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IPACHTE# iZ-5- -Z S'lq 4, Harnett County Department of Public Health Improvement Permit 2 6 8 3 0 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION Wflg AD ISSUED Tt)r kA SUBDIVISION LOT # NEW 5 REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Proposed Wastewater System Type: ff ' 3 Projected Daily Flow: Z `(a GPD Number of bedrooms: 1 Number of Occupants: max Basement ❑Yes /b No Pump Required: IZYes ❑ No ❑ MM,a~e required based on final location and elevations of facilities Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet Permit valid for: L~9' Five years Permit conditions: ❑ No expiration Authorized State Date: 5;- -7- SEE ATTACHED SITE SKETCH The issuance of this permit byte ealth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if t e 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, .1957, .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: _ - PROPERTY LOCATION: 1VV SUBDIVISION LOT # Facility Type: 5 _ Y New Expansion ❑ Repair Basement? ❑ Yes o Basement Fixtures? s _ ~ Type of Wastewater System** z "t (Initial) Wastewater Flow: (See note below, if applicable (JJ KA- S~ 1OLZ A- jj-~ -j 142- (Repair) Installation Requirements/Conditions Number of tren es Z Septic Tank Size ! & a Z) gallons Pump Tank Size /Do Q gallons Pump Requirements: ft. TDH vs. Conditions: Exact length of each trench feet Trenches shall be installed on contour at a Maximum Trench Depth of. / ' `Inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM Trench Spacing: Sf 17 GPD Feet on Center Soil Cover: I~E inches - / (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe i inches total WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: l understand the system type specified is different from the type specified on the application. /accept the speciTcations 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 ownership 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 ATTACHFn SITF SKFTrk Authorized State Age C. ~t.. Date: -3 ` Construction Authorization Expiration Date: 3 Y--1'7- liz- 11 Sd,,- LO L) AA d~, rKl"o -5 r7k4 3iL lYq~ A-77.--r~ /2,C) Department of Environment, Health and Natural Resources Division of Environmental Health Sheet: On-Site Wastewater Section Property ID: Lot SOIL/SITE EVALUATION File for ON-SITE WASTEWATER SYSTEM Code: Owner: Applicant: j-C.-~ t Address: Date Evaluated: :r - 1 ' f 3' d°j Proposed Facility: & Design Flow 1949): Location of Site: er Property Size: Property Recorded: Water Supply: 2fublic❑ Individual ❑ Well Evaluation Method:, ❑ Spring ❑ Other I er T~Au B i g . ~ .,or~ .n.,~ ❑ pit ❑ Cut Type of Wastewater: L~''Sewage ❑ Industrial Process ❑ Mixed P R O F SOIL MORPHOLOGY I .1940 OTHER .1941 L Landscape Horizon PROFILE FACTORS E Position/ Depth 1941 # Slope % (in, 1941 Structure/ Consistence .1942 Soil 1943 .1956 Wetness/ .1944 Profile Texture Mineralogy 1 -V L 40%,, , - feq- r'L 6 &,,V,5~" Soil Color Sapro D th IN. Class Restr Class Horiz & LTAR bid° 6 56 L. C- f-5, P. ZOY. j ifZ s ©Y - - 6.61t.A,-5 SP .3 Li C° 1 'V* Vip 1Z. 5L l - ZLzL~Gr 14 0 Z. d-OL JO-13-10J10 rt- z~ t? F S'0' 7S 0-;Y 5g- '26 - 7 6 ~ A - + r r ^L 331 am' d L,sJ,Sy 1L- 34„ k-r f-"' P. Z.Is ~Q L c' / 5s - t2, -3~ Sep 2 ~1 r_ f _3 c,,, Description Initial Repair S stem Other Factors (.1946): S ste Site Classification (.1948 Available S ace .1945) 5 S stern T s) lei y y~( t r Evaluated By. Site LTAR _ _ Others Present: