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A25 175• PERSON COUNTY HEAL"TH DEPARTMENT WELL AND SEWAGE SITE, LOCATION IlVIPROVEMENT PERNIIT Tax Map # �� Parcel # � 7.nninu (� 1...�.- (� .�-1QiVl�II�iD �1111%NI N� LIM . � � c� a Location/Address o,� (�, �f �tf I ���w b.l�J's Subdivision Name n CI �"' Layout s� _„v� Pn�'-��,n� 7� �3�� � � A 1258 L'dLC ,]�—� � % _ � �s C eG. � o��i2 Lin�� S.R.# 1,33 /�o � s/Q Lot# As Installed , _�°O� �%' (�" . �' S�� �_�oo� �n' _\ w 23' tJ�+�e rc�' 'Qr �Y s' ` ! ��� �r-o e,.�=j /,:e SEWAGE SYSTEM SPECIFICATIONS Repair Lot Area ize of Tank G� SFD �/` Mobile Home Size of Pump Tank �►� Business �# of Bedrooms � Nitrification Line l�fl� ) 3' Max Depth Trenches '' Permit Void after 60 months. Permit Void if not in compliance with zoning regulations. Permits may be voided if site is altered or intended use changed. Well and Septic,�i Layout by ,�.�2 cv�� �,��Pr�,�� l�.�%� � L��}��•�.w C'nmmPntc �a, / x':7_ - .!%i _ 17.,�i�� _ i'i..�, �r 8!���� „1 d�.� `-fyf Date `7 - )�f - �Gt�►..�.�.— oC, `�- LS 'd -`� � � � �� 7��/Qq • WELL SYSTEM SPECIFICATIONS ; Individual�_Semi-Public Required Slab 1� Public Replacement Air Vent �1� '1 � Site Approved Required Wel� Well Head Approved Well Tag (� �1 �� �4 9 Grouting Approved `1 1 �q � � Comments: w e � we � �o � °`^ � ,,, �•. Date r%— /t��� Insta led by [�j�n��r�P� Appro ed by This report is based in part on information provided the homeowner or his/her representative in the application submitted for this pemut. The envitontnental health specialist is not responsible for false or misleading infotmation contained in the application. The environmental health specialist is also not responsible for concealed conditions on the property or for statements in this report that may have resulted from false or misleading statements provided to him in the application. Neither Person County nor the environmental health specialist wazrants that the septic tank system will continue to function satisfactorily in the future or that the water supply will remain potable. c:\amipro�pennitsam O1/95 rev.1.0 ORIGINAL r IS • OE3 �41 � �L9 � -, �' S6' 37"E S>, , ' , , � . 50 . oo � �r 3' 23., ;-� . 9� � � .3�, , � ., IS � �s �Op , ! . , . -- �. _ US�� w ; � '`'—�. ` �. - s7s . ` ��, ` ,,� � . �, � � � p3 , �. ,� I � , • , SQ � �99. ,3�,E. _�ti� �" , `., o `�. -. ., ,� CC 48 , �o '� � � �- �- � , `�, �S � 5 �- S � ��� ~ � . , ,� N� , . As���. `' -- A � .� �._� 2 O %� C . �,,�,g _ 8 0 , � T ~`''— .. �`� �_ .. „ „ �� � 5 g �, � � � � � � n�/,�'� `'`. ._ alrl/Io � ! ��14�01/1�1 [� „�I��e �b, � ,�I ��� 6 7 ' �2 � •, I IS � � `'--.--._ �] ' �,-� , I S 8 . ' S � ,. u �.00, w . .: 1---� "�'� 8 (� 1 W . 2 � ��-1d z��-�s p0o� Oool-S�/ N 339 8 � ' , ,8���'Sga � �;/,L ��Pl,o� ��v � , >i� . 0 U ��� ---�. ���/� l, . ; . ,. � 4 /� . �utr*tE�o , �sE1r�NT 6�-0�- �b-�-� bb- I � : ;�: I S 8�. op , , , . s1 n��� ��} �1�'U I S / � •'V � \ � w � � � 1 . � � : ._. � � ' ' �o � .00 � � � ;� � A � . � � • � ' � /' ,s �'��� s � _ J�8 .0 � � . , S9 u � 1 ' 01/01/1995 22:07 8044547843 BENNETT WELLDRILLING � �,..i : . �. .� � .. .�. �� y : i � ��.� YERSON COUNTY �H���noN*If.r.7.at� N��I.TF w'EGL I �,; PAGE 02 � .. . . �)�lC:__� _,i _,('`�, ., ; (�wncr: � _ � ..0 • d.�� - �- - _ .. .� . _ _. Slti► _ ,%� �� l.c�z'att�►i� l)�re �orts. _._c�n� ._. .. . ,G � � ���� -L��.G_�O���tL��.:.�1.�� ._.�'�rsr�,��',�, �-� -� - -- �-��-1���. .. . ._.._. _.._.�.__..____ �_ `�,�!•�lii��isi�rl N;tme: c��u-� .. . �� _ . _,. .. . . . 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