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A40 30302/0811999 13:49 5971799 �u�Sy p�zuoy�ny �o `i � PLANNING AND ZLINING ) r�uSis . -� -p�����a3 p�Ed s��.� ii� P�E Pioh �wa�aq itB�s u�6ia��}1ddE s��'�d�d q���H �y� �Cq ���s ay� �o uot�er►tena oy� �o ��Ep �t�> »��� S�.�'Q 09 ulyltM •�d�Q t�ie�H �q� o� �lt�datd a�J1 �o ��e�d �t�ur►s � p���ntEap �u anEq I �u�no au� uz ��i� ptr�sa�pun y -�d�Q t�lEaH �y� o� �SUado�d �t�� ,�o l�id ��n�ns � �u�s�ad �snw � `panss� tt�� �iuu�d sluautono�dutI uE �so3�q l�yl puels.t�pnn I•p�1�Aut �wo�a411�us �cwuxi oy� `sv�ueqo asn p�puo�u� �� Jo p����� �st o�ts �t�13t pue2s�spun 7��1��datd vq� uo paaBid �q o� s�c�ijt�B; utnuzt�w �� �u�s��d�� pvE �nii � vat���iiddE si� �o s�n�;uo� �ql �eyi ��.�5� I •���iatd paqu�s�p �noqa �y� Jo3 m�s�Ss lasodstp �BEn»s ts•uo �� ao� uozyEnlEna ���s E�o� au�tu�.�EdaQ �i�a� Rluno� uos.zaa �u� a� uo�l�aiidd� ��Ew �q�aay I � �s�run.�n�.s a�soao�a z"�� ,�o Sx�O� �xz au� X�x�do2id �HZ 3� Sx�irt��� �i�� �,�s ����� _ —r' :pan.t�s oq ai oldoad ao s�uEdn��a �a aaqusnH •g �zmx� znouaasEq �o # `D5 �,�0� Q S�� (,7UOW7$8g � oH ❑ �J� Liesods�Q �88qr� �� "' :suJoo�psq �o i�qwn� —'�`—'—:s�v�Cajdw� �o ��qwnH " —�":ss�utsnq 3o xil�s, ' �] :ss�vlsng �] :�wo� 7ttqoy� :�sno� � :Su�lY�mp 3o xI�1 � :�vns�x�� :pasodold :�itltaE3/�.tru�n.i�s �o ad�S,L'p� P��?I �8 # P�o2I ����5 :�u�do�d o� suonaax�a . - I �-e' �l.' � O �'1 � :�z�s,oZ :vc�, ':diysu�nas — ��ta���a �:�E�/�j xEZ Q�.,.,..... a -:vcs7c�o� ��»u�pt `os31 � oH � sa,�G�Svoda�d �uiu�aCp� vo s�to�n ,CuE �s�+ � �uuds �] �t�►anwwo� � �tlqnd� a�Btivd _ � , :�d.rii ��ddns 1v1E� �� :�oun,o �v ur.�' s5aappe ��n.ias o� p�pL��u} st wals�ts ��s��51p ao�n��5 STy) 3�2t� ��tit��3 so ��nl�n>>s ou� o� p�7��t�t�uE st 3uvtuaa21ci�1 �G- ia �suoisuedxa `5110T�Ipp'2 `�Cu� �i) ad,�> >Eu� •g �� :q�� � n,�„�y :�an»ru�S p�soeos� .�o suol5uowiQ 'L � � �� :Y �uot�d ssauisn -c. 9S� ��:� �uoua awo .� " Fi.y `�`I��I ' `�l "/1 [�' - - ., . Ss �f � :ssa�p ��,�5 :�u��4,�:auMo �np�adsasd/sau � :�q pa;ssnba� �tuuad p�a-� ---' �pt�ilsoa � U3i1��OJ7a� — t�aiw�tJ� — Eua�aE g— ;.,,���;y1k,� .ry �,=��a,�,��''"-`�a.�,:.�r' -.� �Ii ��.q.�;��: 1 �•... ��� �•�'��`.�a w , � �'"'�. �,:�w "' � ���^-ila o a a d' : �a � �' '�,��"�"' � s� � � �'`.�; .� �r.� :�-.� � °�' a ��.. :�:.. ..-�?^'. � � ����� : L: �°!� �+C+� �., �.� �'.' �1'7� �4�:r.. �.w�it�,. '.r,.r�a;. ]I�li'� �ui�s�x� ���id�� — (uoz�iPP�') ��w.s�d s�uau»no�dw� — ll�ly, nna� ao,} >>uv�d ""� (��EJda� �►voH ���qoy�) �ruuod s�u�wandldu.t3 .... w�ZS�iS ai3�aS �U17Stxa aaE�d��p�rd�� �'"' (lo� papao��Jun) 7rtu��� s�u�tuanos�dua�, (�aiso�� u�o^�) us��slS $uns�x3 �o uoila�dsni�� —(l07 p�pao�a�/paysT�qE�s3} ��w,.»d s�uowono�du�� "' t"�%r•. �"�•r�' r,,' "�."'�'� 'dM :,�`� �. +' ����}�� Sd�1 8 ,,,.w.^.�i���'6 �yr r.'�.�'"'�. y= �J�� r�w�4�`a�'.'�:w'^ , � �il.: ',Mi� ,.t' ""•'• . . _... "'�,~ . .i'+i �.�.. %u:�l'ri�rri�J�:�T,.,� iu3rMiyYM��S.+ . . . +i . _.. �M'� �.:r ' : J r. •E� .'S'..?G.#.. . .. - aasQ ao —� — r d � � 1 �lAn�� uV� n�viyv,�l �uu v� 9�� r#� b0�12p ,, � � d � a�e�t !�;�, p�-���� � •9�.� p�Fd �unom�r, ov.