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A29 256� °��1 AaQilc�,i�c�n Dato�: -16- �• I Tax i1�a� �• Amouiit.?a�'d� Sli-�CUd,QS�G�,t�S(v2�J � �°�' ��� Recai��t:��; g � Parc�1 �: ��--,� ��- �I�I�.� �� -- � � �Tr��T� . �71:2L"'V"R9�e¢:a.'b.9CSCA�l�3a.'�.e3f-3L �i'.;S.i�.1L�� �►PPUCATI41� FOR SEi2VICES '!) Perr�rat re+qtae�tes9 �y: {Own�riagentlprnspec�ive ownar): ��� � Hon;er l�hone: :> ' � Address: 3��` /i 8usi�ie:�s Phone: f"" � - o �s 2) N�»� an� address �a� curPen$ owne�: �j�G� , ihe �'�rm , :{j �raFHerfy [3escri�tfic��t: Lot size: 1 R�re- Township: ' E �) ubdivision�f R�S�u1 /)e� Lof � d� Dir�:.e,tions to the prop+erty (Including road names and numbers): �L�/ �'D ..i/.t3.1.�.�;,��f��ji'�l;sit�n. j�� ; �I} Pr���as�d U�e an,�d Siruc�ure nescription: answer�ach af the following questions: � a� i�rc,posed ti! Existing ,.Type af Structure: ��r�i�r�i �4- ) Width: Depth: b) h�':umber nf 8edrooms: : 3. Number of occupants or peopie to be senred: c) Ei�sement: Yes�; Na Will there be plumbing in the basement? d) t�::irbage Dispr�sat: Yes � No � . ;i) W��i;a�r Sup�ply.1 ypd: Frivate ,� (new �; or existing�, Public� Community�, Spring _ Ar� any weils on adjdining prop�rty? Yes� No _, ff yes, please indicate appmximate location on the 'siie ptan. E�j Oc+a.� ;/aur pra�Ze�ty c�antaln previously icten#ifiec& jurusdictional wetlands? Yes` Plo r/� f'L�A�1: !'J4i'� 7HE �OLLdW1NG: 9;�, PLe4T CaF Tf-}� �'Rl7PE�RTI OR SITE F'LAPI i1flUS3 �E SUBMfTTED WITi�f THiS �►PPLYC.4T'�OfV. ➢ t��ft�P��tTI L1WES i4�PlD CORNE�S IVIUST 8E CtE�1RLY MARKED. �, �"'�IE PROPOSEi� L+DCATiaM OF �IL�. STRUCTURES MUST BE STA6CED OR FLAGG�D. ➢"'9�i� SI"f'E AAUST gE 32EADILIt' �1CCESSIBL� �OR Afrl EVAILUATIOId B`l'i9•iE iiEA�.7H DEPARTM�NT :al'AFF. � 1 hereb�. make applicatian to the Person C�unty Health Department for a site evaluation for the on-sSte sewage disposal s.ystem �`c�r the above-cfescrit�ed properiy. I agree that the co�tents of this application are true and r2present the ma,cimum �Facilitie�� .tc� 6e placed an..ihe property: I understand if the site is altered or the intended use ct�anges, the permit shall t�ecam�:: :� J�tid. j � r ar 9, j�l Os" Date PCNa, ��. �srx7�o2 �..��� )� ���� �� �� . , ,� � � ���� I—�',�wli��n�n�«��.