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A40 313
•_i.—�, . ; � _ti_���t � / I / _ , Uj �.�� 0 � � a ,�-g � � . . �_ .. -.-__ . � � 1 . : ._.u�:ti -�! lLL � __.l � L �''.�. t �'r1 �.: ! • i ��l- -� :1L �.__ �� n�.o � � 4 �. a.� � � l 3� 1) A�t ri4�wb�d :� MP�p�w � `: Yi �r i S Ta � 01�' . � Bu�ine�s Plmns: ' O _� 9�� A�ddr"se� .'� �v, • a-.7o2 `� I 2� I�l�ns aed � a� ctie�nt oa�n�r: �' a.l�.t, �. . , �i �'�Y � Lat aimc � . � g � , � � 0.�- 1� v 1/`�... V' D� i� �e p�Opsrty �(In�road r�ne� and�tumba�s�: t2 � � a�rs� � �.-n �u� 4) Propaed Uw and Struc� Dasari�dian: �wer � of ths �9 4� � � PtaPosedE.'�0 0 . b) �Idc �dt Q lbdular 4�nq1s Wlde Q D�6ia.Wtds �3� cj I� ad �o�x �_ . . � I�mber of a�ut� or peopls io ba savei� a) 8oeement Yes Q No�i yea, � cf basen�nt �� . n ��Y�4�� �. . g) D4ne�dona atPropoaed 3trudtae: Widit� °2�Dap�: g� . • S} Wa�er Su�iy TYpr: Pri+rate�� � or eo�n9 �. � 0.�Y 0. Spc6tq ❑ • • Ara any an adjo�dnp p�ly� Yas � No � ItYas. toc�fbn ��� D�aitrd sysban 'i�IPr. (sy�ms c�t bs radoed io oRlsr ofY'�' P�1 �Ca� �Alo�d Cam�i _ Amernd�s �nnwatiw _ . - ��'t�lil� ' CLPARLY STJII� Al.�. �$ �lID tJMEs OF T�lE PROP�R7Y. STAKE 1�E � OF ALL PROPOSm STRLJCTURE9. P�F.�SE ATTACt! 3URYEY PlAT OR StTE PLAN TO TtitB APPl.1CATION t heroby ma�Ce � to tha Pe�aan- Caimty �. De�mrtrn�t ior a mis svak�atbon far ths an-�e sewagn d�asai sya6e� ior the abnve-deacrmed �. �f agree that the c�ntent�e of th� app�on aie true snd t�t the meodcn�n fiac�Ht�s ta be �d an 1t�e propaKy. 1 understand if ihe s�e is aibe�ed or the h�ded uaa d�angea. tl�s pem�it � bec�rte inu�d I u�d�d' that as �, ! am �e i�a' id�in9 �d meddnQ Pro�eciy Mes. camas ana t� the aiY � ior 1ha -_ � of the Per�on Caiu�ty f�(eaith D�n�rtfo. mnd�ut their e�raiva�ons. l ta�der.�aid iha�t i ant traspon�le fior naii�Pn8lhe Heetlh ii my �ina a�ry wetlands as de�ignat�d bY'� �mll ��� . . , r • . . • s -�� . : ,, . wr�. � �Ye . Da�a - . . � � w� ���St�N Ct3lJP� �s'�11/1RflNME�ITAL �E�,L-Ti-i � �s 313 . T,r,�+p F �tfi � ~V � r' , �rF l��e�na C.o zar �- " , / � (;t.C�o Ss s.�tto� Q A�c . � Improveme�t Perrni# � . � A buiidino �ermit cannot he issued with aniv an Imorovement Psrmit New ../ Re�arc Ad� rype at sai,dtuti � Fa . yva� supply tW��I . # of Occupant� #�-of 8�ra 3 O�r Base�nec�? A� 0 8asunent Fcc�es? �/� . �i� �r �: � s. R�?. � Pr�opa� ReQair' (',o n v� �i� Pemrit Can�ion� Keen Sy �.-fi�9fzi�1 Q` oro/�Pr. � 11,I•1'r�� �1r11� � ��_�.�1 � _ � � �� �.,�� r� C'�n vCh�ib r,a �K S� %f7 � I�r n L( n �. n �_ �C �CIIeW2:tiA iA�'7�oU-r . ke. - �: I -a8' � � � � ��a�-o� The issuance cf this perrrui by ttre He�h DeQaitr� In no way gtmran�ess the � oi attta' p�rrn�s. The p� holder is respans�le for ct�ecian9 � aPP�P� 9�9 ���9 �c req�ure�tb. This site is subject bo rovccatton ti the sibs plan, piat. or ffie irttaadad t� ct�attgee. The ImQ�nvement Perrnit shall t�ot be af%cted by a cf�ange in ownocship of !he �ba. This permit ta subject bo camQ!'wnca with the proviaions af the Laws and Rules far Sew�ge Tt�ttnent and Oispaaai SysEems af the No�th Carolina Administrative Code. , Authorizatio� To Construct Wast�water Svstem (Rec�uired for�Buildinq Permtt) Type cfVl�u�x SyaEem �.� nVe��rna% W� F•�: 3�6 a.D.d. Fac�tYT`JP� 3 ��. �QSic�enlcw,Q ►veWJa RnpairOE�nai�1Q Ba� Q Yes No B�t �? 0 Yea�� t�o � . Wa�tavvater SysiBm Reauiremenls ' ' - . Sepbc Ta�dc Size: 0 0 �a Pwnp TaNc Sizx `—" gailons Tctal Tnends Lengttx � fe� M�Cnian Tisnclt DeptK �� Agg�he Deptl�L In- M�num Soii Cavec � inct�es Treadt SeQara�on: � Feot an Car�ter Ott�er: ' Pemut E�on Dat� o� ` 02 %- O G Au�tatized Stat�e Agettt Dat�: o' a2 �� D l . � tllPe � g71� Permitied Q does Q oes net. difter irom the type spes�fied on the appficatian. ! ac�pt ti�e spacificattcns of thts panait. ` flwnerlLegal Re{�reser�tive St�ue: X p�: • � • PCND, tev.11118l99 0 . i •. � Applicatlon #: --�- 3C� � ' . . Tax AAap �: 31 _ • . Parael #: � p�rson County Hsalth Daparfiner�t , � . . , Environmentai Health 8ection �1reMo� Co � 81TE SK�iCH.. • � Authnr d tate ent '� Date . � �� Syitent con�pon�nta nepnaent apprax�i�al� cnnloura an�y. The contrAclo� must flag tbe rystsm . rlvr to i lnnln the lnrtallMion lo lnaara lhat ro er rode �t nra►lhiaiaed � ZS, . �- 7 0�-----� ... Wa�'e� L� � . . `� 5� 3 g� � ob;�� �--; ' � . . . a"`� , � i ., o a �����y , f r5� � — . � 1�i �r"��w�fOA �� . I . . �GP Se�ti'c s�s�`e�., lD� -�ro►� � �:-�-CS �' W c�,�e r 1� ne. . s s �'°�"e �orw� �Pt�'c �, � IO' �.}- ��t � � � �� � r� ,}� ""' '�� oti 'A� f � � se;-�C Sy$rCv'.ti ZS� �� �Cpf,�Q,fly 'in.� � C frl��:l, (tiYh T�e�cl� �e� � 2� p�P P�,� � 1�� "i'a �A�2 1"OO�M1. .r�pr V �J , . ' . �da r3 Ni�-ri�1'Cc.�;o►-. �i�� . c�r�vevJc�y . a� 1��'er- Su�Q�� �i,n� „�0;,,,�� we�l �-o ti►oks� . � Coh�ev�,-�-;o+�,l �epa,�r- � � O . �oo �3i tSk N��`iw,kw. . Q � � � I �re N GI�. • a\e `1'�. • . � V .. � � • 3 � W . J � � 3 �+ �_ � I . . �� Y � � 3 � . e �a � ��¢ °F �� =� r- � . I � ��s1 �� � ; . . . � 1���,�;1-, . . E � ,Qs��'� �,� ;h .�lo�c� gvo+� ,s ' � � �- ri I� � � . � po ri,°}- �l _ � c9�j� • t�e�l � .. ; � ��� Ze,. d-��'^°-s�e' !i . . � � . � . . . . / . /! � � µ7 � . / �� . i � ' �r" ' . . � � � � �` �,�c�` � � �,�s��l a�- �m Pe� � ��� r� • � � � 5'� • / � ,.�1\ow�� c��,.t+u�r,. �- . . / � . / � . / , . ,. / ___ . . . . �� � � _ o Soale: ,_,�.__ v!!1#If1 rav: '1i1/42/9A'• . � r< , . . • � . _. � P�r�on Cau�riy Ei�ilh �t • . . � �tritor�entai �6� Seclion. • ' • � . �� . ias � � _ D �ea�t � �/?, . . . �; � � T� ��� ��fe. � . � . �aedro� t� . � . ,� �f�a•� � L'o��� � - ' . . ._ .� ��� �� � . � �pefiation��.Permit � . . � . . � Sya�m lype (In Acx�ance V1�h Tab� Ve): . Tt�H3 8Y57FlA EU�S 8EE�1 U{STALLED W COMPl.IA►t�IC� 1NI1'Fi APP[.ICABL.E NORTH �. � CAROt�IA l3ENEi�AL STATLTrES, RULES FOR SE9YAOE TREATI�NT AND �SP08AL; . AND ALL CONDITlON9 OF THE 01PROYE71�1T PERYR � AND CONSTRUC't10N . a1)'tNORIZA't70N- . � � Z � • .Zo� Z � . �e . . . �, .- . . . . . . . ; � . . . . .;� . - � .... � • ,: . . . _ --- . t �-�- — . - G'� � . _ __ . ;: . - - � . . -- . . ._ - . _ _ AsG�-� � .. � � - - _. —. . ' . ���t� �-��� . . � . . � � : . � � ;,�:� _ �_ . � � . . . � . � ���_� � . . . � . � . . ' h . • • .i • . • 0 0 0 . t •. pppll�tlon �: _ � Tax Map �: 3_i 3 Parcei �: � por+�on County Hsalth Dapar6ner�t � Environmental Heaith 8ec�ion � 1re�q C�' � SITE S ETCH.. � � "� � . �� .�� � � �+a,� Iv' �.�- , � ���e�--t-� 1�� 0 syitsin Suadivision/BeatloNl.ot# 3 ` �� � t� 1 Data . � � � � nrpreaent apprar�inats co�lor�ra on�y. Tlrs contracto� attut flag ths ryftsrit .� ,_ ___,�._i...a ' _ .� F , ':�$ 3� � . i, � /OD O � ZS� . o ----- 7 D 1-�,� _ ( �9 • � � i3 gr ,�.��;�z — , � � � r�,aw,� i 1 �. - o , �,- �� _�— ` s'�,�.��t,a� �� 5,, _ __ � ''-_ _ __ __ . _ - � �- s �-- � � ; � - � '�� Co�.�e� ,o�,Q,i SePt►.'c � j �is-�e ", �,,�, � � � i�+l�x� w�u.w. T�'e tic� �e(� �ba T3� Ni��C¢,�►o�. �i� . f Cah��w-l-;o+�,l �p�,;�-- �c�e� �oo �3� lSk �k��^��^ . � "�re�t�. • a1�P`1'4 . • . u � �� s,�,, 3 �o . � �� / �. r' � ,� e��¢ `F �`� = ,.--� � �`��'S � �, �- . 1 � � � ����� . � �-,p���� t iL w�,� ; -�\ovc� gv��� � � ~ f pQ. �'yT ar .�_ �_ _ ro_ A;I�-:-. ..__.. .:.�-� �� I � � �i �a1 p Pu,��Se�� c� r �V e�J��i ,.�ra yy� W e � R I V E W �i Y. ..--- � . � -1 _:f. -�- .. . .. _� ' � "'i� • 't � �. P�SON C�UNTY Ei�11/iRONME�iT�L tiEALTH � �L�+,SE S� ATTAC�IE� P�.AN FaR WEi-L SiTE i..AYOUT � ,� y� � �+� 3 J 3 ��� - . � Tor�P IL �Gt. r 1\ �\v e r Zonioi - � � � • �rC' IV� � e U � r►a� , /� - nJ / �1 L�_ i�� �„� � %�i .Pi{�a S S �r0 m �Gc CYI cr� e /"�G- (�°S L� Tvne of Wat�er 5uaola: .� ell Pemtit ' ' lrtdividuat Communiiy . Public m � %• � �: �1- ��Dz �s� ��t►�a s� s�n� - Welis must be 10 feet from prope�ij/ lines- Wells must be 100 feet fiom septic systems. '. WeUs must be at least 25 feet from arry buiiding foundation. Other condii'sons: � � PC}-l�, tev. 1 VZ9199 �1/15/1995 14:45 8�44547843 BENNETT WELLDRILLING PUGE �� ���`' ;���� �C' �L'e1L0.�'�Jrl. �`i �� ��.�`�'l�-�` l�/'.c�f.��1 .d� ��►����` � � �Q�,��. t�� ��� ' �' d � Owner: � w� � x� t�Sap �fo P�el # �i.� L�oa�ion: Snbdivis�o�n: � Lat # � �Vaa Coma�m Dietioce Frmm �aarest Prope�ty L3ne (Mia�ommi 10 �et) DLqro�e fio� 3o�ic Sysoem pN� 60 fioot) Total Deptb: ,,,(�,�_ 8 Y�+ead: G� aPM Stetic WaEar Levd: 8 w�ter Be�ia,g Zones: Deptb it R� ft_.,.,,.� $ � �; gro� ��,� �o , it Di�mebor:��� in 1`ype: Cialva�i�oed 3�eei � Wdgi� �_ 13ic1cneaa: _,/ d D Sdg#rt ebova C3ro�m� .L e�.. ia Dave 3boe: �,_ Yes No AtYy p�oblams mao�rod WIu'1� �tin$ cssingR Yes ✓No If'�ro�" �iv�a s�o�: i`s�'O1lC N�: � sa�c�� co� c�a�►�vc«��c Aan�i�r Spaca Wid�i _�_ � '9Vstar iu Ananlu speoe Yaa - z/_ No Met�od of C�ro�k ��d � Presaa�e ,� P�nd Dopth tfl F� Ms�i.b II�ed: No. Bags Pvrtlmd cemait �_. R�a�t af I Bag �-� Poam�s vEmi�mare (esad. g�avci, cut�aga? — Ra�o � ._-�— � ID P1� �Yea _r% 4 x 4 sleb ,,,�,�Yes ,�No D� }�.ot L°c�'°� Drsw�� i i�Cby cartify tbat tiHc ebove info� �adoa ia coatct a�ad t�st t$is �rell was �'tn aoocndanoe with �+egal� �et 80� by che ra�ao� Co�ty Heiaitii Depa�aom� Si�taro oi Go�trae�r ��� . - � # —=� � • - pt� iar OlJ16A