��� p °° � r _, • _ T ' � . PLEASE SEE ATTACHED PLAf� 7axMap#: , 1�� Zoning Appilcant: f�'� aw^ � � J Locafion: S 7 J � U F� � Subdivision: �r� �Cf Gs SecUon: FOR SOIL AREA AND SYSTEM Pe�e� # 3a3 Townshfp ���t I�t �l C r i n.S � an t Lot: �S V� Improvement Permit A buildina permit cannot be issued with oniv an Improvement Permit New � Repair _ Addition _ Type of Structurei�i� Water Supply �r��at��C I f # of Occupants�R1G.X. # of Bedrooms � Other • Basement? �i O Basement Fixtures? O Projected Daily Flow: ��g.p.d. Permit Valid For: �lFive Years ❑ No Expiration Proposed Wastewater System T e: I u�G � C'nrivell'�� �G� I� Pump Required? Yes �N� PermiYConditions:� L%J� �¢�� Dl u�S F�m ct.nv vco�� Sy6��c m. Kec� s�.�tcm %Dc,� -! �`n �t r�cc ,��'"n l l 0.S Flcc. rG a� U/1 JD �►:I�` � /i � cs on Coe'rEou r Owner or Legal Represe iive Signature: Date: �"-�3'"6D Authorized State Agent: Date:� " � � The issuance of this perm 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 Buildina Permit) Type of Wastewater Syst�mCO� VU1�vnA. �iWjry 1Nastewater Flow: o� g.p.d. Facility Type: mObl l� '�flM New$ Repair OExpansion ❑� Basement? O Yes 0 o Basement Fixtures? C] Yes C�f�lo Wastewater Svstem Requirements Septic Tank Size: � i ��� galtons Pump Tank Size: ��1� gallons Total Trench Length: `1�� feet Maximum Trench Depth: �. inches Aggregate Depth:� in. Maximum Soil Cover: �, inches Trench Separation: �1 Feet on Center otn�/�l�t EH�San 5���� Arr�or f-v i�✓t�.fla-fa'o�� F�Iloc� IaY� Perrnit Expiration Date: �'"� �D �OCZ�� � Authorized State Agent: • Date: ��l � J �o �roV idk� � The type of system perm ed O does Q does not differ from the type specified on the application the specificatians of this pertnit. Owner/Legal Representative Signature. Date: 6 a 3 G v I accept PCHD, rev/ 10/12/99 � : � O � 0 n Application #: Tax Map #: � , Parcel #: 303 Person County Health Department Environmental Health Section SITE SKETCH . � Oa.Krid � AGrc�S a?S �c�mmv �otcJKinS — Applicant's Name Sub ivision/Section/Lot# �—/9-oc� Authorized State Agent Date System components represent approximate contours only. The conlractor must, flag the system nrlor tv be�innin� the installation to insure tltat proper grade is maintainecl . �� • `o � ` o r -� y i � �s �,.� � �' ' J Y ti .� � � M� �` .� � '� � - � � 1 y �1� .� � � � � � . � �y�y . �' . . y � y y � � Scale: ���� � � � clac ¢ N zQ-� Q PCHD, rev. 10/12/99 � PERSON COUNTY ENVIRONMENTAL HEALTH PLEASE SEE ATTACHED PLAN FOR WELL SITE LAYOUT Tax Map #: /"f �v Parcel # ��� Zoning Township F/ Q� '`� V C. (' qpplican� �m m y �"�Cl(.�� � 11,5 Locatlon: Su6division• �an r� d 9 G/'ICrCS Sectton• ��� �pe of Water Supalv: Reauirements• Well Permit �Individuai Community � Public Site Approved by � n� �+ �- 7-oo Grouting Approved by n� � - -a� Well Log �5►� �+ �- -cu Well Tag Air Vent Hose Bib Concrete Siab - � �1/. /. .11P " �• • . . . - . . . ...Il .%1 .�1 �.�// . . *'"'See Attached Site Sketch�`* Welis must be 10 feet from property lines. Wells must be 100 feet from septic systems. Weiis must be at least 25 feet from any buiiding foundation. Other conditions: Ktx� wc-I l�.oO� AIu�S F�orr, �n.4F-f.11 �,�h�rc�, ,S�►own On < PCHD, rev. 11/29/99 Date: f-�Q-� ' Owner. Location/Directions: Subdivision Name: Drilling Contractor: ' ' PERSOft COUNTY ENVYR6NMENTAL HEALTH WELL LOG . �1 Lot # c�, 5�' . WELL CONSTRUCI'ION � Distance from Nearest Property Line ! v Distance from Source of Pollution ( G o Total.Dep.th: oZ�D Ft. Yield: y GPM Static Water Level a?.,s" Ft. � Water Bearing Zones: Depth /y5 � t F� � Ft� �t. Casing: Depth: From 6 to ' Ft. Diameter: Inches TYPE: Steel � alvanized Steel � If Steel, does owner approve: Y�s No � � Weight: � Thickness:�_ Height� Above Ground: j�i . Inches Drive Shoe: Yes ✓ No Were Problems Encountered in Setting the Casing? Yes No � If "yes" give r�ason: Grout: Type: Neat Sand/Cement / Concrete � Annular� Space Width Inches � � Water in Amiular Space: Yes � No _ _. Method: Pumped � - Pressure � - � Poured � � - . : Depth: From � to O Ft. Materials Used: No. Bags Portland Cement Weight of .1 bag__lbs. If mixture (sand, gravel; cuttings) - Ratio: to ID Plates: Yes � No � � � � 4 x 4 slab Yes .� No I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS CORRECT AND THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH REGULATIONS SET FORTH BY�THE PERSON C^vtJi�'T'Y HEALTH DEPARTMENT. r��i%�=-�—��ii_ _ , � r- - - • y � •► • �. - Person County Health Department ,q-�1� Environmental Health Section Tax Map #: / I`f V Parcel #: ��� Zoning: Township: ,���� ��� Subdivision: Section: Lot: �� Applicant: Location: �� � �� I tl�l I � �l �� ���'� l (,�,� �I L ���1.-{ Vt-�� � Operation Permit 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. -� A thorized State Agen 7-(�-D� Date i ,� ,(v'► ,5�� (�'I �, � ��� ' � '_' � 5 ��� �, I V1�l.Dl�cE� ,;� ►r 2?' � . ��(,c� 1S Tax Map #: I� "�v Parcel #: �b ✓ � 115 �� 2 � 25 I I 5' I 2v' �75' PCHD, rev. 10/12/99 Person County Heatih Department Environmentai Health Seciion Zoning: Township: �Gl,� �� �ir Subdivision: �a�� �, �� Section: Lot: %� Appiicant: ;�����`�a.w�� �s Location: �� P �,p ��J Operation Permit 1. LOCATION AND SEPARATION DISTANCES A) System meets .1950 setback requirements �_ B) Distance from system to any wells �100' C) Distance from septic tank to foundation (n' D) Distance from system to property lines y10 � 2. SEPTIC TANK A) Visually inspect the exterior walis and top of the tank ✓ B) Visualiy inspect the interior waiis, baffle, tee, filter, riser, lids, air vent, bottom, and water tight outlet �� C) Date of tank manufacture �-0 D) Tank serial number � 0 — E) Liquid capacity of tank I 0��_ gallons 3. SUPPLY LiNE TO TRENCHES A) Grade (1/8 inch per foot minimum � B) Material supp�y line ' constructed from � C) Diameter D) Length 3 � E) Distance from tank to drainfield/distribution device � 4. DISTRIBUTION DEVICE(S) A) Type . B) Is Device water tight C) Distance from the distribution device(s) to the trenches � 1 D) Is the device on a level foundati�n � � E) Ooes the device perform according to its design specifications F) Record the inlet and outlet elevations 5. NITRIFICATION FIELD A) Trench depth � mches B) Trench width inches C) Distance between trenches � q� 61/1 i i�Vl�� D} Number of trenches E) Length(s) of trenches F) Aggregate depth �_ inches _' n G) Aggregate material and size • 't� H) Record septic tank o ttet elevation 1[�1 I) Trench grade � Il�IG L 1/4" per 10'�' . J) Step downs �J a. Minimum of 2' of undisturbed earth � b. Proper rise over step down ✓ c. Sofid pipe used _,� d. Elevations of step downs �(Record elevations and show on as built) ����f See "as built' pfan'"o attached sheet. PCHD, rev. 10/12/99