Loading...
A27 103_ '� The District Heal�h Department CASWELL - CHATHAM - LEE - PERSON COUNTIES VUater�Su I and Sewa e Disnosal om�r ,�M po EMENTS PERMIT�No. r dw'ne�h �s / 1 Y_�i ate V 9_ z A.� Z 5 � e c✓ee Fa r� s N a \..�Il�itil:�Vl. � „ � Water Supplp: Private � Public Sewage Disposal Facililies: No. bedrooms �- Dishwasher, Disposal, washing machine, other au �natic appliances Size of tank: !� �� NitriBcation line: ��� %� 3� Other disposal facility: Water supply and sewage disposal facilities location, installation and protection must meet state and local regulations. Septic tank should be pumped out every 3 to 5 years an3 shall be main- tained by owner in such a manner as not to create a public health hazard. Septic tank and nitrification line MUST BE INSPECTED AND AP- PROVED BY A MEMBER OF THE DISTRICT HEALTH DEPARTMENT STAFF BEFORE ANY PORTION OF THE INSTAL TI COV- ERED AND PUT INTO USE. Date approved: Sig Sanitarian Well: Sewage Disposal: I Counter- 9igned BY� (Owner or his representative) Cerlii'icaie of Co e2io Date Approved: � � � . � � �/ ,) . ,/ //�LI�/ �i � � _ Location of well and sewage disposal faci;ities sketched on back. $� NOTE: Make sketch of installation showing lot size and shape, location of house, septic tanks, privies, water supplies, etc. Note special problems existing on lot. Write in measurements in order that installations may be located at later date. Note location of water supplies on adjacent lots. (1) � iJ �} �' (2) �� � The District Heal�h Department CASWELL - CHATHAM - LEE = PERSON COUNTIES , Water Supply and Sewage Disposal ,�� y�' � IMPROVEMENTS PERMITcrNo� (.q�!���(,� Date b " rl � ` �� � ?�Y 1''►f Contr�s`or: ��� � /.r Water Supplp: Private � Public Sewage Disposai Facilities: No. bedrooms Dishwasher, Disposal, washing machine, otKer a tonyatic appliances �` Size of tank: � � �� �f � Nitriflcation line: � � � ` Other disposal facility: Water supply and sewage disposal facilities location, installation and protection must meet state and local regulations. Septic tank should be pumped out every 3 to 5 years an3 shall be main- tained by owner in such a manner as not to create a public health hazard. Septic tank and nitrification line MUST BE INSPECTED AND AP- PROVEB BY A MEMBER OF THE DISTRICT HEALTH DEPARTMENT STAFF BEFORE ANY PORTION OF THE INS LATION I COV- ERED AND PUT INTO USE. ' J Date approved: Signe Sanitarian Well: Sewage Disposal: By: � Counter �,vt� sign ( wne • his representative) • Certiiica2e of Completion Date Approved: � ' L' B : anitarian (OVER) Location of well and sewage disposal facilities sketched on back. NOTE: l�tdtte sketch of installation showing lot size ullu shape, location of house, septic tanks, �l�ies, water supplies, etc. N special problems existing on lot. Wnite in measurements in order that installations may be located at later d . Note locati of water supplies on adjacent lots. r� r�� (1) �2� �I � � 7/' I I/ I I I I` ► �������� ����0����� -- — �� - , The Distr�et Heal�h Department CASWELL - CHATHAM - �EE - PERSON COUNTIES �� er�Sun I and Sewa e