�n,11 �L�a:n.]1�Ila Applicant: Location: T�x M�p ' ' Parcel � � : ' Su,bd!ivis�ion � , „ � %, Ph:�se Sect�ion Lot # Improvement Peranit � Permit Valid for �iv Years No Expiration Type of Facility: New �/ Addition _ Water Supply �/� # of Occupants # of Bedrooms � Projected Daily Flow �,� g.p.d. Proposed Wastewater System: Type: / � Proposed Repair: G Type: Permit Conditions: G Owner or Legal Representative Si hue� ✓� Gfi� Date: � 1 DI l0 7 Authorized State Agen , Date: The issuance of this permit by the Health Department in does not guarantee the issuance of other permits. It is the responsibility of the applicandproperty owner to in sure that all Person County Planning and Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes. The Improvement Permit 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 Rules for Sewa�e Treatment and Disnosal Svstems' _(15A NCAC 18A .1900). Neither Person County nor the Environmental Health Specialist warrants that the seQtic tank system will continue to function satisfactorily in the future or that the water supply will remain potable. Authorization to Construct Wastewater 5ystem (Required for Building Per�it) * See site plan and additional attachments ( Co ). ?bTiyG Proposed�Vastewater System: i',i',�'� � w���. Type�z�� Wastewater Flow�g.p.d. New ,/ Repair E sion Soil LT . 3 g.p.d./ ft 2 Type of Facility: �� Basement _ Yes �/No Wastewater System Requirements Tank Size: Septic Tank: �� gal Pump Tank: /opd� gal Grease Trap: gal Drainfield: Total Area: �_ sq ft Total Length ,3Qo ft Ma�mum Trench Depth ao in Trench Width 3 ft Minimum Soil Cover: !P in Minimum Trench Separation: 9 ft Distribution: Distribution Box Serial Distribution _� Pressnre Manifold Specifications: J 3 G�.c%f�S � �do � Anthorized State Agent: Date: o Permit Expiration Date: 9 7 / The ty�e of system permitted is permit. Owner/Legal Representativey Conventional Accepted Alternative. I accept the specifications of the Date: � / �� /a'I PCHD rev. 11/10/OS � ��;�� � � ���.� ���T �� � � ��� ����,,.,,,,.,���.�,.�. ���.�.�. �� ���r- ��.�s� s�� ���� �� �€�� �a.� srr� ��ou�r T� �� #: .��9 �� # � �ro�� . . � ....�� i. �- Subdivisiori: Seaaon: I.o� 7 , . - � � rLfi .QO . �'�e o� Wate� S�ole: �uia��easts: .. � •� •...• .�� ' . Site App=ov�ed by � Groutyng Approved bY o 0 7 We11 Log M T �ell Tag 5 � Air Vent � ' Hose B�h ' �oncrete Slab � a _: r We11 Dr�%r vA, ,, ,, �� , �• �, , � � ��'� - I ... � . �• ���. . . 1, ! : - � '�SeeAxt�c�esi Site Sketch� �ells must be 10 feet from propertp- liues. Wells xnust be 100� f�t from septic systeins. Wells must be at least 25 f�ext from anp bw`ldtng fouadaxion. Otiier conditions- - PCI�, =ev. 09 j07/Ol 6� T���� ��!`� ���,Sf I�I�I�.��� �r �� �-- �_ � � ���°� IE.a3�a ��.,.���¢�.11 ]HI��.Il,� Owner: ��j Tax Map: Parcel #: �`� ate: q Line Tap Tap (Sch) Tap Flow Line Length Flow / foot # Diameter(in) ( m) ; (ft) 1 / o p. / !OD ' , b 2 3 4 5 6 7 g �a 9 � 10 OD ft of line x,65 gal. per 100 ft = = 100 = l9�ga1 75% x J��gal =1� gal per dose �.3 gal per minute (gpm) = Flow Rate FricNon Head Loss: l•78 ft per 100 ft o supply line x o0o ft of supply line �` 100 = 3S: � ft �S� ft x 1.2 =� ft of friction head � ' �' - Manifold Size: -s�' " Force Main Size: Z " PVC Total Dynamic Head =��ft of Eleyafion head + Z ft of Pressure head +�,�ft of Friction Head = �TDH=—= ,��,�,�.��� Pump Requirem nt• 30 -3 GPM @�� ft of Head Drawdown: �al per dose = 21 gal per inch =� inch drawdown per dose ��� r:. �� � � ������ � � �� - - � ��i�����t� ' . � : . . . . 't ' � � - � I I I I �[(�)1�0�00 1�I 1�� (�I 1�1 ���'i�iiiiiiiiiiiiiiiiiiiiiiiii � ,. I ,.. ..,. .. _. ���i���i��iai�������a�*�ii�iii� ! = � � ' :� ._ .t� : •: �: r�n�. �aim� ifold Size / # Taps Maa No. Taps off one 'ZM mjII � 7a» t9 $ 3�t� td' 3 1» tf Schednle 40 .,-,,.,.,.,•,w-,.,.,-,•,., ; z„ q 2 PVC •. ... . • 3�+ 9 $ 3 �iti,hr�+-+'-�++��^"+�+"rti'µ''�`tii�,:.ti � 4" 16 9 5 � 9m� ♦s � �� 40+ 21 1: � � � " F`low er T3 Size �titaterial FIOW GPt�t t/2 " Sched 80 S.5 ;. " Sched sp 7.1 3/,'• Sched 80 10.1 ,�,'• Sched 40 1 �.� � Sloped To Shed Wataz NEMA 4X Simplex Contml Pazul Y I'� 4" X 4" Pressure Treated Post ' I 12" Snparation Electrical Conduit � I Duct Seal Both Ends Of Tha Con�ait --- 24" Mininaun ;. ., Threa�ded Gate Yalve ; ''s Union . • ' •� . � 6" Cover • ' � Acces� Cover• • , ' . ; 1 � , • � _ . % • ��'._ � .. � ; ' . • :. • ;•; ' Opening Filled With t �� z�p co�a Anti Siphon Hole \ i Tu� } laxid C Gmut Inlet Fmm Septiu Tan]c Post sment (Dovm Hill) 4" SCH 40 PVC Pipe � Check , Valve Higkt Water Alami Level ' (6" Separation� High Level - Pump 4n �� ' �Vapox Lock , !, `��DrawdaNm Hole _. ' • � � (Up H�11) . � . Low Level-Puxnp Ofi �� �•. �. ' P:ecast Concrete Tank � ;.; (MatesialStrength>3500 . , ., . � , •`� � • ' • • � - Rnpe 4" Conexate B1ock - . �,' • : , , •� . 0 o GALLC�N PU.L1�' TANK T� ��� � ���� �r �' Co:urete Riser Zi° Sepantion • • ' %r..tltJ� : `--- '�;,,1.•Portlazud Concrete Cnout , z, Mutu • - : . � Opening Filled With Supply � portland Cemcnt Grout Line �• Outlet To Distnbution 2" SCH40PVC Pipe Float Wires .' • .� i Floats . �...Removabk "•�. F1oat Tzee , , �'� r 1 .�: �;ti t.�',• , �,....., �_� � . . 3 � �� a 5�� - _ ' � " q.67 9.��' � 1.46 . • S26A 9 � \ 18 �_�� _� 8,��,0���� w��.� 3 ac• _ 3 69� 5 ^� � ,6,z�E � ti �ameS K' S26B _ �2,62` � 1.0� � � N� 3�� y� Math�S 50 S27 _ 13 p1 '� b �n � � a 5�ry� � ;v� {, �'� 105 � N c-3 1� ~ S 5�r4s'o�'E p.C. '� 3�2 S2a 14 1 C ��6 N a'� 1 N � 1 a�. 2 �, go.00 S 0_ 19',4% � � � �- c-Z 1.20 a� ,�a,��, � - . 17 � � .Q01 z ,ea� a�. .Z�,� � � ` . . •m ` .1.15 • N 99�4s'24'W o .�?o�� � ` . o ac. 2ps.76 a► N 2a$• L5 i C-23 .,� �o °' �-- -\A �v^� y? 20 i°,� 1 ,� � O.gc Nellie 5• c- n- r'�► R� �.00 � �.57 0� Tony .c. 13 y446 c ��p •o� C7C� cJ �'' . C s s6•o2�so� 2 1 s, c- 2'� � a�� °�' � �p a r i a n 3 8 5. D 5 � �i C—� 2 c� c i p �` t . p,round i �,00 � Z••N Y.� c f {O . W �// . aC�2 3► S C?4o �o, C�� 6p� be reta'tng e �O � i :, � Pond 4° 32 �o � by Tony g�o�m�ined 0 ;° � � <�a ;�� c-39 � .28 S and R . � ` � � c� , � C327 y Q g5�.2�, C. �� �_'� 9�3g.� O z Cor�r�on \ 6•77 °�' 22 w �;� � �a W , L5°°9 � '`•g8 �£ /V �ti� eownei� / prea � in H°With P°nd' ' �.00 '' � s s6•22's2� , � obibr �_� �'%id N s,� ,�. � �' � L 87.59 S � • Con�� �..�p eow�ers\ e� � QC• NN o : o. �� �SO��s' 8�`3�`Y ���X Tfi• / �rner � / N sS'9,�• �i � o � a N 2 3'05 . o� , A46j �9� / i � N` 294 �s \ / � 1Z L1 2�6 0 28��,�, c� � h �'oor' °°�` ac• � N S� !� �?��YP• � SuppN . � • 6 �y 40 , Ease. � � r ��3 3 23 26.47 cy ,� N 75•42'28'�r g' > �' J S�• r� �� D_pl_2 9- "v� �• Z g 39• c p�� �O' '' 2'rJ' H' ��i � m 1.00 =. 3.67 138.76 �' 9`�843�k' � O ��R.5729 58 , �,24 •} 1p'P�.Easa. M w aC-.. -3 S30 . �e 528 � 5ti2��4�W `Y / pRCs�3 428�05 W ac. �� � 24 ��' c'28 •>> g S29' w� y. R, N 2oo.s2 •8 cH= 1ag,k4 N 3� `� � �.00 0 >,A _ Baynard i s�. �3 << ac. Z 5�,5� s 2'�9 .527 m ton � D�oo-42-00 i Se3 y c-30 0.�. c-37 sp. •>>�� •. � Cru P 7�5 �, � R"s�2o'o0 W �Y C-3 . C-28 15 ���.W 31 s. 88 �' s s p.B. 342- // ARG S 36'22'15'W . cu I o ?.21 . S�� �00 �o c_3s s �.04 ��°' • � 1�10�p�• 10, Ad�onal o� CH- �o.00 M �� C�32 . aZ s�, aC. gp.00 � 8.00 �,yo • E' g.69 Rood ROW dediaoii o i � d�' � , � _� 33 ��o �..5 � ' 26B Z ��g ��W C�� C-34 `�os g'F a� 3 �i �Lze� 67.50� � �' 3a �• ;� � S s� �, s " S25 � �� CES 'tr, `�'� �3 5 • ci� _ C� ,� p� SupPN REhI 3 r- � R� G��t • y,,�` V�e FAse. REFE 2% ,��v,,� 28 r' �' 29 s s 15' SuPP►Y � � . ho �rton i� �. 9 4 N,�� �'� m�, �'� �. 5 7 �'� F l 3ne E� �� y�` s �,�o`-'" g t a r l e t t �• p. B• 342 g 3 5 . i � a�• '' N � ac, N d�• � ' a' ' w' H a lbrook P.C• � 2 6 cu vj n' , � �'�� p.B. 332-3�3 p.0 .1 3 2 p 240.00 30U.00 _ _ 273.19 _ _ � R �� 45.00 — — _ -fM �9�5� Contra� - - — � Corne� I 15' SupP�Y N 83•02'09'W N 838�42�W `�� � . I Line Ease 9 � pennY � F.Arno3�2_508 jNOF � . . D.B .�--� i ,. ����and Denny ► �� � ������ ��yl�. � ' � ��/ � ���� • IU-�" �,-��.�-���.��.,�.�Il 1�1L��.Il,�I�. � SITE SKETCH - �I� @ N�.me :_/� l,�1���-r-� � Tax,Map # Zg Parcel #��� y!o Q Su�div�sivn.:,.. ,/l� Section/Lot ZS + SZ.s� � � �/��/a � Ati � tii�ized Sta.te nt - �D t S��stevt: conapdH�rtts lep�resent approxinzate cont�surs only. The co�trac�tor nzust, flag the system prior to beginning the installation to insu're t�idt �it.b,�iel�gm�e is Ntatntai�zed • 3 '� �v�tit - �o �t� . 3 �-r� = qoo �z' Z. , � � e—N . � > ���G 1. _ _ ' • �✓' G/J�ifi Gr `DD � tf ZO 'T��G4� �Oi'�ati(,S i � SUPP�V ";de E.4SEMENTq�p� ; '---16�g� I N. ; Sc��e: v� EASEMEry7� Cvtttrol �mer � :7' ,/ �--- . ,�; ;'1 � . � ; .��;;,� �. ,: ,. ;1 :': 1 �' ir y EAS+E1 � i . � M � ♦ � � �,� p4 �"Erco z 2•�,�,.��'� ��s� F� 2)q4 �rso' 9, �T�5) ,:. ._._: --:�M H . F T� 3� r 4 r�, y,,;. � [i,yE 4�es�8 r�' � . . �ew � "'------=--. � � ' / T� �.�s�, �.. ���-� � " G .ao � (Cpr27�OT2�OT ��OT� 2g� J LOT 25 EASEMENT AREA � Notes All supply lines must be installed at the same time within the supply line easement. All supply lines must be pressure tested before lines are covered. Prior to installation, supply line and drain field easements must clearly marked. Contact Surveyor if in doubt. Drain field layout is approximate: � Pump requirement (TDH) is estimated. � Any questions contact Person County Health Dept. (597-1790). PCHD, t�i+. 09%i2/01 e , � ���� �� ���� �� �.. � �. .�� � � ��� � �.�a�-za-��a�-na����.� �'���.���n Appiicant: `�-�� Location: � - r) 4 S. ! �x M�p ` � �,rc : � ' Subdlivisiom a= ��'J � -�' � Ph�.s�e 5ection; ot # — # of Bedlrooms . . ������� �� �� . System Type (In Accordance Wifih Tabie Va): �-b THIS SYSTE31� H.4S BEEAd IiVSTA,LL�D IP! COMPLIANC� W(TH APPLlCABLE . NORTH G'�ROLINA GENE�L4L STATUTES, RU�ES FOR SEWAGE TREATMENT AND DISPOSAL, AfVD • ALL COMDITIONS O THE lMPROVEME�T PERMIT AND COiVSTRUCTIO�i .�llTHORI��tIIAl. � � /J . . _ _ � � A rized State Agent I nstalled B �` l t,W' � d � 3 -- ZQ ---d � . Date Date: � o?' � � � �� � � . . . � v, �` g� 2-2 t-� `� � �� p,� � ��fc�� ►�oti�� �� �- � .,F. 1 � — ._. �,�1Y . 1;+�� av? lY• � N �D � . . . � ��S �C ��e ✓Lt4�t� �j /„/ <<,� � 3J �ov f j► �r�e S 't � ����y�����s N� f: � Z �'�D�✓ �� �(,t�P �✓�;� v�l ��l g?��t2��- FCHD, rev. 07/29/01 ����� �e�������3:���� �uR"0��"�..��� ��� �� - 0� Tax Niap # o?q Parc�! #�_ Sysiterr� Type (Table Va} OvimerlApplicant . . Subdivision . AddresslLocation Ser./Phase Lot # � Se��c. '�'an� nit"sa @3a� 6tra 0a��on n� I i�� a� � � State�ID/date ,�`ri� 32 b/S 1 l�'�`T� o Trencfi Widih� '� ft. � Ca aci o0o ai. � � Trench De th d?a in: Tee and Filier � � Trencii Len �3 � ft. � Baffie � Trenc� Gtade � � Sealant � Trench S acin �..