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PUMPLINE TO DRAINFIELD 13A
SEE PIAT CABINET 16
PAGE 491-496
FOR PUMPLINE DATA.
3"PUMPLINE INSTALLED FROM LOT
TO OFFSITE DRAINFIELD AND
PREVIOUSLY INSPECTED BY THE
PERSON COUNTY ENVIRONMENTAL
HEALTH DEPARTMENT.
REFERENCE IS MADE TO THE
RESTRICTIVE COVENANTS RECORDED
AT DEED BOOK 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 BE 10' MINIMUM SETBACK
FROM PROPERTY LINES AND 25'
MINIMUM SETBACK FROM THE
Bt1ILDIN6 FOUNDATION.
CONSTRUCTION IN THE PROPOSED
BUILDING AREAS MUST MEET ALL
PERSON COUNTY SETBACK REQUIREMENTS.
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12' PUMPIINE � _
EASEMENT -- � �
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7A
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�-- PUMPLINE
IEASEMENT
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16A
T—
� 26A
I NSET DET'A I L
DRAINFIELD
LOT 14�
SCALE 1"=50'
22A
DRAINFIELD DATA
LINE BEARING DIST
L-171 S19"18'24"E 82.87'
L-172 S02°13'S5"W 56.94'
L-173 S30"04'22"IH 13.25'
�-175 N40°46'34"E 25.52'
L-176 S69"06'29"E 51.52'
L-177 S00"56'40"W 107.10'
L-178 S02"02'39"W 34.70'
L-179 S09"O6'13"W 37.79'
L-180 N70"14'03"W 44.84'
L-181 N16°42'24"E 17.12'
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Applicant: v9 �►`°�2
� �we 1 C � � ►,�t", � � n
Improvement Permit
Permit Valid for: Five Years Non-expiring �
Type of Facility: '�1�� i i��o S• New X Addition
Number of Bedrooms �/ Oc upants / Emplo ees / Seats:
Proposed Wastewater System: �
Proposed Repair: `J� r�� ��ca�. � i d�--�
Permit Conditions: '�0�2 S/'� �� `� h
Authorized State Agent:
(X) Owner or Legat RE
Tax Map: Z Parc�e�} : ��
Subdivision 1K�S
rhase/Scction/Lot �
Water Supply: �/�%`e � �
Projected Daily Flow: fn O gallons/day
Type: �_
Type:'�
Date:
Date:
The issuance of this permit by the Health Uepartment does not guarantee the issuance of other required permits. It is the responsibility of
the applicanbproperty owner to insure 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 is not affected
by a change in ownership of the property. This permit was issued in compliance with t6e provisions of the Piorth Carolina °Laws
nn�! Rules for Sewage Treatment and Disnosa! Svstems'(15A NCAC 18A .1900). Neither Person County nor the Environmeatal
Health Specialist warrants that the septic system will continue to function satisfactorily in the future, or that the water suppiy will
remain potable.
Authorization to Construct Wastewater System
See site plan and additional attachments (�.
Proposed Wastewater System: �Cl�p Pp�— v�s� V' �*)TYP�� Design Flow �i�� gal./day
New � Repair _ Expans oi n��' Soil LTAR. ��3 � gal./day/ftz
Type of Facility: �✓f 12 ���'. Basement: Yes _ No
(*) System Types Illb, Illbg, IV, and V, reguire periodic system inspections by the Person County Hea[th Department.
Wastewater System Requirements
Tank Sizz: Sepiic Tar�k ��� gai. "
Drainfield: Totai Area ( �� sq, ft.
Trench Width 3 ft.
Pump Tank � �Oc� gal.
Total Length � 0 � ft.
Min.Soil Cover � in.
Grease i rap `� gal.
Max. Trench Depth � in.
Min.Trench Separation � ft.
Distribution: Distribution Box / Serial Distribution . / Pressure Manifold
Specifications• � S���C Sl�'e�C U�w! A'� r v� ���� � s�"� �
Authorized State Agent: r'� vy'�.✓ Issue Date: (` Z�" � 5
Permit Expiration Date: �'- 2L�— 2 c�
The system permitted is: Conventional /Accepted �/ Alternative / Innovative . I accept the conditions
and specifications of this permit.
(X) Owner or Legal Representative: Date:
Person County Environmental Health, 325 S. Morgan St, Suite C, Roxboro, NC 27573/ph.• 336-597-1790 (rev 5/12)
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� n.avra��aa„-�+-,• a�a.a��.� ���asn.�.tL-�a
NEMA 4X Simplex Contml Panel
4" X 4" Pressase Treated Post � �
Sloped To Shed Water 12" Separation I
� Electrical Co�duit � I
. � � � •�
G° Covar • ' � Access Coves� .• ,'' e~' ti i I
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'�� ► � ; ':�. ; •.t`• '� . ;
� �• , ` • - - . .
. �,. Opening Filled With � Anti Siphon Ho1e' \
Inlet Fmm Septic Taak Portland Cement Grout �D� ���
4" SCH 40 PVC Pipe � •
� Cl,eck
• Valve
� , High Water Alaxm Level
(6" Separati�on)
High Level- Pump On -��
� . ;: � � f[ rVapoxLock
Hole
' • � Drawdatim �Up H�71)
•Law Level-Purnp Ofi' --•---�
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,-.. :,
' Precast Concrete Tank 4" Co:uxete
� � ;•; (Mate3ialStiex�gtk>3500PSI) B1ock
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T�x M�� r P�i�cel #
Suhcllivision ' �' ' "
Fl����s�e S�ct,ion'Lot #
Duct SealHoth
Ends Of The Coxu3uit
-�- 24" jyIinir�n�m —i
.. .� .,
Threaded Gate Valv�e
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Concrete Riser
�" Separation
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4.,�....-Pozt].and Concrete Gmut -
_ , _. Masti.c - - ; .
Zip Coxd �• , � Opening Filled With
Ties Supply :' portland Cement Crmut
Lixis • • '
Outlet To Distnbutiox
FNylon 2" SCH40PVC Pipe
F1oat Wires ' .
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i
FJoats . ,
_Itemovable .:
F1oatTree ��
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'�7 ..
••\;t� •�• �.
�� 5 0� GAI,L�1�T PULV�.' TA1�TK
P�RlP RA?ING �
Pnmp Hus ge Rated ro Deliver
o2���Gallons Per Hinute ,
Agaiast � Feet df Tota.l
Dynaraic Head (?DN) .
rycr�v�
I3��avo�a
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- � � ���`� G�e �Q���e 1 �
lE;�-�� ��¢�.0 �ti�[�.�.JL.E� Owner: `
Tax Map: �% Parcel #: Date: ��Z �i'� � 5
I.ane T�p Tap (Sc�) Tap �'lo� I.ine t�ngt% �ovv / f�ot
# i?iameier(�) ( m) � � � (ft)
� 3 �{o �2„ /So � � � g3
2 �(v 2• 5 /So � -08
3
4
5
6 ��
7
8
9
10
30 � ft of line x 65 al. per 100 ft=��s W'—'� : 100 = LQ S g�
75% x� ga1= � ga1 per dose � gal per minute (gpm) _�'low Rate
I'riction �ead /
Loss: � Z ft per 100 ft of supply line x'" `� �0 ft of supply.line = 100 =�' S
`f' � ft x 1.2 = in ft of friction head
� u� p ���
ft i S �-c+n �
q�� p�-o�
Manifold Size: �_" � Force 1Vlain Size: �" PVC
�otal D y namic �$ead = S� ft of Elevation head + 2 ft of Pressure head +�P ft of
Friction Head = S� TDH
� �l�e�. 1-,-��P
Pump Reqtaireanent• � GPM @�'� � ft of Head Q��r� �(,
Drav�down: �`{ . al per dose ��T gal per inch =�`� inch dra.wdown per dose �r
30
�ea�a1 I9esig� �for�ation
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l�Yaaifold Siz: ! � Ta s
u%ld Max �To. Taps off one side
;� (a2ednce b �/z ;or ta in �oth si
li4" t3 S 3/a" tap9 �" �
Z" 4 =
3� g 5 3
dU+
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� �`low er'iap
Size �Llcu¢rial Flow GPYI
<; �� Sched 80 �•�
�. " Scsied 10 %-�'
;, » �cl:ed 80 10.1
,, .. Scited 40 ?= '
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WELL PERMIT
(New�, Repair_ )
Tax Map: �� Parcel: � Q �
Subdivision: �_�P,�Qrv�
Applicant's Name: �� V�D SQ
Mailing Address:
Phone Numbers:
Lot: C�
y�: Z� �.�, �� v�e l C �„ ✓�e�. —� ji
� —�� � a� ..P� -� L d-F-
�CS��s
Permit Conditions:
1.) See attached site plan for proposed well location.
2.) All applicable State and County regulations governing construction and setbacks apply.
3.) Permits ezpire S years from the date of issue.
4.) Issuance of a permit does not guarantee a potable water supply
Other Conditions/Comments:
Permit issued by:
�Tew Well:
EHS/Date
Location:
Grouting:
Well Log:
Well Tag:
Pump Tag:
Air Vent:
Hose Bib:
Casing Height:
Concrete Slab:
Well Driller:
Pump Installer:
Approved by:
Additional Comments:
Date Sample Collected:
EHS:
Person County Environmental Health
325 5. Morgan St.,Suite C
Roxboro, NC 27573
Date: ��'"(
Certificate of Completion
DI.iner:
EHS/Date
Depth:
Grout:
DAbandonment:
Date:
Method/Nlaterials:
License #:
License #:
Date:
Date Results Mailed:
Phone:336-597-1790 Fax:336-597-7808
11/26/13