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IPAC RHTE#ia- a9 69 69- Harnett County Department of Public Health Imarovement Permit 2 7 0 5 8 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: CY Pc.s~ C,~ v(ZOP1 ISSUED TO: c~ OSG'S Z) SUBDIVISION Q -j PcLESS 01 Iff- LOT # 11 _ NEW REPAIR E NSION ❑ Site Improvements required prior to Construction Authorization Issuance: l Type of Structure: Proposed Wastewater System Type:`'/ o vG'C 0 N Projected Daily Flow: "rjb' O GPD Number of bedrooms: L., Number of Occupants: max Basement ❑Yes eNo Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Suppl Community X Public ❑ Well Distance from well 10 0 feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: ~\'i~• The issuance of this permit by the Health Department in no way guarantees the issuance o he site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. Date: SEE ATTACHED SITE SKETCH The permit holdef is rdponsible for checking with appropriate governing bodies in meeting their requirements. This all 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: 0 9- 'V)ivwz~d N N "Z C Facility Type: SFO J.1' XNew Basement? ❑ Yes ~!k No Basuirt Fixtures? ❑ Yes Type of Wastewater System** / (See note below, if applicable Installation Requirements/Conditions Septic Tank Size tCd o Id gallons Pump Tank Size gallons PROPERTY LOCATION: C_y99JGS3 C'\;w y - A V SUBDIVISION (1. 95MS5 'F a~ j7 E LOT # _ ❑ Expansion ❑ Repair 'X No--- ~.C.ov U ct N S`)S~ G~ (Repair) (Repair) Number of trenches S Exact length of each trench 5 C-') feet Trenches shall be installed on contour at a Maximum Trench Depth of: l% -~2-Y inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: _ (Initial) Wastewater Flow: "M Q) GPD Trench Spacing: Feet on Center Soil Cover: ro 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 specified on the application. / accept the specifications of this permit. Owner/Legal Representative Si nature: Date: This Construction Authorization is subject to revoc ' the site plan, t, 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 suftjecl_W compliance wit n pr of the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: --Z~~ S Date: 7 )a, 14 Constru n Authorization Expiration Date: c. 7 HTE# Permit # ~0OS~ Harnett County Department of ealt Site Sketch ISSUED TO: Authorized State Agent: PROPERTY LOCATON:-yP~~S:s C-~y2G`e~ _ SUBDIVISION Q-)e9U5:). P o n-SE LOT # 5 (oL1vErz. `TOLy's Date: I l c~ 3L}p '2 0 , dL_tJE L`)PC?£Ss 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: u, (bGW~Ccwm Design Flow (.1949): (,i~ g Location of Site: Property Recorded: Water Supply: ~Public❑ Individual ❑ Well Evaluation Method-~ Auger Boring ❑ Pit ❑ Cut Type of Wastewater: 'j--t 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 % Depth ((n, .1941 Structure/ .1941 Consistence .1942 Soil .1943 .1956 Wetness/ 1944 Profile Texture Mineralo Soil Sapro lass Color D th IN. C Restr Class i 5 Horiz & LTAR d•_1~UU st PS yl ~ # T Nr-n V 1 \ v L1a SGL 55) ~a~ P~ 15C L Description Initial Repair System Other Factors (.1946): Available Space .1945) S s em Site Classification (.1948): System T s) Evaluated By: cl< Site LTAR i,`,.% ) % I Others Present: