Loading...
IPACHTE# ' al`b Harnett County Department of Public Health Improvement Permit 2 6 8 7 4 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ocz ?9 ISSUED T0: y n K cvS ~2yG~ C) 0 ti N G SUBDIVISION ra,aTi s gat ,,P LOT # ~ NEW,< REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: ~7Q (GO-nGQJ Proposed Wastewater System Type: ~~°l~ ~Govu-5~t5rJ SZS~G,t~ Projected Daily Flow: O GPD Number of bedrooms: U11. Number of Occupants: max Basement ❑Yes i< No Pump Required: ❑Yes ❑ No 'X May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community , Public ❑ Well Distance from well l 0Q feet Permit conditions: Permit valid for: Five years ❑ No expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the iss site is subject to revocation if the site plan, plat, or the intended use changes. The Imps the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. Date: 1 ,2. SEE ATTACHED SITE SKETCH other permits. The permit holder is re onsible for checking with appropriate governing bodies in meeting their requirements. This tent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, . 1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout. ISSUED TO: yN u Co Ns 2~c, s jN ~14 Cr PROPERTY LOCATION: Q ocs ~Z SUBDIVISION aa15 ESZs R,oS.Z LOT # $ Facility Type: X(bo~ X New ❑ Expansion ❑ Repair Basement? ❑ Yes >9, No Basement Fixtures? ❑ Yes No Type of Wastewater System** 0 sk k)C a t (3 N "Z~)) sN (Initial) Wastewater Flow: 140 GPD (See note below, if applicable Z~/, (ZZ0 uL~ i cr A '~'I 57 Gm (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size ~ n c) O gallons Exact length of each trench 30 0 feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of: \N R ~ inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/-1/4" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Aggregate Depth: inches below pipe inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: 1 understand the system type specified is different from the type specified on the application. / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation if t lat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Construction Authorization is s to compliance s~ tthe prgrikns_o and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: v J 0~5 Date: \ '13 Y-~- Constructio thorization Expiration Date: 1' HTE# V~-= 5 lL~~ Permit # a 05) `3c v a J V2~ o2s- ~e~a~ sp fir- 1-o Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: Lj Design Flow (.1949): Location of Site: Property Recorded: Water Supply: Public[] Individual ❑ Well Evaluation Method: Au er Bo ' ❑ Pit El Cut Type of Wastewater: "Ell Sewage ❑ Industrial Process Sheet: Property ID: Lot File Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F I 1940 SOIL MORPHOLOGY OTHER L . Landscape Horizon .1941 PROFILE FACTORS E # Positiord Slope % Depth (In.) .1941 .1941 Structure/ Consistence .1942 Soil .1943 .1956 Wetne / .1944 Profile L 5 Texture Mineralo ss Soil Sapro Color De th IN. Class lass estr Class Restr Horiz & LTAR 1 s- idle C; X- S (,t_ T-Q S c Description Initial Repair System Other Factors (.1946): S Ste Site Classification (.1948):?5 Available Space .1945) Evaluated B v- S System T e(s) a5%~ aS`1r2G~ , Others Present: : Site LTAR z,