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IPACHTE# )a~-S- X):~OIA Harnett County Department of Public Health I Drovement Permit 2 6 9 6 8 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: MPCV(-5 YxD ISSUED T0: zs~, ~E-~nMAS riU`s'~£ SUBDIVISION P\pSLD LOT # NEV~ REPAIR ❑ E) SION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: F $ ~ Proposed Wastewater System Tyype: aS@/e Projected Daily Flow: ~`h d GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes ,%-!o Pump Required: ❑Yes ~No May ^ay be required based on final location and elevations of facilities Type of Water Supply: ❑ Community/ Public ❑ Well Distance from well 1 ©d feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: -N V R -~S Date: 3 1111, 17. SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuanf~ther permits. The permit holdd is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the 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: R-vr~ y4w,a5 PROPERTY LOCATION: M ~.cz~t t~ 1 ~SUBDIVISION Ns-FOt~ LOT # n0 Facility Type: New ❑ Expansion ❑ Repair - 21\ Basement? ❑ Yes -X, No Basement {Fixtures? ❑ Yes ~o Type of Wastewater System** (Initial) Wastewater Flow: GPD (See note below, if applicablef r ` ``+-til t~-C ti D t~ (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size 1 O O O gallons Exact length of each trench 1 S"O feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: \a inches Maximum Trench Depth of: ~^3-\ 3C) 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 inches below pipe Aggregate Depth: inches above pipe Conditions: MCG--V ~ 4 S `t-I~CL~t inches total WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED I 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 subjec if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This Construction Authorizationsuhject to compiisq~.e with~tt~e pwsto he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: NDate: Authorization Expiration Date: c t-4 5oL L '~GY~cn6.rv"C orb 5 i L (Z sz,;Nc~q.-1ro 1'$p tog' 1 J Q T d--aG)G v Q6P P fit,,.,, 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: 3 a 1 Proposed Facility: I-j E.UI M- Design Flow (.1949): I-Y Location of Site: Property Recorded: Water Supply: Public[] Individual ❑ Well Evaluation Metho4: Auger Boring ❑ 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/ Depth .1942 1941 .1941 Soil # Slope % (In.) Structure/ Consistence Wetness/ Soil .1943 .1956 Soil Profile Texture Mineralo Color Sa ro D th IN. Class Restr H i or z & LTAR Description Initial Re air System Other Factors (.1946): Available S ace .1945) S st in Site Classification (.1948): ~c S stem T e(s) Evaluated B Ss~~ 2 Y p~ Site LTAR , Others Present: