008152199 SEPTIC DENIAL - Laserfiche WebLink

- P RMIT-4 3 INSTAL --9-- ER*I - -❑- REASONS FOR REJECTION 4 tticruana WATER-- SEWAGE DISPOSAL SYSTEM N • g� Acres /35 (1) Void after (12) twe v - months- (2) Automatically cancelled when site conditions are changed from those shown on permit. (3) Automatically cancelled should facts later become known that a potential hazard would be created, by continuing installation. FHA /VA ❑ Yes ® No Date Case No. 1974 79 • Owner M. Butte Address 2019 Joanne Dr., Troy, Mich. phone 31_3/6113 -7821 (Mailing Address) y+ � O Occupant pat �'opp� _ _ Address Phone J*[ (Mailing Address) Exact Location of premises Rt. 7 E, L on Lakeland Drive, R on Thomas Avenue, to corner of Lake Dr. and Thomas Ave. (Subdivision, Street or Road Name, Section or Lot No.) FOR: ® Dwelling ❑ Other Automatic Washing Machine Yes ❑ No Consumption 600 gal. per day Actual ❑ Potential ® Bedrooms 3 Garbage Disposal Unit ❑ Yes ® No (❑ Actual ® estimated Water) Additional wastes _ dishwasher --� Yes No (1) To ATER SU "installed LY (ExistiClass d lass Approve. . ❑ Other ( . ft. to be groute. ft. (Unless su rted by pose - ve evidence Cla-. III is to be conside d as to be installe.- SOIL STUDY Naturally drained, suitable by sight ❑ Yes ❑ No Technical Classification ( 2 ) Krowr Estimated Percolation Rate 1 -10 111 11 -25 11 26 -50 ❑ > 51 ❑ Percolation Test Required El Yes No ❑ Rate (Minutes per inch) (Minutes per inch to nearest 10 minutes? Depth to Grey Mottles Lwe 4 7 _ inches (estimate over 4 ft.) OTHE R feee • infPa " ;l7 'VT / 1 // Surface drainage required ❑ Yes ❑ No OTHER DRAINAGE HOUSE SE • R LINE Size ::.•.: - -- Type of = erial required py 4r,p' tance from Water upply 15+ fe- - (4 ) D' AILS OF CON RUCTION Water .ht Septic Tank of .. Material Li. id Capacity • i.• gallons. insi.. Dimensions ength 8 •et. Width feet. Liquid De- th 4 feet. ,epth of Air Spa. a __l_ __fee SUBS "FACE ABSORP ON FIELD Num•: • .. - .. • - Ty. a aggregate required NIII0 r. • ' :•ne ( 5 ) Tota' Depth of - ..regate from base .f tile to bottom o •itches 6 )inch-- AI : wable fall 2 o 6 i hes. aggre.- e minimum depth inches or ore. Depth of drainfi: d to in •es from surface of ori.' al ground. Distance from ell to septic tank SOT fe -t; distan.- from well to drain e • 1 + eet. r Rough Sketch of Pr -mises (including adjacent • operties if •ertinent, Showing - ocatid of of Line, Buil.ings, Water Supplies, Sewage Disposal Systems, Trees, and Other Possible Sources of Contamina ion of Water Supplies, by Indica ingDisttances nd Slope with regard to one another. A SEPTIC TANK iN I ALLA rIOlNN 3 So (' 3711 ft o IIII d I, 01 �y 4 Lt � 04-----. A j a i . , . , r g i ' I Q OW), T r) +' o - ^ r C 3 0 0 ) I" YO/ 7 -1:- feet a Note: Owner or his agent must notify Loudoun C©unty Health Department, Phone 777 09-th when in- c stallation is ready for inspection. If any Sewage Disposal System, or part ther of, i s covered before being inspected by the Health epar a t, it shall be un- °' covered at the direction of the Health Director or his agent. CONDITIONS DISCOVERED DURING INSTALLATION MAY REQUIRE ADJUSTMENTS OF w SYSTEM DESIGN. Changes from above specifications require Health Department approval before being made. Based on the above information, the undersigned recommends that this permit be issued Date Approved Date (10 / / /79SigneM - � - _ - _ - ' LHS - 121 REV. 12/71 (Reviewing Authority) / (Sanit.rian or Health Director) Virginia State Department of Health DUPLICATE