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IPACHTE# 1~ 5~~5I ® Harnett County Department of Public Health Improvement Permit 27091 A building permit cannot be issued with only an Improvement Permit N PROPERTY LOCATION: Potvsa ~2 o~t~, ISSUED T0: C-u rn f5S<Ct1.q'-'raQ VN pc'N is SUBDIVISION Cr.e,2bl-fit P, oN5 LOT # t 1?z_ NEW REPAIR ❑ EINSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S96-fl (,,Spracz~Q Proposed Wastewater System Type: (w r4 c 2. "J ~Q lOtA Projected Daily Flow: 3 6 ® GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes No Pump RequireXYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1'~)O feet Permit valid for: Five years Permit conditions: ❑ o expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the ' ssn` site is subject to revocation if the site plan, plat, or the intended use changes. The Impr the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. 1'►~ Date: "N SEE ATTACHED SITE SKETCH other permits. The permit holder for checking with appropriate governing bodies in meeting their requirements. This k~tllermit shall 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 T0: Cvchc~5r22 t~,tv~ ~1cTt~~ Facility Type: Sf ~CSO~p,Z_ Basement? ❑ Yes No Basement Fi Type of Wastewater System** ~u vw t (See note below, if applicable ®'v M4~0 Installation Requirements/Conditions Septic Tank Size i c 0 G gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: ~S ~tv G PROPERTY LOCATION: Po nt0~0sj5t~ SUBDIVISION _C,t~fZC71.1NP~ SPSoN LOT # t~3 _ New ❑ Expansion ❑ Repair ctures? ❑ Yes ~J<No <~-5o V-GA) VC; I'd %t, am\ (Initial) Wastewater Flow: ':V6_ GPD (Repair) Number of trenches 1 Exact length of each trench 2.QCl 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: Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE 1OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: /under tend the system type speciTed is different from the type specified on the app/ication. /accept the speciTcatians of this permit. Owner/Legal Representative ture: Date: This Construction Authorization is subject to revocatio "the si Ian, plat, or the intended use changes. The ConstructiDispostal zation shall not be transferred when there is a change in ownership of the site. This Construction Authorization is sub ompliance n he Laws and Rules for Sewage Treatment and nd to the co nditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: ?a5 Date: gJ W Co ction Authorization Expiration Date: _ 9 t ©c~ 1'-A 'Zi ' 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: e~~~~ Proposed Facility: 3 Design Flow(. 1949): 305 Location of Site: Property Recorded: Water Supply:Public❑ Individual ❑ Well Evaluation Method1Auger ring ❑ 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 OIL MORPHOLOGY .1941 THER PROFILE FACTORS L E # Landscape Position/ Slope % Horizon Depth (In.) .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR C~ V~ ss) ~5 "J ~ ~s~ala~Cn Description Initial S st Repair System Other Factors (.1946): Site Classification (.1948): -~5 Available Space (.1945) v Evaluated By: System T e(s) ) t Others Present: Site LTAR