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A41 79�-��, ; , �f ���� ��\� �-.._ �-.�- C� � �LT�T�� 1��rn.wu��arn�rnsrn:n�ixn.�:�n.� � ��,�a�4:�.a Applicant: Location: v T�x Map � F�rc�ei # ry S;t� �.d'i,v�i.s�i o n ��__._„ .:�,:: - :���1t # ::, Improvement Pe'rmit ,' Permit Valid for �ive Years No Expiration Type of Facility �$,�,,G ��'�// i�s,�c� ,� New ��ddition Water Supply # of Occupants �-G # of Beet ooms Projected Daily Flow �� g.p.d. Proposed Wastewater System: � Type: Proposed Repair: ° ' Type: �J� 7Z9 l�i^�'✓�.e c,JP // Permit Conditions: Owner or Legal Representative Signature: Authorized State Agent: jr/�iQ, � ;�.� � �.�;(a�, Date: '% � C�- � Date: � a6 - o� The issuance of this permit by the Health Department in does not guarantee 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 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 vi�ith the provisions of the North Carolina `Laws and Rules for Sewage Treatment and Disposal Svstems' (15A NCAC 18A .1900). ' Authorization to Construct Wastewater System. (Required for Building Permit) ,; * See site plan and additional attachments (�. Proposed Wastewater System: 'p w � New ✓ Repair Expansion _ Type of Facility: � /Z S,r�,l� �<=�,��h ,�s,?��,,� Type � Wastewater Flow _�g.p.d. Soil LTAR• g.p.d./ ft 2 Basement _ Yes ✓ No Wastewater System Requirements Tank Size: Septic Tank: %pr�O gal Pump Tank: � gal Grease Trap: '�--�- gal Drainfield: Total Area: �,as � sq $ Total Length r- � ft Maximum Trench Depth �� in Trench Width � ft Minimum Soil Cover: � in Miriimum Trench Separation: _� ft IDistribution: �Specifications: Distribution Box Serial Distribution t/�ressure Manifold Authorized State Agent: __ /_ i��,E� ,%�i.S. Date: �o :�6 � 0�2,� Permit Expiration Date: �O -�,6 — p? i � The type of system permitted is r/Co ventional Innovative �_ Alternative. I accept the specifications of the permit. Owner/Legal Representative: �� '' Date: � (�- �--��, ;>��..� ���� �� �� ������ f ��.�����.,,-,Y„ ��.�.�.0 ���.a�� SITE SKETCH Name �c�o. c�e,� r.rz 'J`�U}JC�1ViSiOri . T �� Autho�ized State Agent � Tax.Map #��/ Parcel # � 1 �e�e�# S,��e/L�� 3 �o'a%-d�. Date S,�rstenz compohents represent approximate contours on� . The contractor must flag the system prior to beginning the installation to insure that �itnpergrade ts maintained � sa /7cicf;r/ �cc�� �"P/'�„� �1 � C�6r?�,-i � ----_—_. �%{e� O u,T SyS f e� �r'�es w: J�� q, i'i"Gt n--s'• I�� n'g r T� ��rls T� ��j,s . // / J o� • Sa,L C�',Enn�a M f'Q-j'es 2� y�o� �f -�o �/Ju m� S�Ste�/1� P� '�S �t r� Y�Rn� r�-d lc�� Q�..� �On..�rD��a�ie � ,'^�'Cc��'p�� , 3. �ns7�1��5� �'O��rtVen�}�'On2 ���+CS �T lF�l`o�,c���� GtS s�wc.�n �,•1 �{-h Jo /'Pssu rc hur n���c� �'��,'6aLt� t� r� , � � Scale: � „ - s.�� � 30� � PCHD, rev. 09/12/01 ' (H�S) PEa� azmru6p �Z �AIILi�iC?TI�J � . Eaol 30 aaa3 � zsuTEBd , � aanu=H �ad suojie� �'� , . : . � , • , • � . , ,•. ' . . . • . . . . . , • � . �. '� •; . - . . • ..,•'� zaAzlaa o1 pa�� ag as� dmn� ,�, . , , . ... ' , , • . '•�. . � 9NI�V8 dHtld " ; ' �}�'� d O��i ��5� �a ... • • �y ..' , r • L •� � - . •J � • , � .$� �' ��Z �Z ' �� ': �, ���rt� � d� fi ; . . �qog 'rs'°'p°°t� p a% �,' '�� - - �� � ��,���,g� ., , . . • � ` �r0 auu'd - Iaa°'i �H � � . � •' (��S.$) . . ; . na.z�tyr�m� .. '� ,• �.m � .a� �T�e . ��y���. �r uoEd�j �� �.fOaV•� Y4 . . � oz }� •�a aaa o� x�s .,� � . , � ' fa�g�al � �� �a �.t �uaas �.a �� � � �u�a , ��s �z ��s ��s � �.m p�t �do . • � . . Kuum P�rt �ado .'• tuo� dsz _ , . . - ' ' ,� ' • .; '; •' �", • �,-T—�' ` " '"s ' ; ,; '� ,'. . - • ?4�1� . . � � � , • }nnuJ e}aaRxo� pa:r�}:oa . . , : ' � � � ' ; .. , . ,�o� ��� � �, • ��'J .� .1;'�"�: ' - �A -` ., � ;. . : aa'[�d �J ��.L � uoiiusa'S.9 • t.., �°3I��i�3 . . . � �� rtrZ YOIil2lft�s a �+j ��$� �$ �.1. �a� • � � �cao � u�a �us ��a �i g �� �� °}°� ��eros �a �� x . t�di°�°� �S �� VFi�i c ��r �.�'bd � Fitting to allow for connecting Aluminum or steel clear pressure monitoring tube shoebox-type covers with handles {leave tube in bottom of vaultj (150 Ibs. each, max.) Support straps hreaded tap or bars Ball valve �nifold supports � '�I � � � � � �.�== � (Dead level manifold installation Cravel pit for iMernal drain discharge j��e 3�� ( s � -���s ��� � ; �� �% `"� Profile View of Pressure Manifold for Sloping Site Installation (not to scale) � Tsp - dired thread or sa�idle , C��� (if tepped wrth msls sds�tor, tr� Press�u�e bcsd �teck fh�sh wrtli mside wsl�l ,�--. � � �� �; �x� �, ��� • � � �� � � � �� � �� _ 9 _iZ��� IRIII #a�� —� ���`t � . ...ts '�«- ���� -t �.: ��"+'��-r;s�'�s �.. IE55$ E Sd]115�[[IQ*� . . . , 1 � �� �y,�,�s'"�'� �r� _ a� „� � ��� �«.�,+�� �s- . :: ��-. ..'. -'. :�. . , . .. .- ..— -+ ,.. `�' :. :a- '� �.. "�` a_ '.- .. g _ . . . . .. . �� r; �` __ �S s-...a��t..,.,.p _ _ 3 si _ �: s.�i � _' "' + ` �: %��"�'., $L4B.. �� _„ .���...�. 2' mm. .� _ �:� � � � ' � ��� ��� � � f , �� �, �� �� � � E#fh�R su�ply 1'me �� £,.�,s�,� �� �" �� �,� �- � �� � � . � r � r� v.. � h`"''. � �� -��+� �`ar7" �` �,�"��� '`' ux �. ��� e, � ,� li��� ZRm. � � °x:. � � ��s � � � r"���c�,`` �� ��& � s` � � � � . � �' .:� �,�+�.*� � ) 4 . r �, �, . i � ; �. ,y ;w--� �.. �_ .. � �`" .-:�'�' �`� T� � � �EII191 Vffil� f�ISIII ss a ��o� y�� o u o 0 0 0 o n Txue�avoit bsll valve (6all velve w�t two disc��ect ,••,;+a,�) 1 1 1 1 1 1 1 1 3" �lr �5 Observsti� port (tee wrth extmsian to drauilu�es ffi mai. 1.O�o slope brvugl'� to grade; w�lt mtwvsble csp} Plan View of Pressure Manifold for Sloping Site Installation (not to scale) �%4 2:e�su.: :rezze4 '.....• past �: ?QC'_Y3lent � C NBNIfl �% . ..� . 3nclasure i�atet tiqht , + �stall ? circnit corrasian resis� � .scounect svitcfl � 1 � panel does 2at ` �Ye a dead front _ .._.:_:a � l �� aanaal uiscouuect. :,.. : . � / I ate: a breaYer dues �:�c•:�: t coustitatz a , \ sconnect) > 12' ta . fiais6 qrade �uap �upply circai"_ � �lara Circuit , �ater iight 5ea1 — _ - '� 3qdranliL ceaeat� • Schedule �0 ?QC SupQly �-- — — -- �iqqyback Pluq and Receptacle ._—� � . , 4z4 ptessnre treated ,� � post ar eqnivalent N81� �� 34�=a511te �atec �i9�t ,. } catrosian reai9t�t � 2� 31Il11Ui GdS i'1Q�lt Condnit >12' ta finisd grade . paip sapplp circuit alari caatrol . � �ater Piqht Seal Hydraalic Ceaeat Harness gzcess Cards — __.. �.. � Sctiedule 40 PYC ' • SaPP17 Simplex Control Panel With Huilt In Alarm � P�� ��� gate: lhis is DOt d YlIIIlQ diagrai! Cousalt an 8leciriciaa! �� Duct Seal � � :,ackiaq St.a�s 3araess Szcess :�.i� � —__ Receptacle mnst�be aotor rated �oy-Paltaye alars ' connection Onct Sea, " he a:arz aus� be i0UQL21 I1 :5E L'_�:�]?