a. • . �i�. ��.��.�. . Name �� �S Taz lYlap #�02� Parcel # o� 3�� Su 'o vi r� • 3ection./Lot# ,y�J-2T • . Zz D Authorized State Agent ' ate . .� Systes�t com,�iosrex�is r�r�ese�t ajyp�oacimate�co�ours only. The conir�tc�or must, j`lag tha systern prior iv � lsegi:sning the installation to ituu�se �hat propergrade i�r maYntaine� : 0 � S S�r`` � r� �,��'� ���'"� � � / + t ( ^ � r �� � � �, �j��t�� � ^� ;,� �C2�z�. ` o�-' sl � t�� ;� � ��s.e ✓� s� s� `� �`�' � M�ts.�. I,,,e � ns�Gleo� � �r;,r�,�,� . a s S�tacN�t• � . �� l j ��r; � 2'�?�, � L� ' . � D� �� � � f ' �-� ����'�s� - � - t�U � . � 4• r i - -_ ,— � _ , i!� � �,e<< /i`� � _ �/ 1' ► ti� � �� �� � ' � M , f ,/ 60 � . ,r.. � � � � • � � � � to �gR 50 �" � a�'� •�• � � � _ ���� r � I�+�eS � . � � � � � '� ' �' . � � 1 �n .�..�, �� � �rPssur-e � M�;-��d . zs' M��• ,_:..�r.. . � � , Zo � N � �.� �� S : I��I�:� ��T �-. ... � ____.,,_ ������ � �rn;vai.�r�acn.�aa��n.��cll �Zr��.11�3�n,: : WELL PERMIT PLEASE SEE ATTACHED PLAN FOR WELL SITE LAYOUT Tax Map /� a� Applicant: � Subdivision: Location: # , a 3 � Township: Lot # Type of Water Supply: � Individual _ Community Public Requirements: Site Approved By: Grouting Approved By: We1T Log: Pump Tag: Well Tag: Air Vent: Hose Bib: Casing Height: Concrete Slab: Well Driller: Well Approved by: ****See Attached Site Sketch**** Liner: Installed by: Depth set: _ Grouted: _ Date: Water Sample: Wells must be 10 feet from property lines. Wells must be 100 feet from sepric systems. Wells must be at least 25 feet from any building foundation. Other conditions: Date: PCHD rev O1/27/04 ��`�. � 1I�I��.� �� � � � �T��°`� �SP���� �� `� 1E�-���. -�.,. ��.¢�lt. 1HI�„�..n�� Own r. Tax Map: /4� `1 Parcel #: a 3 Date: 2 I,Ane Tap �ap (Sc�). Tap �'!o� Y.,ine I,��gth k+"iow 1 foot # �iameier(in) { m) � �. ft) 1 Z SC� S�o '7S �D 7 2 �. 3 �� 4 5 6 7 8 9 � 14 � dv ft of line x 65 gal. per 100 ft=��� �� ? 100 =� gal 75 °lo x�ga1= �`� gal per dose �per minute (gpm) = Flow I�ate Frictio He�d I.oss: •*7�f ft per 100 ft of supply line xN�Ov ft of snpply.line =100 = � ft � ft x 1.2 = 2-- � ft of friction head �. Manifold Size: ���" I�'orce Main Size: �' " PVC Total Dynamic �[ead =.��ft of Elevation head + 2 ft of Pressure head +�' �ft of Fricdon Head = •2� TDH � ����,,,� Pnmp Requirement: � GPM @ Z�• ft of Head Drawdown: ,�_`'f'�'`" per dose : 21 gal per inch =� inch drawdown per dose a., i :.,.�� ,� � ,�. ��.� � � — =i+�����t0 — . � : .,.� I I I I �� �[i�)��0�00 1�1 (i) ��� ��� iiiaiiiiiiiiiiiiiiiiiiii�iiiiii � � .� � � . : , _ . :� � : : : .,: 9ma� rr.��. 1w1/ao�c ifoid 3ize 1 � Tape M�c Na Tapa off one sic ¢ce by'h for tappinR botl r�ra 3/.» tam I 1' —.�/ / �� � . . . . _ , _ �'low Tap Size �Ylcuerial Flaw G��I ,!, ,• Sclted 80 .i.5 . 1�� ,• Sched �0 i.l si, �• �ched 80 10,1 �., .. Sciied 40 I=•' �.,��,�.� ���.e�.� �� �. � '-,-1 � � � � � 1L I���-au-��.,� ��.�.�.Il I�-3C ��.Il�l�n. NEMA 4X Simplex Control Panel +4" X +F" Pre�snre Treated SJ,oped To Shed Water 12M $ap�ration `� Electrical Conduit = i , � � ., .: . • �� , . 6" Cov�r � ' � Accera Cover. •� • , • : ; ' •1 � � • � - r . i i . i ' y Inlat Fmm Septic Taxik d" SCH 40 PVC Pipe ' � � � � � • `' • � . 1 �;, Openin= Filled With . Anti Siplwn Hole �� Portland Cexnent Givut �� g�� Check , Valve High Water Alarm Level (6" Separation� ' Hi;k Lerel - Pump On ,��� � �Vapor Lock . i� xo18 . � �Drzwdawn �Up Hill) ,' � . Law Lavel-Pump Ofi --�^'� ' � �' . ;I � T��x M���� � ' ,� P�rce�l # ' Su�haflivisioi� �� � ' � � Flr���s�e'Sc�ct,ion Lot # Ihut Seal Hoth Endi Of The Conduit -� 24" Mininnim —1 � . ., Tiueaded Gate Yalve __.. .� Zip Cv Tiss ' Precut Concrete Tank 4" Conctete •�;.; Material Strength r3500 PS Block ,� . . , . . . . ':�;.: . : , • '-_ ', . :' : , , •� Cosurete Rver b" Saparation • • • � %�:.rfifl' - ;�,�..�Portland Concrete Gxqut • ' . t: 1Yfi7t]C • ' : . . ' op4�F�awth Supply � ' ' poztland Cament Crtout Line • • ' Outlat To Distr�bution 2" SCH40PVC Pip. e Float Wust �� � •r i Floatf :: �,R.emovabk '.:' .' F7oat Trea , , r � �.,. • ' �. � :` 1�. ..' . f� G� GALLi]N FUtV� T�K a �:. .