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HomeMy WebLinkAbout19980625 Ver 1_COMPLETE FILE_19980617' '?"RState of North Carolina Department of Environment and Natural Resources Division of Water Quality James B. Hunt, Jr., Governor Wayne McDevitt, Secretary A. Preston Howard, Jr., P.E., Director ILFW'A 1 '6,10 • 2 AOMN% NC ENR NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES August 17, 1998 Hertford County WQC 401 Project # 980625 COE # 199811390 APPROVAL of 401 Water Quality Certification Mr. Charles Glisan 117 Holly Grove Williamsburg, NC 23185 Dear Mr. Glisan: You have our approval, in accordance with the attached conditions, to place fill material in 3,812 square feet of wetlands or waters for the purpose of constructing a bulkhead and home, as you described in your application dated June 17, 1998. After reviewing your application, we have decided that this fill is covered by General Water Quality Certification Number 3112. In addition, you should get any other federal, state or local permits before you go ahead with your project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water Supply Watershed regulations. Also this approval will expire when the accompanying 404 or CAMA permit expires unless otherwise specified in the General Certification. This approval is only valid for the purpose and design that you described in your application. If you change your project, you must notify us and you may be required to send us a new application for a new certification. If the property is sold, the new owner must be given a copy of the Certification and approval letter and is thereby responsible for complying with all conditions. If total wetland fills for this project (now or in the future) exceed one acre, compensatory mitigation may be required as described in 15A NCAC 2H .0506 (h). For this approval to be valid, you must follow the conditions listed in the attached certification. If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition which conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions are final and binding unless you ask for a hearing. This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786. Attachment cc: Wilmington District Corps of Engineers Corps of Engineers Washington Field Office Washington DWQ Regional Office Mr. John Domey Central Files John Parker; DCM Sincerely, re on Howard, Jr. RE L K. 980625.1tr Division of Water Quality • Environmental Sciences Branch Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone 919-733-1786 FAX 919-733-9959 An Equal Opportunity Aff irmative Action Employer • 50% recycled/10% post consumer paper DEPARTMENT OF THE ARMY WILMINGTON DISTRICT, CORPS OF ENGINEERS P.O. BOX 1890 WILMINGTON, NORTH CAROLINA 28402-1890 REPLY TO June 24, 1998 ATTENTION OF Regaiatary-Hivisinn?..,` Action ID No. 199811390 Mr. John Domey Division of Environmental Management North Carolina Department of Environment, Health, and Natural Resources 4401 Reedy Creek Road Raleigh, North Carolina 27607 Dear Mr. Dorney: Please reference the application of Charles E. Glisan for Department of the Army (DA) authorization and a State Water Quality Certification to place fill material within wetlands and construct a pier and a bulkhead, on property located off State Road 1308, at Leisure Shores Subdivision, adjacent to the Meherrin River, near Como, in Hertford County, North Carolina. Your receipt of this letter verifies your acceptance of a valid request for certification in accordance with Section 325.2(b)(ii) of our administrative regulations. We are considering authorizing the proposed activity pursuant to Section 404 of the Clean Water Act, and we have determined that a water quality certification is required under the provisions of Section 401 of the same law. A Department of the Army permit will not be granted until the certification has been obtained or waived. in accordance with our administrative regulations, in most cases, 60 days after receipt of a request for certification is a reasonable time for State action. Therefore, if you have not acted on the request, or asked for an extension of time, by August 24, 1998, the District Engineer will deem that waiver has occurred. } .e ?•Ttia .:.:fit: r. -2- Questions or comments may be addressed to Mr. Raleigh Bland, Washington Regulatory Field Office, Regulatory Division, telephone (252) 975-1616, extension 23. Sincerely, GQQ? R Raleigh Bland, P.W.S. Regulatory Project Manager Copies Furnished: Mr. John Parker Division of Coastal Management North Carolina Department of Environment, Health and Natural Resources Post Office Box 27687 Raleigh, North Carolina 27611-7687 DIVISION OF COASTAL MANAGEMENT FIELD INVESTIGATION REPORT 1. APPLICANT'S NAME: Charles E. Glisan 2. LOCATION OF PROJECT SITE: Hertford County off SR 1308 at Leisure Shores on the Meherrin River near Como, North Carolina Photo Index - 1995: 144-1526; D-5 1989: N/A 1984: N/A r a, State Plane Coordinates - X: 2,580,000 Y: 992,400 Murfreesboro Quad. (upper right corner) . , 3. INVESTIGATION TYPE: CAMA and D/F 71998 ? 4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - 04/23/98 Was Applicant Present - YES 5. PROCESSING PROCEDURE: Application Received - 05/29/98 Office - Washington 6. SITE DESCRIPTION: (A) Local Land Use Plan - Hertford County Land Classification From LUP - Rural (Land), Conservation (Water, Wetlands) (B) AEC(s) Involved: EW,PTA,ES (C) Water Dependent: YES (D) Intended Use: Private (E) Wastewater Treatment: Existing - N/A 7. Planned - Septic tank and drain field (F) Type of Structures: Existing - None Planned - Dwelling, bulkhead and pier (G) Estimated Annual Rate of Erosion: 2' Source - Applicant HABITAT DESCRIPTION: [AREA] DREDGED FILLED OTHER (A) Vegetated Wetlands 404 delineated wetlands ±3,558 ft2 (B) Non-Vegetated Wetlands ±254 ft2 ±585 ft2 River bottom bulkhead shaded backfill (C) Other ±25,984 ft2 I grade lot (D) Total Area Disturbed: 0.6 acres or ±26,823 ft2 (E) Primary Nursery Area: NO (F) Water Classification: B-NSW Open: NO 8. PROJECT SUMMARY: The applicant proposes to fill ±3,558 ft2 of 404 delineated wetland, construct a house, build a 6' wide by 35' long pier and ± 127' of bulkhead. WO.6 Charles E. Glisan Hertford County . Project setting The project is located off SR 1308 at Leisure Shores Subdivision on the Meherrin River near Como in Hertford County, North Carolina. The property is bordered on both the upstream and downstream sides by undeveloped lots which have been mowed over and are growing back in vines and upland grasses. The applicant's property is undeveloped and has also been mowed and is growing back in vines and uplands grasses. Various species of wetland grass are reestablishing in the center portion of the lot which has been delineated as 404 wetlands by the US Army Corps of Engineers. This wetland area is an old drain from a large wooded wetland to the river and it has - been cut off from the river by an access road. Several hardwoods are present along the river shore and the site elevation is X3.5' above the NWL. The Chowan River is classified as B -NSW by the Environmental Management Commission. The Meherrin River at the project site is joint water and is not open to shell fishing. Project description The applicant proposes to fill ±3,558 ft2 of 404 wetlands in the center portion of the property and construct a dwelling. A 127' long bulkhead is proposed for shoreline stabilization and will average T below the NWL with a maximum of 3'. The applicant proposes a 6' by 35' long pier and a 15' by 25'L-head at the waterward end of the pier. The proposed pier will be centered on the lot. Anticipated impacts The project as proposed will result in the filling of ±3,558 ft2 of 404 delineated wetlands and the filling of ±254 ft2 of river bottom associated with the bulkhead construction. The placement of the pier will result in the shading of ±585 ft2 of river bottom. The project as proposed will result in localized turbidity as a result of the construction activities. David W. Moye - 4 June 1998 ForiA DALMP-1 APPLICATION (To be completed by all applicants) 1. APPLICANT a. Landowner: Name l VNy\CC Z . Address W1 1 %o,\., 6;ru ve City P State Zip all 