� liviaq irea or �he dve'_'_:sg ;not ia L�e cravi space qaraqe o: nudec a aabile �oae; fhe �ane: aast be aad��lz and zisi5le ta spstzi :sers _+ � � � Laciing straps • ' r ���.�.� ���.� �� �--^= � � � ���� ����.�������.�. ���.���. WELL PERMIT � PI.EASE SEE ATTACHED PLAN FOR WELL SITE LAYOUT Tax Map #: /��"/ Parcel # 7 1 Township �(a ���✓-e�' Applicant Subdivision: �, Twe of Water Suvvlv: Re�uirements• Site Approved by Grouting Approved by Well Log Well Tag Air Vent Hose Bib Concrete Slab Well Driller. �ectivn:- Lot�Si ��� � �3 � �Individual Community Public Well Approved By: Date• '�°5ee Attached Site Sketch'�* Wells must be 10 feet from property lines. Wells must be 100 feet from septic systems. Wells must be at least 25 feet from anp building founda.tion. Other conditions: � � PC�ID, rev. 09/07/01 Applic Locati .� �1��� �� ���� �� � ' v " `,.�� � � � � 1i � I� ��a �- � �s-�. � � ��.I1 IL� � .�.11 �7� �x M�p � P�rcel # � Subciivision Ph�se Section;Lot # # of Bedrooms ''�� �.� � � � � " � � �� System Type (In Accordance With Table Va): �,� THIS SYSTEiVI HAS BEEN INSTALLED t111 COMPLIANCE WITH APPLICABLE NORTH CAROLtNA GENER�►L STATUTES, RULES FOR SEWAGE TREATMENT AND DISPOSAL, AND /�1LL CONDITIONS OF THE lIUIPR�VEIVIEiYT PERiVI1T APID CONSTRUCTIDN AUTHORl�r4T10N. � � ���,,,� a 1����I�1��} Authorized State Agent , . Installed By: .�,,,,,ti ..�zrr z . .r��`�,� , �3 �SS � �, �v � �� �ibu5�, -�1--{ � Sii �+ wefne55 �af-{(e5 h�c�+� is �-r,'Able wQl� l5 y�°rv Anq���at � �, 9 / � ��� . Date Date: _� /3 "d�` in bcF�cr�, of k�no{. 'L �!� ky PCHD, rev. 07l29/04 � ���-�tc °���� a��������� ��'$�+���..��-� (���� �0 � i�� Tax Map #��_ Parce! # Sysitem Type (Tabie Va) �b �wner/Applicant erQ ' Subdivision Address/Location SecfPhase L.ot # 3 State �ID/date 578-I �Z/Z' 8-A�" Capacity p % S- /ODo 9a1. Tee and Filter Baffie � Sealant Riser (if applicable) Tank Outlet Seal Permanent Marker Pump Tank � SI � l �0� /Sealant Riser Water Tight � Pump Check Valve/Gate Valve Antr-si on o e F(oats/Switches Alarm visable and audible Electrical Com onents � � Rate m � A roved Pum lUlodel Blocic Under Pum Pum Removal Ro e/Chain . � Distribution. Syst�m � Serial Distribution � ressure ani o Low Pressure Pi e A r. Pi e Materiai and Grade � Valves � Trench Width � , ,3 ft. � Trench De th ` in. � Trench Len th � ft. Trench G�ade � Trench S acin � � Rock De th and Qual' Dams/Ste downs etc. Pressure Laterals � Hole Spacing � � �-as o e ize Pi e. Sleeve Turn-u s/P.rotectors ftequired� Setbacks . From Wells " From Propertv lines ✓ vuw�C� �viau�ayG vva� ,/ SUffaC@ W�t@fS ✓ Public 1JVater Su lies Vertical Cuts >2 ft•) �/a � � Wa#er Lines ✓ Vehicle �Traffic � ✓ � Easements/Righf of Other Easements Recorde Co�raenent� reement -I3� s pct�d rev. 3I1310�1