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IPACHTE# /,7-5 y Z Harnett County Department of Public Health Improvement Permit 2 6 81 6 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: /~'~y; A''2- ISSUED TC1thJk5 A SUBDIVISION LOT # NEW REPAIR ❑ EXPA ION Type of Structure: L) 0 Vi+s~ Proposed Wastewater System Type: Projected Daily Flow: 3% 0 GPD Number of bedrooms: Number of Occupants: 4-1 max Basement ❑Yes No Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yes 13'N o ❑ Ma e required~td on final location and elevations of facilities Type of Water Supply: ❑ Community E Public E Well Distance from well : ° feet Permit conditions: Permit valid for: (Five years ❑ No expiration Authorized State Ag nit:'- Date: !'Z"f /Z- SEE ATTACHED SITE SKETCH The issuance of this permit by/he ffealth Department in no way guarantees the issuance of other permits. The permit holder is responsible far checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if a site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. 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: 5 ! GL0)PROPERTY LOCATION: Z SUBDIVISION LOT # Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? NE] Yes EJ No Type of Wastewater System" Z071IzE`,/.)i/U"~Z' (Initial) Wastewater Flow: -.3-'w GPD (See note below, if applicable 052,,11'~b0 c^ (Repair) Installation Requirements/Conditions Number trenches -3 Septic Tank Size /00 C gallons Exact length of each trench >o feet Trench Spacing: 7 Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of: Z -)/8 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: 414- inches below pipe Z inches above pipe / L 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: /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 the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chance in ownershin of the site- This Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Date: Construction Authorization Expiration Date: f --Z : i 1 H T E # f4- 29/97 Permit # 2616 Harnett County Department of Illblic Health Site Sketch PROPERTY LOCATON:, " ISSUED T0: SUBDIVISION LOT # Authorized State A Date: /Z- .W 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: J0 'v 11~ Address: Date Evaluated: Proposed Facility: 0 11 i`4 Design Flow (.1949): 36 0 Location of Site: Property Recorded: Water Supply. / Public❑ Individual F1 Well Evaluation Method:[3 Auger Bo .ng ❑ Pit ❑ Cut Type of Wastewater; 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 # Position/ Slope o Depth 1941 (in.) Structure/ 1941 Consistence .1942 943 .1956 Wetness/ Soil .1 1944 Profile Texture Mineralo S Sa Color D ~ IN pro Class Restr Class Horiz & LTAR CAL 4 r v SG C~ 5W5 I Description Initial Repair System Other Factors (.1946): Available S ace .1945) S stem Site Classification (.1948): PS S stem T e(s) 75 -2 Evaluated By: Site LTAR z( `z Others Present: