A24 183� ��� 4� I�I�I����T
- . � .:. � :�:�:v���
�����o���� ����
., � ,�I�=SH�, -CH �
�Naaie: ��- �� �.' Tas Ma� # Z��Paxcel # � $ �
��S�i': �' � � .e . u�e.: ; .. secdoa/Lot#
�+^ `^rC„� ' _ Z—1
Authoiyzed State A�eat Date
S,ys�remcdnrp'otrenisxejiverentappioxi�ate�rontonrsonly.' Thetonttuclbrmase,�lagtherys7empriorlb
begiruiing�lrs uu�tallatian ta i�tsr!trthcap�nperg�ds is mainfarired
. . r - � . . --- - � . _.
,
/ 236
N
v� �, ��a� � e�
� s6
c
3�� PVC
� c's, � CONNECT I ON
-o �
� � \ � Z�z
��
�9 �
\ `�c�\
�� �l �� � �� CE
l=5
�.. �
�
N
1�
�
SEE NOTES
12'
PUMPLINE
EASE�IENT
�-1
___ �
_i 1 `
7r �
1
3 +r �
s�6 ��3
30A
420 CONTOUR ----��
�
CE � j
146 (
� � V
�M � � �_ h°' l��
�o
u
/ (50 � ���'—j
� �3.as �
� �
! 2A . �
!
J /�
------t___ __ L_ ---
15' PUMPLINE EASEMENT
7------------------
� "PINESBOROUGH ESTATE"
� P.B. 11. P. 16
238 INSET DETAIL
DRA I iVF I LED
LOT 6A
SCALE 1"=50'
w
�
�6A DRAINFIELD DATA
240 �L-143 S03'S3'13"W 75•28'
L-146 N88'49'58"E 61.06'
L-147 S01°32'S8"E 41.16'
L-148 S06'13'58°W 43.37'
L-149 N88°25'15"W 19.94'
�
�r 15' PUMPLINE EASEMEN=_
/ �/
/ '
i
3" PVC
CONN CTION
� �.��,��
� S
�,� ��
' D,
J�� '
PROPOSED
BUILDING
AREA
,
` �
.
�\o
CAROl.INA POWER
& LIGHT COMPANY
HYCO LAKE
y.- �so �� 3.zs'�
PROPOSED
WELL AREA
SEE NOTE
� � �',,,-
dr4� � t� elcQ
QY� .
6
1.20
ACRES
CONTOUR
Nj j h, Mu+rv�
�H Ka�p �`��ks :
/� ��
�---•
�l( — 50�
� /y _ ��r
� 0�
��,.�-�,,�r �; we - 1
�uS.e_ — l � �
t
, L.aK�.—� �a
1,,, 5�r
=
� �� -
� y
�
\ ��
\
\
\
� N62 e
\ \ 2S� 9 � 72..
� • 2a. �'
\
�
\
\
�\
3" PVC
r.nNNFr_srnN
�
`� CE
\
�
\
NOTES
PUMPLINE TO DRAINFIELD 2A.
SEE PLAT CABiNET 16
PAGE 491-496
FOR PUMPLINE DATA.
3"PUMPLINE INSTALLED FROM !OT
TO OFFSI7E DRAINFIELD AND
PREV.IOUSLY INSPECTED BY THE
PERSON COUNTY EtVVIRONMENTAL
HEALTH DEPARTMENT.
REFERENCE IS MADE TO THE
RESTRICTIVE CBVENANTS RECORDED
AT DEEO BdOK 856 PAGE 428.
3" PVC CONNECTIONS SHOWN ON
THE LOT AND DRAINFIELD ARE
APPROXIMATE LOCATION ONLY.
WELLS MUST BE 50' MINIMUM SETBACK
FROM ANY DRAINFIELD AREA OR SEPTIC
PUMPLINE EASEMENT.
WELLS MUST 8E 10' MINIMUM SETBACK
FROM PROPERTY LINES AND 25'
MINIMUM SETBACK FROM THE
BUILDING FOUN�ATION.
�
�
P�:iH:Ov�c�
��
�u
,
ub
���.�� IPI��.���
,---= t-�- � � ����
�-� �P-��-� �
IE;��� ��¢�.v. IHi�,�.11,e�. Owner•
Tax Map: 2 Parcel #: 18 3 Date: I�-Z —( S�
I,ene Tap Tap (Scfl�) �ap �lo� Line �engtla k'�ow /�oot
# i?iameter(in) ( m) �:� ft)
1 � o . 50< <zo
� �� Cd � , z o
3 50' �Zn
4 So' .z�
5
6
7 Z v`P� o
8
9
10 �
���' ft of line x 65 gal. per 100 ft=�^ 4 �l Q; 100 =�' �i gal
75% x �� ga1= � S o gal per dose � gal per minute (gpm) = I+7ow A�ate
�'riction �ead �
Loss: � 5a ft per 100 ft of supply line x"'' ��a ft of supply. line =100 =�_ft
� ft x 1.2 =�_ ft of friction head �. �
Manifold Siae: �" Force Main u�ize: 3 " PVC
�otal Dynamic �e� _��ft of Elevadon head + 2 ft of Pressure head +� ft of
� ���►� ��e
����
a,���°X�
Fncnon Head = �_TDH � � ��,,, Q/� ��
Pump Itequirement: �� GPM @ 5 3� ft of Head g�%'r ° x.
