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> Orange County Health Department <br /> f Environmental Health Division <br /> P.O.Bog 8181,306-C Revere Road <br /> Hillsborough,NC 27278 <br /> Phone 245-2360 Fax 644-3006 <br /> www.co.orange.nc.us <br /> WASTEWATER SYSTEM CONSTRUCTION AUTHORIZATION <br /> Parcel Pin: 9843137930 TMBL: 3.55-4 <br /> Application Date: 03/29/2005 Permit#: CA05-00133 <br /> Applicant: NC UNITED METHODIST CAMP Owner: NC UNITED METHODIST CAMP <br /> Address. P O BOX 10955 Address P O BOX 10955 <br /> RALEIGH NC RALEIGH NC <br /> 27605 27605 <br /> Phone: 919-304-39001 Phone: / <br /> Property Desc.: S/O SR 1120 Lot Size: 201.05 <br /> Prop Address: 4300 CAMP CHESTNUT RIDGE RDDIRECTORS HOUSE-CAMP CHESTNUT RIDGE <br /> Permit Type: RESIDENTIAL REPAIR <br /> Facility Type: RES SFD IP Number: IP05-00220 Expires: 03/29/2010 <br /> Water Supply: Community Well <br /> SYSTEM SPECIFICATION <br /> Wasteflow: 480 GPD Primary System Type: Conventional(Shallow) System Class: He <br /> No.of Bedrooms: 4 Nitrification: 530 Ft.X Mt.Wide <br /> Septic Tank: 1200 GAL Maximum Trench Depth: 24 In. <br /> Min.Pump Tank: 0 GAL Horiz.Trench Separation: 0 Ft. <br /> Other: Innovative System Type: <br /> Repair System Type: System Class: <br /> COMMENTS: <br /> I: PRECONSTRUCTION CONFERENCE REOUIRED(added by script) <br /> 2: NOT DESIGNED FOR GARBAGE DISPOSAL(added by script) <br /> 3: EXISTING SEPTIC TANK MUST BE PROPERLY ABANDONED BEFORE Q.P.(added by script) <br /> PERMIT CONDITIONS - <br /> * REFER TO THE ATTACHED SITE PLAN SHOWING THE SYSTEM AND FACILITY LOCATIONS AND OTHER SYSTEM SPECIFICATIONS <br /> * THIS AUTHORIZATION SHALL BECOME INVALID AND MAY BE REVOKED IF: <br /> * THE INFORMATION SUBMITTED ON THE APPLICATION IS INCORRECT,FALSIFIED,OR CHANGES. <br /> * THE SITE IS ALTERED,OR <br /> * THE SYSTEM INSTALLATION IS NOT COMPLETED BEFORE THE EXPIRATION DATE. <br /> * THE SYSTEM SHALL BE INSTALLED IN ACCORDANCE WITH: <br /> * ORANGE COUNTY RULES FOR WASTEWATER TREATMENT AND DISPOSAL SYSTEMS AS ADOPTED BY THE ORANGE <br /> COUNTY BOARD OF HEATH <br /> * ORANGE COUNTY WASTEWATER SYSTEM SPECIFICATIONS.AND OCHD POLICIES. <br /> * SYSTEMS WITH A CLASSIFICATION OF III OR HIGHER WILL REQUIRE PERIODIC INSPECTIONS BY THE O.C.HEALTH DEPARTMENT <br /> ISSUED: 03/29/2005 /k�' /Zr EXPIRES: 03/29/2010 <br /> EAvi nmeatal Health Specialist <br /> 168 <br /> C44130M2 Pick up Mail_ File_ Reviewed <br />