Disnosal /JZ �IM AO EMENTS PERMIT�No. r � Date � �- �y 1 Owner: f'� � " - i V c���n� , � . D n„ 1 r e - n n i. _�ti , ,. U . Contractor: r � Water Supplp: Private � Public _ Sewage Disposal Facilities: No. bedrooms • I�ishwasher, Disposal, washing machine, other sutom tic appliances Size of tank: ___���� Nitrification line: ���� T� Other disposal facility: -. Water supply and sewage disposal facilities location, installation and protection must meet state and local regulations. Septic tank should be pumped out every 3 to 5 years an3 shall be main- tained by owner in such a manner as not to create a public heaith hazard. Septic tank and nitrification line MUST BE INSPECTED AND-AP- PROVEII BY A MEMBEft OF THE DISTRICT HEALTH DEPARTMENT STAFF BEFORE ANY PORTION OF THE INSTALLATION IS COV- ERED AND PUT INTO USE. Date approved: Sig e � woii. Sa ' ari Sewage Disposal: By: Counter= '�� signed '� '��( (O ner or �s representative) � Certif'icale of Completion Date Approved: �L(�C-1—(�= BY� itarian (OVER) Location of well and sewage disposal facilities sketched on back. NOTE: ������e sketch of installation showing lot size ������ shape, location of house, septic tanks, l �es, water supplies, etc. Note special problems existing on t. Write in measurements in order that installations may be located at later dat e location of water s plies n adjacent lots. (lf � t - - � -^ �2) . � -�;'f � N� —■ ■I s■ � �,�� �� ���� ��. V ` 1y s 1� �../ � � �i.. � � �� ��v�.a-�o�.-��..����.� ����.���s. �x Map " arc�e # Sw� cilivisio�n � ilcl.rs' `Je(:t1011: OO t : # of 6ediraoms A}�plicant: w�.a ���a..�.�. � Location: Z7 � i �..n P.� � � , � e ::� � �;:� � � �:� � :". _ - , � , --- ,, : _ . . , . ; . .. ; System Type (ln Accordance With Table Va): o:.�» TH1S SYSTEI�i i-8A� BEE�! If�ST�►LLE� 1RI CfltidlPLIAIdCE iiViTH AE?PLlCABLE NORT}f �� C�ROLI�dA GENERAL STA't�JTES, RULES FOR S�KAGE TR�ATMENT AND DIS�OSAL, AND AL-L COl�dDIT1�NS OF ` THE IMPROVEiViE1VT PEi�MiT AND CONSTRUCTION AllTl-IORS�ATI�N. � ' . `�S � t( --l�--c��.o ' .. �luthorized St te Ag rtt � Date � Installed By: �•�� 1��.,...,s �- �,, � Date: u -i 4 -�� . . / e � L c h����"� � n � , _i . � �. � . , , / x°� � • r . r� , . r � fitii cts�w.n6.n1�s Wt�l1'�� 3�(S�"" , �y, . � r �_.., � �i.�� � , � _ • �.b�+� , �a�SR- � � ���-Q/'r.o.r't. � � 2 � �� ��C�J �{� � G:�1- � � �� '� i��cidw� : �re� 12a�k> PCHD, rev. 07/29/04 ti � ���ic �r��� ��:��'�-���.h� �"��'��..�� i �-�� �� - �� Tax Map #'� ?? Parcfl� #( 03 5ys�ern Type (iabie Va) � OwnerlApplicanf Subdivision Addi�ess/Location Se�fPhas� Loi # � � � . �- � Se�t�c '�'aa�k In�t�a �a� itn ��on ra� nQ�a a� � State � 1 D/date Capaciiy Tee and F�itef Baffie Sealarrt Riser (ifi a�plicabie) Tank Outlet Sea! Permanent Nlarker � �uta�u T�n�t /Sealant Riser � � ��rnp . Check Valve/Gate Valve le and audible � Rate m A �roved Pum ii�c Biock Undef Pum Pum Removal Ro . � Dis#ributio�. � Serial Distnbution ressure an a Low Pressure Pi e A r. Pi e It�ateriai �Jat��s and .Grade Trencf� UVidth � Trenct� Death Grade � � Spacing epth and� Quali �te�downs e#c. �e Lat�rals � Sleeve � � Requi�esi S�ffiac�s From� Wells �� � From Propertv (ines � � Surface Waters Public Water Si - � � � . Verticai Cuts �: Water Lines Ve�icle �Traffic n,�:,,.....,a �,,..s�,.. . Coarements i iQ ies f�.) �/Right.of other � pct�d rev. 31'13/01 ���� ��. ���� �� � � ' � � � ���� �-�',:�ra.�-.n��m�rn: ,i��.m►.�G,�.11 I�-�I �c:..�n.11 tG:il�. Comment Sheet 1Vaane: Address: Page: �'ax 1l�ap: 2 Parcel #: /0,7 I9ate Co�►�ents i� � ! � �L 2�� � �:�,� � � ,-_ _ _. � i2-�5��� ____ , __ � � �� , {�M� �� <<�� � °- rz�=�" - -� =�- - ��,5 � - �-- i���.,�14. �, j� _ brl/e�^" � —1 `•i� _ ��• -(- _ .. _ _ � ( S[�cs^^�r�. ( C(6Vw�V�` -�:11 '3� � LZ—�I�rJ — o — ��� _ — �s� �iauS� � — �— � -- - i--- -- - - - -- _ ----- { -- -- - - _ _ - _ . - - - -- - - — -- -- -- ---- ---- � Page 1 of 1 � �•' '� � \ �.:�: �` ,� � � � �� � �� � � � �, � �:�'�� � �� �.. � � - �, a . �° �� ; ,�, 'Z ` �:: � ,� �"„ � ...�...�.r .g�-� � :: �� � �� "al � �"'" .. ,.e� "�� �.. " - � 1 x;�.5 � ,� . . :� � _ '� � § � ��, �� ���$ & � �� °�§ �� � � ��� � , � � � ,: � �:b � � � � '�� , �.:� .,,:xa�� � "�'a�'��'" >y 5� . ��� � . . � =. �" � �<,. � .. ,� � . . . . �,�� �, . . . . � � � �� . . � '� � � � � � �. . . . � � � � _ � ,� '� ,, � < r �.�`,�` ; ,a� s. � a ; _ � � , �, l >,� &M � � .< „ i1 � ¢ ' & � , ,. �� �' � �' � 'h . _ ;„`7' . � �"�, ' ` . � +'E "g t r �' � � �ti r� � � � 3�'. � ���•a�:... � � £ � � � ��� ��•,5 �� ��"� . � . . �� ' ��� " x�� . � �� �, '� . . � � � �'` `°' � � w � .„,,, : � z .. : .� . ' '•° � � - . �, * � Y � — � .`.� , .. , . .. : �. � '� � .. . .�� "�� a . a��� . ... . � � � . . . x �.. �� �"�x°.:. i �� . ��'���.. ��� ��� . �� n-� � . _ '� •� ��� a � � � ��` � � ��� � a � ��. � 5 �R . . a ,�� � ; _ ;� � � , �:: � ��� �'. . . . 2 } � , . S��A� �� . . �� '; . � . . � °�: ��, .. , , ° ��� ����' � ., z� � � - � � �.: ��'�'�__ . ,°� :.� �: _� n � �- . . � � .. � � � . � ��� � ,.� w>�.a: �, � � � .. �. �� � �� � � a� � ��y � ' �q � £ i3 _ .. � �'..: r . � � �.: ��\.., � «m�`u� l � ��s � �.. .� � . ; . . .. . . y�� . � � . . . ` . . �� � � � �1 � . �:� � � � . �� ,.. Y� � �. � .. ' 1�1 \� �'� �'�`� �. g . ,, a ��. � ��� ,. y� � a� � � � �a � a � ����� � �� � �,��.� � � � � ''� �+" �, e t. � � � '� ; . � � � �° �„ "� ,� � � < � ��_ �i , � .i.r .. � . �. „�r � � �. �r - � �d� ..�• � . . .. ��i„ .. � � ; � '� � � � � ` �,�a�� �� � �� ��' � � -� � �'�� � � '� � � �..� �� _ � � ��� �",� � � � � � .,�� � .,., � � � �, ,��� � � W � � �� �, � %� ��� � �` � � � � �� :� T �•, �� �, � ``� ���� � ��. - � ; . �,� � , s �� � � �� � � � � F � ' v�- ' 9,' � � . � � �' � ..� � . 1 V' � �... e z- ���� �� 4a_a � �u � ��, �� .� �._ �. � � . � � �. ��;� � � : a �� . �r5 �^`- � �". . � ���,.,,: _ � . Scale: l� �25 http://gis.personcounty.net/connectgis/Map/connector.aspx 4/18/2006 ����� � � ��� :� Page 1 of 1 ;w»s >��",�� ,�����,—F�cr�c�nY-nr�— -- a�� ����:' m� ;z>;. q» 3''+�"`� �r - � c,r� -'s . .. '�• ,�.�.. �.,,,�,.,..� ,�4 °�. � y, '. �" � , �"` � "> w � �, , �'s � � st � � . € 4, .- . �;^ L �"aro . � � a � � ��sl � s g�, �h.�4 ' �.a�.� i� b�g� .� ,t# �A. 4 �A , �. . �&� � n,°i ". -:�d. }� r '' � �q,�,a�.� "� �' , � � F• � ti _�_. ^.� � �F .,� �F�� � . .. ;�" � r � z i z '�a� x� . ' � ��! ,\ 4 �� �� :�� ek ti� ' �4 " y L a � s t�, a, �� ' 4 q �'1F'' � �" . . . � �� ' � � . � s � �� �, Ar ' ��. - � '� ��� k �'F � . � ��K'� .�.F.�� �i �- �' ..� .�. E �� P s w� ��h y s���, `�`��j R��i�d �i.� y� C.L .& :g;•" A .`�q, ��' � ,� ' �; 'y ' 4. a� , , S � E '$ Cz a � �. �'6 � �g4' � �-�^ �'' ��dt -a �=Si:i � ,�� �������6 s,r _ �1 : "-'y �'�� � , � ti�, '��.�� ,{a,� �x ��t k r ��� y z � c� � . r a -�ia� � .. .�. b �,� � i�''1 - 1 :c:;: �,+,+, � � � "�" -. � -y. ��. � c�,�" � � A, ��.y za -�'p . �V . _ •f ft �.,i 't s ' 7'. F s+f.'�°�• a:. .� �, � � `� � �' �� 'i t +� �i s"s.,� �-: . ��l r *y� i,'.. � 1 �'f-.i � .�.i3 ��� � � s��y� � . ��. S 1 a ,� , . � ��ae� . . `��s tR'j. - �'q�,, ar ,'� < � =ic ' �. �� *,�r _ � � �� �. < „S ._ �� , i. .a� � � ; . .�1,,,.a� ��0� , w � �� ,;. � � . E ���. �x.l: ��q ��� E [ � Y < ��^ � 9 d��� � a � a� Y a � � � � %q T- �. ' as =. . �. 5'��. Y 4 �� b � , . �` � �i. � � �"a I i L �'S { t i ; �= � �� ^& � � � � r� �� �.�'� � . S� u . � 1 t ^ � � �y "� , ii rp . *` ��, . � r r � o �� s _ .E: r . , � p� � "�,`'r � , : , `�� ^�. _ � � s '� �,'a �"� �� �� a� .�, . t, � . � �� � � ',� M� `=s� ,� i : .�- j a� w�r � � � ,. ` ,�s �.,y.g � � ."�� � � � . i ,� 2" ��i��, "� f � i� �� +' � � Y�`.:� r "�a . s "� .. �r° � � F a# � ,�" t .F+' � - ��d � ,�°* � � ` + � �r�����' �� � +"`'.�� .�,. , , ,�, a _ � � g � ., . . � , * .� . �,.. � { � . , � � ����. � s a� � '. � ` � � � �9 4 a �$� �� � ���- { '�£ : w � ��� ''.�h"Y �eh & g�� � � � � ',� . . , � j �. � �. �, � �'a �.�� � ^„ . �>�. « v "� � 6� ` � a t _ � +.. � ��� m � � F � �* � � � ��' i °�5�� �� �� .� � '. �� �' `� . > - ����; � �: b �� �,�`: e_ �'�a a ,� "� n r,�L� � x � " �' � `� � ' ��� „; � � � � �'����� � �'� � �� � � �� �� �. � � �' ,�^; ,x� ' �"��:� f ° t ':,� � � �' ew � .o- � �:�.. �' , "'€ � `'k g � ' ' iyF' E ° � x.:a �� �, � �`�" � ` . � 'a �'� g��4 �a a ' y� ,� ` ,: � +w:,��! t'* �'i ;� � � � � .�� � � � �� ����� � x �,. � �� �s �a�� ,r� , �a'� � '�.. ��$ �;y� a� t �a;"wa„>_ � , :s � ��>rx 4 �° y� u �� � '�A � � � .. d � .�-� . �� < -'�,��'... ,�d ��; ` ' a Y Scalc I� �2qq��� RECN: 3 373 PIN: 9 986-00- 8 6-4104.000 SUBNO: -999 NAME: LAWRENCE CECIL TOMMY & ANh` MAR NAh�E2: B/LL/NGADD: P O BOX 641 CITY STATE: ROXBORO NC ZIP:27573 DBSCR: 31 & 98/100 ACRES TAXMAP: A27 ] 03 ACRE: 31.98 CAL CACRE: 31.24402G5631 LANDVALUE: 171080 BLDGVALUE: 393107 OTHERBLDG: 6943 SALEVAL UE: 1 SALEYEAR: 94 C(IRRENTVAL: 571 I 30 PLAT: DEED/300K: 234 DEEDPAGE: 270 TO {VNSH/PS: 108 !D KEY: 15972 .. 4 � � '� i � .^ _`*. ,� J i . .� � ( .iz � L '�+o..../�...�. '� a � :n 3' � 2q �� ,�'�. ��' � � � ' � � u. -_ � a � s �a ` � � '�.;.� •1 s ��,�;, �* , . r � y �*� � � ,,,: �xu �� u ' � � � '$= � 4 < ) @ � 2 � � �� �'-b 2 Y : � f��M1`'.�p �" q> d �� � � '� = ; � L�., 0, e a,�.� . �; "'. m atg<: _.. � iJ�7U �� � � ���� � :t�t� .:_ e'i "`_.� .. . http://gis.personcounty.net/connectgis/Map/connector.aspx 4/18/2006