Iirawdown: �So �al per dose ��l gal per inch = S�� inch dra.wdown per dose
30
G�ea�ai I9esig� �f'or��ion
i� . . ,.t ..
��
�����rs . , ,. ,.
i I i i
�u �i► �u �i�
� 1 � 1 ,,:,1,._-
9mema � ' r
�
_ �
� - .�
1 �
�cc�»�omno
::::..:..::.::::: �:.:::::.: � �::::
..........:.........,..........-..
� �.
3"
E��
4
off one side
4�1+ � 2I � 72 I
� ' i'!ow per Tap
Sie hlcuerial Flaiv GP3�1
?•z " ScJ:ed 80 �.�
�. � Sc}ted 1p %._
;4 " 5c1:ed 80 10,1
,, ,. �clied Sp L.�
:�
`�--,����,� ����� ��
��•. ,� 1�� � � � � � �
I��w-a�-��.,�-m. ���.;�.Il IHI�.�Il�I�
NEMA 4X Sunplex Control Panel
4" X+1" Pressure Treated Post �'
�
Sloped To Shed Watex 12" Separation
� Electrical Conduit �
5" Cover • ' � Accets Cover• .• , ' . � � 1 �
� • - .• ;
.. , � � - . �." :1
• � � - , . '�• . . ;
�,, Opening Filled With Anti Siplwn Hole' ,`
Iz�let From Septic Taz�]c Portland Cement Crraut (Dovm Hill)
4" SCH 40 PVC Pipe � Check
, Valve
High Watex Alarm Levei
(S" Separati�on�
;.,,: , High Lerel- Pump On
� ; �' �n rVapozLock
• � Hole
• •; Drav�down �Up Hi11)
. Law Lavel-Pump Ofi
T�x M�� � P�rcQl # '
Suhciivision /,� ' � • �
PIi���se Sact,ion"Lot # �
Ihut Seal Hoth
Ends Of The Con,d�.iit Concrete Riser '
-� 24" Mininnim
' • • � • - • ' • . • bu Separation
T�readed Gate Valve • �
Union . , • ' :r .cfiy�' •
.• �
'�r.-Portland Concrete Gmut
Mastu • - •
Zip Cvrd . � Opex�izig Filled With
Ties Supply �'� portiand Cexnent Giaut
Line • • `
4utlet To Distnbution
•(-Nylon 2" SCH40PVC Pipe
R°pe Float Wire! ' �
� .r
i
i � Floats , ,
♦ • ..
' �Removable �•�.
F1oat Tree , ,
f ' � Pump .:
,-.. s .
Precast Concrete Tank � 4" Con�crete - '
;.; (MaterialStrength>3500PSI B1ock � I "
, � . � , . . . . . . _ , •�.
� �`:� ' : • �. . ' _ . • - . •` • ' . ' ' ` • ' '. � � 1 • �. ' .
l s� � ��La�v � T�x
�ur'�P ���
Application Date: � s ,� p� /� �� c� -� �� i�� ��� Tax Map:
Amount Paid: � 000 , OC� ���� • ` � � � a � Parcel #.
Receipt#: ( 4 3�-4 I 7 lS0 �- c.i�`�k IS' 16 C�,� � �..�
�� ���� S� ������ � j2 �d�
1 � � � ' � �`' � <C � �� � � 8��� S�� ��"�1P
��rav�n u�ea aa *•-+*� �c�, ua �..en.11 It�l aem an.11 �l�n � ��,'� �`�•
�
Application for Serviees (Septic Systems and Wells)
Services Re uested
Improvement Permit (Site Evaluation) ❑ Construction Authorization
$200.00/$300.00 (if > 600 d (Fee is de endent on the e of s stem erniitted)
❑ Mobile Home Replacement or Building Addition ❑ Permit Revision
$150.00 (if site visit re uired) $75.00
0 Well Permit (New/Replacement/Repair) ❑ Repair of Existing Septic System
$300.00/$200.00/$75.00 Application: No Charge/ CA $150.00 or $300.00
1) Service ques ed�j -�--
Name:���� \�-�`�t,'. Jf" Phone # (home):33� ��/"���%��.�
Address: � `� �>. . U.r-c (work/cell): :�3 • _� - �� '
r ; n. . � OZ
�Orl"� r' ��7GLttV��W� �
2) Name and address of current owner (if different than applicant): �
Name: `'S' � m� -
Address: �
3) Property Description: Lot Size: Subdivision: Lot #: — ��p�• 3�
Address and/or directions to Pronertv: _. _.
4) Proposed Use and Type of Structure:
Residential �. Business/Type: Other
Number of bedrooms � / Number of people served (seats/employees):
Basement: Yes � No (with plumbing: Yes No _�
Garbage disposal: Yes No `i�
5) Water Supp1Y:
Private Well � (Proposed � Existing _)
Community Well: Public Water System: .
Are there wells on the adjoining properties? No _
Yes '� (please show location on site plan)
Note: A completed application must also include:
➢ A plat/site plan of the property that shows property dimensions and the size and location of all
proposed structures.
➢ A signed copy of the `Lot Preparation' form ver�ing that the property is ready to be evaluated.
I am submitting this application to request services from the Person County Health Department. I understand that
if the information provided is incorrect or if the site is subsequently altered, or if the intended use changes, all
permits and approvals shall become invalid.
Signature (Owner/Legal Representative): �- �� Date • '�.� ���
10/08 Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790)