Application for Permit to Construct an Individual Sewage Treatment and Disposal System

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1 Application for Permit to Construct an Individual Sewage Treatment and Disposal System Home Phone No.: Work Phone No.: Application No.: I, _, (Name) (Mailing Address) (City/Town) (State) (Zip Code) hereby make application for a Permit to Construct an Individual Sewage Disposal System to serve a: House: Mobile Home: Other (Specify): If in subdivision, give name: _, Lot#: Street: Tax Map#: _ Lot Identification In order for your application to be processed, stake the corners of the proposed building and center of the lot with distinctive markers. Place site locator card on front of property in a conspicuous location. Contact the Health Department when the lot is staked, house site located, and lot posted. You can prevent delays in the evaluation by flagging all the property corners. Applicant's Sketch of Proposed Installation on Lot Sketch must show dimensions, proposed and existing structures, proposed pool, proposed or existing wells (including wells on adjoining property), proposed building to road and property lines. Attach copy of deed describing boundaries or plat. Please Give Exact Directions To Lot No. Bedrooms: Basement: Full Partial None: Plumbing in Basement: Yes No Well: Existing Proposed None Public Water: Yes No If commercial establishment, answer following: Type of Business: Number of Number of Occupants: Employees: Other: (i.e., seating capacity, meals per day) Public Number of Hours Restrooms: of Daily Operation: Information not in conformance with actual conditions on the property will avoid the Permit to Construct. "Permission is hereby granted for health department representatives to enter the above-described property at reasonable hours for the purpose of septic tank inspection and / or site evaluation." Date Property Owner or Agent's Signature DHEC 1740 (01/1997)

2 Site Evaluation (Health Department Use Only) Environmentalist: Date: Site Evaluation Sketch: Show direction and approximate percent slope, low or wet areas, ditches, soil boring locations, adjacent wells and residence sites, and other pertinent topographic features. S B Depth Color Texture Water Table / Mottling Notes: DHEC 1786 (2/1997)

3

4 The following steps are required: Upstate Environmental Quality Control (EQC) Greenville Office 200 University Ridge Greenville, SC Phone: Fax: Onsite Wastewater (Septic System) Permit Process Information Sheet 1. DHEC Application 1740: Fully complete DHEC form 1740 Application for Permit to Construct an Individual Sewage Treatment and Disposal System. The application must be signed by the property owner or a legal representative. 2. Copy of Plat or Deed: A legal document specifying the boundaries and size of the property. 3. Fee: $160 Evaluation fee must accompany the application and be paid at Greenville County Building and Codes, 301 University Ridge, Suite 4100, Greenville, SC Site Plan: A sketch of the proposed site plan to include proposed home or building location, driveway and parking areas, any additional building structures, pools, and existing or proposed wells. 5. Prepare the Property: A) Place the yellow Site Location Card in a clear, sealed plastic bag and post in front of the property. B) All property lines are to be clearly marked or cut, and visibly identifiable. (Flagging tape is recommended) C) Mark the corners of the proposed home or commercial building with labeled wooden landscape stakes (or) 24 stake flags, available at your local home improvement store. (the footprint should represent total dimensions and include walkways, flower beds, steps, porches, decks, etc) D) Mark the corners of other proposed buildings, pools, or structures that may influence placement and configuration of the wastewater system. E) Mark any existing and/or proposed wells. (Labeled wooden landscape stakes(or) 24 stake flags should be used to designate all proposed and/or existing structures and wells) F) You may be required to clear underbrush, thick vegetation, or eliminate features that inhibit site evaluation. Clearing should expand at least 150 feet in all directions from the proposed building site. 6. Call local EQC office to activate application: When the above items have been completed and the site is properly prepared for evaluation, please call to activate application. Evaluation of the property will not be conducted until you call to confirm that the above steps have been completed. 7. An additional fee of $ will be assessed for any of the following, including, but not limited to the examples provided: A. Reevaluation due to improperly prepared site: Reevaluation is necessary where staff determines upon arrival that the applicant failed to properly prepare the site as required in Regulation 61-56, Section For example, improperly prepared sites include those where applicant fails to designate the site or clear the property, identify necessary property lines, locate proposed or existing well(s), and/or identify the proposed location of any additional structures on the property that may influence the placement and configuration of the system. B. Reevaluation due to project deviation from application: Deviations from an application include addition of bedrooms, changes to the location or size of the proposed system, or anything that increases the wastewater flow. For example, where the applicant (or representative) fails to site (e.g., flag proposed system location) the proposed system in the location designated in the application, staff may determine upon arrival that reevaluation is necessary to establish the suitability of the new site. C. Reevaluation due to project deviation from issued permit: Deviations from issued permit include addition of bedrooms, changes to the location or size of the proposed system, or anything that increases the wastewater flow. For example, where the applicant/installer fails to install the system in the approved location, staff may determine upon arrival that reevaluation is necessary to establish the suitability of the new site. D. Site evaluation for reapplication due to voided permit: Permits will be voided based on a determination that an Approval to Operate can t be issued for the installed system. For example, installed system necessitates a change in design standard. Reapplication is required if permit is voided. E. Reevaluation due to site denial: Request for an administrative and/or field review by Central Office staff as result of a site denial will require a reevaluation fee. **Reevaluation fees must be paid at the local EQC office located in the Greenville County Health Department, 2 nd Floor, 200 University Ridge, , prior to further processing of your site.***

5 Upstate Environmental Quality Control (EQC) Greenville Office 200 University Ridge Greenville, SC Phone: Fax: Applicant s Name (Printed) Applicant s Mailing Address City State Zip Applicant s Daytime Phone Number Property Location Property Tax Map Number I, the applicant, have received and read the Onsite Wastewater (Septic System) Permit Process Information Sheet. I understand the property must be properly prepared for evaluation and that I must call the local EQC office at to confirm property preparation and activate the application as processing of the application will not begin until I call to activate the application. I have also been informed that reevaluation fees will be assessed based on parameters listed on the Onsite Wastewater (Septic System) Permit Process Information Sheet. _ Applicant s Name (Printed) Date _ Applicant s Signature

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