Loading...
A32 201N O a ����g� �, �� ��� � .� $ �'� ' �' � � � ���b �� � �� d� $� � =�_ap � s������ � ��� _ s �_ � � � � g���� � �. ti a �,-$ aa�c� � � � ����� �����Z ����.�� �� ��� ��;� �Rm"�p� � g �� � g� ��� 0 3°�� D� � �� ����' � �� �� � a�� ���a�a� �� �� �. _���:-� . �m�-o� ���3 � •� � -� � � , �. � � � � � ��_ � � B� �m�Qo � , .y � oa � l� n p � 4'9 r's / �te Charles E.Hall D.B. 265-270 D,B, 133-177 : sa:��, � � � r� f 1, ,. - i �„� ,�: ;.,; � �� ,,, ,'� .'+ f.j �a * � "• ��r.Y'`�.S/�..,, Y i ' .� . �,:��� �.9A-, � '.. , i �,.._.�� � .^�., , � �. - _: � �t.�; .� � � �a :� -�- :� ; ,� . �.�s���. 'v � +' i.v�"� � e,' `�4r��'�-� ..�.�` > > � .�, ;: '� ��-� `'.��, •��,��)n�,... � Charles E,Hall D,B. 265-270 D,B. 133-177 s (�— � �� �°`��o Linda S,Hall D,B, 208-348 I Ctot) N $5'23'05'E 282,82 249,12 33,70 Control Corner I o� � 1,97 ac, 370,00 — S 87'07'39� N �� 2 � � `�c .--.v� . � , 1�29 ac, 322,62 S g2�48'18'W Charles E,Hall D.B, 265-270 D.B, 133-177 0 1 an_Asr.ley � H°`e� 19 t60 S,R� 11 N 07'32'32'W �-64,75 Control Carner � S 07"57'48'E 133,09 � 1 . =0 �°1�6'41'E S 07°43'43'E —. 91,11 S 07°43'43°E — 43,39 S 07"09'S9"E 39.63 S 07'll'42°E — 66,98 �!��d�?R� ��i�i� a '.( ��������ME��':��. ����'�1 ��� D��� �'��' ��'�. s�:�� ,�Y�� ��'iti�l� ��''� l�J TownsM�r P►N New �/ Addition Crn�aP�r�ern@n� ��r�aii�. Type of Structure � Q�_ WaterSuPP�Y W '` � � of Occupants ��� # of Bedrooms � Other Projeded Daily Fiow: 3 4 g.p.d Permit Vaiid For. nre Years ❑ No Expiration Proposed Wastewater Syst m- Proposed Repair: �N = _ �wner or Legal Authorized StatE System Type�. �� Date: Date: ��"�'�fli �t The issuancs of this pertnit by the Health Departmertt in no way guarantee.s the issuanca of other permits. The pemiit holder is responsible for checfcing with appropriate goveming hodies in meeting their requirements. This siie is subqect to rev�tion if 4he siie pian, plat, or the irrtended use ct�anges. The tmprcvement Fermit shall not be affecbed by a cnange in ownership of fhe sifie. This permii is subject to camptianc� witf� the provisi�ns of the taws and 92uies for Sewage �reatcneirt and Disq�asal Sy�tem� of �e �larth Carolina Administrative Code. �wthoriaaieora ?o �rastruci 1f�astewat�r S�stem 1Reauir� for �uitdinc� ��rtnifi� WastewaterSystem Description: �i�11A1� WastewaterFlow: 'V� .p.d. Type:�q FacilityDescription' ���1 �'es' ' Idew� Repair�Expansion❑ Basement? � Ye's "'�No Basement Fix�ures? a Yes 1�..No lNastewaber Svstem Requinemer�ts Tanicage: Septic Tank size'� �� gal. Pump Tank size gat. Grease Trap size gaL Trench�: Total iength v�� fi. Trznch �dth � ft. Tctal Area �� � sq. ft. Max. Trench Depth: �� in. Aggregate Depth:� in. Soii Cover: � in. Trench Separation 4 ft. on center P�„� �;��on �te: _J — — o � . Authorizad State Ager� Date: t�— c� �� *See attached site pian and addendum pages for additionai permit canditions. The �ype af systerr� g�ermi�ted � does � doss not difFer �rom the type specified on the agplicatian. t acc�pt !he specifications of this peeinit. . OwneNL�ega1 Represerrtative Sigrtature: /� Date: �oerartion Pertnit System Type �in accardance with Tabie Va) � This sysbem has been instalted in compiiance wiTh appl�able �11o�th Caro(ina General St�es, Laws and Rules fior 8ewage T�+ea6merrt and o� ana a!! conaitions of ihe unpro,rement Permit ana consisuct;on �u�OrQaticn issuance of mis permii im�es no g fhat led wiU fruution properly icr arry givc� period af time. _ I_ I� oa . uihorized. State Agent. . Date - PCHD, rev. Q3/07lQi s E,Hall �5-z70 33-177 24���z Contral Corner �� 0 00 2 � o. 370,00 o: ;���6�__--- 2° 4g� �ga �l � � � � . � S � ������9 :���R9� ���&�����s�T.�� �3��.�i � . ���a��i� ��� �����?Es� ��,.�u� r��'�C �� �d� �..�'����' �A � �3�. � � �'$ 20 .� � � . - T �P Zctilng AQP� � Towaahip � . . s�,�_ __ � � . waa ���t ,; Tv�e �f 1Nater Su��iv: Individual Communiiy PubGc Reauiremenis: S'�te Approved by 2_�.—�2 Grouting Ap rov � by � � � � . . Well Log 2�2Z—D Weil Ta � � . . Air Verrt � Hose Bib � . � � " Conixete Si , . Wetl Drille� ved B � � � Daie: � 3 � �� Well Appro y• . � �*See /�ttached Site S�$c6�'`"' Welis must be 'f 0 feet from property lines. � �1�yells must be 100 feet from septic systems. . Wells mus# be-at least 25 feet from any building foundation. Other candi�ons: � PCHD, re+r.11/29/99 ; � j�) � .� ��� � ��� � D�ri;lle�r ID � , � 1 � " ( � (�) [ V ' � - � " Com�p�ny N�me •:!%�,L� ll ' i -,., , i i.- i � i, D�t�e Drililed a r� - - , ,� � Owner: � Location: � Subdivision: Well Log Tax Map � 3 2 Parcel #�1 Lot # Well Construction Distance From nearest Property Line (Minimum 10 feet) (p � Distance from Septic System (Minimum 60 feet) �� �' Tota1 Depth: � ft Yield: �_ GPM Static Water Level: Water Bearing Zones: DepthZ36 ft ft ft ft � Casing: Depth: From [� to �_ ft. Diameter: �C� in Type: Galvanized Steel I,/ Weight: Thickness: ,�_ Height above Ground: l�� in Drive Shoe: ��es No Any prablems encountered while setting casing? _ If "yes" give reason: Grout: Neat: ✓ Sand/Cement Annular Space Width Method of Grout: Pumped _ Materials Used: Yes Concrete GraveUCement inches Water in Annular Space Yes Pressure _ _ Poured Depth No. Bags Portland cement Weight of 1 Bag If mixture (sand, gravel, cuttings) — Ratio to ID plates: Yes No 4 x 4 slab _ Yes _ No Drilling Log Pounds No _ No to Ft. Location Drawing From To Formation 'P�C�I- G'�ld b -1 6 � J � � . J . a � �! s �, z � I hereby certify that the above information is correct and that this well was constructed in accordance with regulations set forth by the Person County Health Department. Signature of Contractor ti,z. � � ID#'25 �� Date ���' CHD rev O1/16/02