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IPACHTE# ►a,5=R-qo,'4s Harnett County Department of Public Health Improvement Permit 2 7 0 5 4 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: t►,.,(.E%A lq-9 ISS qED JTO: I~ti, tr ~P-(~ O r,C5 SUBDIVISION ?4rT a rx5 90% J-1 LOT #3 _ NEW< REPAIR ❑ E NSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: ~Cn ~yb` n3~ Proposed Wastewater System Type: Q u rNP -7° CAP Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: W-Z max Basement ❑Yes '~RNo Pump Required ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: C7 Community Public ❑ Well Distance from well L ©d feet Permit valid for: Five years Permit conditions: ❑ No expiration Exact length of each trench 2LM Trenches shall be installed on contour at a Maximum Trench Depth of. 1~ (Trench bottoms shall be level to +/-1/4" in all directions) GPM Authorized State Agent:: Date: 5 2`1 - SEE ATTACHED SITE SKETCH ermits. The permit holder is resp Bible for checking with appropriate governing bodies in meeting their requirements. This The issuance of this permit by the Health Department in no way guarantees the issuance of. site is subject to revocation if the site plan, plat, or the intended use changes. The Improent Pe it 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 (Retired 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: ~7 t tea- C%- ~ G S`~ GS PROPERTY LOCATION: 1 s e.~ GE V-4 SUBDIVISION Pfd N5 ~a tS LOT # Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? 0 Yes -~K No Type of Wastewater System** u c~4-S v ,SOfo v C EN ON (Initial) Wastewater Flow: GPD (See note below, if applicable PumiTo a5"O~a ~...GflVG~O~ (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size ►®cnc!) gallons Pump Tank Size ,®©O gallons Pump Requirements: ft. TDH vs. Conditions: feet Trench Spacing: Feet on Center Soil Cover: 'Z inches inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe 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: / understand the system type specified is different from the type speciped on the application. / accept the specipcations of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to evoca he site plan, plat, 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 sufyItkcompliance 'th he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 5 Constru ' rization Expiration Date: - HTE# Permit # a.`10 5L3 arnett County I e ,,tl tnle t of Public Health Site Sketch e 141 OD c 1 p 2CQA12„ ~10~x3~y : tip 640 0 C 15®1; T~', ~:~J C.PLw5r . Ov- 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: Design Flow (.1949): LM Location of Site: Property Recorded: .~l Water Supply: ❑ Public[] Individual ❑ Well Evaluation Method:❑ 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 SOIL MORPHOLOGY I .1940 .1941 THER PROFILE FACTORS L Landscape Horizon E Position/ Depth .1941 # Slope % (In.) Structure/ Texture `-S r 0-'4 .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth IN. .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR 11a y~. ,X sC,t, F'n. sg e~`fCz-`1 ~.e~ fSS Description Initial Re it System Other Factors (.1946): A S ste Site Classification (.1948): Y Available Space .1945) Evaluated By: System T s) Vn^K~ Others Present: Site LTAR c