� � Riser i� a licable � � Rocic De th and C2uai' • � T'ank Outlet Seaf Dams/Ste downs etc. --;_ ' Permanerrt Marker Pressure Laterals � .:--; . Pump Tank � � Hole Spacing � ----� State a e - p � o e ize .� �- - Ca aci o o d ai. Pi e. Sleeve � ' Watemroof ISealant � Turn-upslP.roteciors -r" Riser Checic ValvelGate Va[ve t4larm visable and audible Eiectrical Com onents � Rate m , . A roved Pum Mlodet7 z Blocic Under Pum � Pum Removai Ro elCt�ai . �Dis�ibu�ion:Sys�n � Serial Distribution Pressure an o Low Pressure Pi e A r. Pi e l�iateriai and Gi ,.-� -- � T �� . Required' Set6a�� From� Wells From Property lines StructureslBasements � c es / rainage ay: Surface Waters Public Water Suppiies Verticai Cuts (�2 it) Water Lines Ve�icle�Tr�fic � � �e� Easemenis Recotded -�- Comm�nts � a pc;�d rev. 3I'13/01 i._._..._._._ ---�- _.,.. _. ._.. `--�,� v(�4�'(�� � uw � .,.........��� �-�-----�--�-�5 ' .._.., �„� 11 •/1L�'r�l `.y.1J `4� � �� -�t � r ' I �'+" � ..`�. . . � V Y � � � -� M..r�----- ��� ' O _ / /' i�ars.•:s-ssyrs�s�rs�assE.r►_1 �3lsr.ar.x4�t► �� � 4vvncr: . . _. � _ __� t'�!"Nt L� 1�aP :�-E �rcd! iV . .��� Lc�cu�an. ,_ �. ._�..�..�...�.�..------•-- - 4ubd'evt�ion. . _. __� .____ ------ Lot N .�,.,. 1�Vdl Cs�ts�cli�s Di�unca From rwearat Prop�tsy Lin�c (Minirru+m IO Cart�,,,�,�.,,,,_._. D��tt�nce t�om S cic Syscsna (Miaimufes 60 1 D � �'asl Depti+: ..�� R Yie4d� �_ PM St�ao Wst�r i.svai: _,y�_,.__... Wst�tr i�asrin� Zones' D�ptt� �..._. !t ..�.�. fl -- � .,._._,........ � C�u1e�: Deqtis: From _ (�.,,,,_ to �l� �t. D►s�eeer: � i� Type: C3�Ivsrtiiz+ed Stesl we;�l+t: Tlu�knsa: ��,_ �isi�c abovm Ora�d: .,�,.�,..,�,,,..,, in Dnve 3hoc: _ Yaa _,_ yu Arsy problear vnsou�e�d �ahil� w�iti� am�iag? �Y�ee ,_� It' "ya" �'sve rca� • _ _ ...,.r.�. ... ..,..._._..__. _..._..._..._......_�..�.....__..__. Grs�rt: ✓ C.a�ata e3rtvoVC�a�c __._..�,... Neat� 3and/Cect�ent ,._. ....�••-- � Y�a `' lo Aruiula 9pwc Wtdth _�,�,.�.,,.,_ �Iw W�ur ia JU�uta •.�.�.. _. Mathad �t (3raut: F�� _ _ _.. P�'� .. �a� .._._. �P�h �. � to �a � _ �t. M�trrtaM Ue�id: No. 8a�i PoctlsnQ c�merit ._ Wri�t of t�� ,��., Pousid� �f mixitua tosnd. arsvol, cutttngt? � R�►ttia _�tu ..�.._._ iD pl�tas: �,. Ya ,.,r No t z 4 �l�b ___, Yss _,,,_. No Ussr: ��� _.r. ._ Datc imullsd: �„�, C}rout: _,_,,.._._......_ ln�s�il�d ��r. ..._._.�..._._.__.__.. 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