95 Day Phone MO -,6 Fax ISI -a5r3 -31. rj' b. Authorized Agent: Name Address b. City, town, co unity or landmark C c. Street address or secondary road number _ l.et 2h off J S R 136 8 d. Is proposed work within city limits or planning jurisdiction? .. Yes X No e. Name of body of water nearest project (e.g. river, creek, sound, bay) IWo ? o vw; % ^ 3. DESCRIPTION AND PLANNED USE OF PROPOSED PROJECT a. List all development activities you propose (e.g. building a home, motel, marina, bulkhead, pier, and excavation and/or filling activities. City State Zip Day Phone Fax c. Project name (if any) N M NOTE: Perndt will be issued in name of landowner(s), and/or project name. b. Is the proposed activity maintenance of an existing project, new work, or both? 1&\'i w6rk c. Will the rojecit be for public, private or commercial use? r, VMTe d. Give a brief description of purpose, use, methods of construction and daily operations of proposed project. If more space is need o, please attach additional pages. ?v.,d o. yacr?e.? ?\ObD, t 2. LOCATION OF PROPOSED PROJECT a. County )A e Yk?elrl Revised 03/95 0 Form DCM-MP-1 4. LAND AND WATER CHARACTERISTICS m. Describe existing wastewater treatment facilities. N0y\P a. Size of entire tract; 2j1RA sa.tC. or . IA uxc r n. b. Size of individual lot(s) a6,4A 5r,_W Qr .lo`Aa c-care s c. Approximate elevation of tract above MHW or NWL 3,/2.t m"e. OWL d. Soil type(s) and texture(s) of tract e. Vegetation on tract J1h,xecl hardwoa 1 . nnax d.." v^?,r?n?s o,rc?SSCs . f. Man-made features now on tract _ Novae g. What is the CAMA Land Use Plan land classification of the site? (Consult the local land use plan.) Conservation Transitional Developed Community i/ Rural Other h. How is the trr ct \?Oned by local I?government? n i i. Is the proposed project consistent with the applicable zoning? _X Yes No (Attach zoning compliance certificate, if applicabk) j. Has a professional archaeological assessment been done for the tract? Yes No If yes, by whom? k. Is the project located in a National Registered Historic District or does it involve a National Register listed or eligible property? Yes )_ No 1. Are there wetlands on the site? X Yes No Coastal (marsh) Other_ If yes, has a delineation been conducted? AS (Attach documentation, if available) Describe location and type of discharges to waters of the state. (For example, surface runoff, sanitary wastewater, industrial/commercial effluent, "wash down" and residential discharges.) 3??trTc.?2 9 o. Describe existing drinking water supply source. mcme 5. ADDITIONAL INFORMATION In addition to the completed application form, the following items must be submitted: • A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties. If the applicant is not claiming to be the owner of said property, then forward a copy of the deed or other instrument under which the owner claims title, plus written permission from the owner to carry out the project. • An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale in black ink on an 8 1/2" by 11" white paper. (Refer to Coastal Resources Commission Rule 71.0203 for a detailed description.) Please note that original drawings are preferred and only high quality copies will be accepted. Blue-line prints or other larger plats are acceptable only if an adequate number of quality copies are provided by applicant. (Contact the U.S. Army Corps of Engineers regarding that agency's use of larger drawings.) A site or location map is a part of plat requirements and it must be sufficiently detailed to guide agency personnel unfamiliar with the area to the Reviwd MM Form DCM-MP-1 site. Include highway or secondary road (SR) numbers, landmarks, and the like. • A Stormwater Certification, if one is necessary. • A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in which to submit comments on the proposed project to the Division of Coastal Management. Upon signing this form, the applicant further certifies that such notice has been provided. Name Address 2 n Phone of\Q- $5 ' 11010 Name Rc? # A C Sti.o ?? ?? o t L Address 1551 S??11'??0 `.av?C da?k. ?[s _Z?43? Phone 'l5`I- °l8ta- QU8? Name Address Phone • A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates. 6. CERTIFICATION AND PERNUSSION TO ENTER ON LAND I understand that any permit issued in response to this application will allow only the development described in the application. The project will be subject to conditions and restrictions contained in the permit. I certify that to the best of my knowledge, the proposed activity complies with the State of North Carolina's approved Coastal Management Program and will be - conducted in a manner consistent with such program. I certify that I am authorized to grant, and do in fact, grant permission to representatives of state and federal review agencies to enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up monitoring of the project. I further certify that the information provided in this application is truthful to the best of my knowledge. This is the day of Print Name Signature t?l?? • A check for $250 made payable to the Department of Environment, Health, and Natural Resources (DEHNR) to cover the costs of processing the application. • A signed AEC hazard notice for projects in oceanfront and inlet areas. • A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A - 1 to 10) If the project involves the expenditure of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act. Landowner or Please indicate att project. ?DCM MP-2 ? CM MP-3 V DCM MP-4 DCM MP-5 DCM MP-6 achments pertaining to your proposed Excavation and Fill Information Upland Development Structures Information Bridges and Culverts Marina Development NOTE: Please sign and date each attachment in the space provided at the bottom of each form. Revised 03/95 Form DC*-MP-2 EXCAVATION ,FILL AND (Except bridges and culverts) Attach this form to Joint Application for CAMA Major Permit, Form DCM-MP-I. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Describe below the purpose of proposed excavation or fill activities. All values to be given in feet. Average Final Existing Project Length Width Depth Depth Access channel (MLW) or (NWL) Canal Boat basin Boat ramp Rock groin Rock breakwater Other (Excluding shoreline stabilization) Revised 03/95 YS 1. EXCAVATION NJA <ZQ a. Amount of material to be excavated from below MHW or NWL in cubic yards b. Type of material to be excavated c. Does the area to be excavated include coastal wetlands (marsh), submerged aquatic vegetation (SAVs) or other wetlands? Yes No d. Highground excavation in cubic yards 2. DISPOSAL OF EXCAVATED MATERIAL NIA a. Location of disposal area b. Dimensions of disposal area c. Do you claim title to disposal area? Yes No If no, attach a letter granting permission from the owner. d. Will a disposal area be available for future maintenance? Yes No If yes, where? w Form DCM-MP-2 e. Does the disposal area include any coastal wetlands (marsh), SAVs or other wetlands? Yes No f. Does the disposal include any area in the water? Yes No 3. SHORELINE STABILIZATION a. Type of shoreline stabilization Bulkhead Riprap b. Length 121 c. Average distance waterward of MHW or NWL d. Maximum distance waterward of MHW or NWL 3' e. Shoreline erosion during preceding 12 months (Source of information) Akoplicr"n f. T e of bulkhead or riprap material uYln d p g. Amount of fill in cubic yards to be placed below water level (1) Riprap .(2) Bulkhead backfill q .Ll h. Type of fill material i. Source of fill material Locr --iny o? If yes, (1) Amount of material to be placed in the water Moyle (2) Dimensions of fill area 1(;6C I;3 ter. (3) Purpose of fill 1"'I i6t ;,Nr 110"-Ai c n,???Jr- }lp.? b. Will fill material be placed in coastal wetlands (marsh), SAVs or other wetlands? _X Yes No If yes, Sarno. qS 0" c nv, (1) Dimensions of fill area I S t X VS (2) Purpose of ill le'v- r l 5. GENERAL a. How will excavated or fill material a kept on site and erosion controlled? s b. What type of construction equipment will be used (for example, dragline, backhoe, or hydraulic dredge)?; b ?rG?, ?,n c o.CK}?te. c. Will wetlands be crassed in transporting equipment to project site? Yes X_ No If yes, explain steps that will be taken to lessen environmental impacts. 4. OTHER FILL ACTIVITIES (Excluding Shoreline Stabilization) a. Will fill material be brought to site? X_ Yes No Revised 03/95 &alr 121 ? . 915G.Y" Form DCM M -3 UPLAND DEVELOPMENT (Construction and/or land disturbing activities) Attach this form to Joint Application for CAMA Major Permit, Form DCM-MP-I. Be sure to complete all other sections of the Joint Application that relate to this proposed project. a. Type and number of buildings, facilities, units or structures proposed A Q C 1> b. Number of lots or parcels one G) h. Projects that require a CAMA Major Development Permit may also require a Stormwater Certification. Has a site development plan been submitted to the- Division of Environmental Management for review? Yes _ X No If yes, date submitted Describe rho osed method of sewage di osal. j. Have the facilities described in Item i. above c. Density (give the number of residential units and the received state or local approval? Nos units per acre) 0n ? 1 (Attach appropriate documentation) k. Describe location and type of proposed discharges to d. Size of area to be graded, filled or disturbed waters of the state (for example, surface runoff, including roads, ditc es, etc. GY,?IV.e a sanitary wastewater, industrial /commercial effluent, ?.1214A acres l "(wash down" and residential discharges). Juo? -e rtr.N_A e. If the proposed project will disturb more than one acre of land, the Division of Land Resources must receive an erosion and sedimentation control plan at least 30 days before land disturbing activity begins. If applicable, has a sedimentation and erosion control plan been submitted to the Division of Land Resources? Yes X No If yes, date submitted f. List the materials (such as marl, paver stone, asphalt, or concrete) to be used for paved surfaces. 1i A 1. Describe proposed drinking water supply source (e.g. well, community, public system, etc.) -611 in. Will water be impounded? If yes, how many acres? _ n. If the project is a oceanfront development, when was the lot(s) platted and recorded? N/A g. Give the percentage of the tract within 75 feet of MHW or NWL, or within 575 feet in the case of an Outstanding Resource Water, to be covered by impervious and/or built-upon surfaces, such as pavement, buildings, rooftops, or to be used for vehicular driveways or parking. O"7o Yes No Revised 03195 cloy-yS F, . 611SGv. Form DCM-MP4 STRUCTURES (Construction within Public Trust Areas) Attach this form to Joint Application for CAMA Major Permit, Form DCM-MP-1. Be sure to complete all other sections of the Joint Application which relate to this proposed project. a. Dock(s) and/or Pier(s) (1) _ Commercial Community X Private (2) - Number r%.-, rN (3) Length R5' (4) Width (5) Finger Piers Yes No (i) Number (ii) Length (iii) Width (6) Platform(s) X Yes No (i) Number O?A e (ii) Length 15 (iii) Width ZS (7) Number of slips proposed IJ (8) Proximity of structure to adjacent riparian t property lines 5o' a,A tkl (9) Width of water body 35A" (10) Water depth at waterward end of pier at MLW or NWL L.,' OWL b. Boathouse (including covered lifts) N/A (1) Commercial Private (2) Length (3) Width c. Groin (e.g. wood, sheetpile, etc.) M/A Ga (1) Number (2) Length(s) d. Breakwater (e.g. wood, sheetpile, etc.) ?d /A (1) Length (2) Average distance from MHW, NWL or wetlands (3) Maximum distance beyond MHW, NWL or wetlands e. Mooring buoys hJ 1A (1) _ Commercial -Community _ Private (2) Number (3) Description of buoy (Color, inscription, size, anchor, etc.) (4) Width of water body _ (5) Distance buoy(s) to be placed beyond shoreline f. Mooring structure (boatlift, mooring pilings, etc.) N/A (1) _ Commercial -Community _ Private C C93- (2) Number (3) Length (4) Width g. Other (Give complete description) App ' t o ame -A iA- signet Ta.,, I P, 14 9 Date Revised 03/95 ` l?al ?L lO W 004 KY%? - COMO . I?t . ? . 1 1 1 1 o ' s ?r 40' ROW b?t?T 1. - 35' 1 1 ? 1 r ct ? LR'?? 50 MENTMRIN .x x -,4-lle, -1 LEGEWN pvbb QIE,. PRdToSEt Fill W M 4% * bs'.-'t ,aw-- 3558tZ o tm-Tlot wLl vEn SCRLE ?` i":p 40*, III r X x-x- x- X --x r6 25? 'j- RIVER -Slof IsiTE CARP I NY ta. 1°1el CNWRIES E. G stet li1 MlI.Y GUNE W.IILIRMSU?LG 1\1 R 2315 ?E1bti -'15'1-258-3'151 CresS ?tC'?tOri o? ???Y.heo?d ?j MINA 04 t crcrsS . ?c iar? Q ??E4' II ?I - N.GUL! M ©F V5\ CRmms E. GUSAti TIMAI to , Xgaa 1J» u - 406WOOD M, almm.t, AEZ'%n c . to Crams AL?10 ?? I O??UY ?M SRL? TRE??ELI WKm 25W&L Pil' W %TRQ\N PtU ENb ov FIMTOV.m w 6-` CM%ES 1E. GLZSAR BRAY 116, I!V° t LUG u -%GWmD mlw am M,C. 1ka'Ma QD -t- -T I n Lm 2D - b o ww'A vo;,rk - Como , ?3,e . Loc4ox\ J Sttoclupt 4-5- mg-'hosr-M S* Vwtr I 5"r- I ? r ?l??t?S E . ELI 111 ?Dt?Y ?W?E w?.uT.??? ,vA ,,904f t? ' Action 1D: County: 1 e r Notification of Jurisdictional Determination Property Address U.S. ARMY CORPS OF ENGINEERS Wilmington District 'Authorized Agent ilka r (-e ?. t_- Telephone NumberL /?-?) I )_-?? 1 Size and Location of Property(w• ter ody, Highway name/number town, etc.) Indicate Which of the following apply: makty- P i N K\\1't-r • There re wetlands o the above d tnes cribed prop ty which wesb'y sugge should be del eaed and curve d. The sure yed wetland must b eritied by ou before e Corps will ake a final juris eug ctional deter ination on ur property , '° Bec of the size o your pr perty and ur present w rkload, our id ?ntification an delineation of our wetlan s cannot be ccompl' hed in a t' ely manner You may wis to employ a onsultant to o am a more ?mely delin tion of a wetland .Once your nsultant has agged a well d line on the p operty, Cor staff will r iew it, nd, if it is a curate, we s ongly recom end that you ave the line su eyed for fina approval b the Co s. The Co ps will not m• :e a final ju{ dictional Bete ination on your property wit ut an app oved su ey. ,? • The wetlands on your lot have been delineated, and the limits of Corps jurisdiction have been explained to you. Unless there is a change in the law or our published regulations, this determination may be relied upon for a period not to exceed.thrc y?uter?,5 from the date of this notification. • There are no wettan s present tie abov described pr perty which ar subject to the pe it requir ments of Sect' n 404 of t Clean Wa r Act (33 US F 1.344). Unless t ere is a change in t law or of published re lations, th' determina 'on may be rel' d upon for a peri d not to exceed thr e years fro the date of th s notificati n. The project is located in one of the 20 Coastal Counties. You sh uld contact the nearest State Office of Coastal Management to determine their requirements. (q/ 9) 5Y6. , V 7 V Placement of dredged or fill material in wetlands on this property without a Department of the Army permit is in most cases a violation of Section 301 of the Clean Water Act (33 USC 1311). A permit is not required for work on the property restricted entirely to existing high ground. If you have any qu stions regarding ?he Corps of Engineers regul.atory?progr. m, please contact t G41-L at s Property owner/Authorized Agent Si nature Project Manager Signature Date _ W-:2 S -9 Expiration Date SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM. CR.SAW form 566 I Affr R2 uJ 1 yr: + FiR57 COPY OFFICE SECOND COFY ELECTRICAL OR BUILDING INSP. THIRD COPY HOMEOWNER HERTFORD-GATES DISTRICT HEALTH DEPT. P. O. Box 246 - Construction Permit - P. O. Box 71 Winton, N. C. 27986 Gatesville, N.C. 27938 HERTFORD COUNTY 358-7833 GATES COUNTY 357-1380 {,e r. r + r' r/• t jrT,..'i } ?, i? Ti. n r ;i N. Owner Address , Phone No. Location S. R. No. Subdivision Name "'! Lot No. ' .3 Pin Number No Bedrooms - No. People Washing Machine Automatic Dishwasher <' =;E Liquid Capacity of Tank c:. No. of Lines Length- Width ` - Depth Source of Water Supply Distance From Well Lot Size r, " Date _ I Inspector { ;% 't t ':f3 6'?? > _ House Mobile Type of Comments ' !fir i f tf{f }? ? f ,,il i`Ji s. F [ Sri, r rr=. ir'. a ! si -l ;h ?, ?° .'t4 •1l,=° et;^ c.e:'c ,7/% :1f/ ,.-;,;a1 ,J.!' .6• -.1 i J , I I A ir, 'o t , ;'tl 1 f All i i 7, e "e a .t +t? t t' t n IMPROVEMENT PERMIT 9UBTECT TO REVnC-ATTOM TF .r,TTF PY.AM nR irmTTiNnFin TTCF TC CUA %TCFn