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IPACHTE# ��.-- �`�10`7 Harnett County Department of Public Health Improvement Permit 27159 Authorized State Agent:: Date: Q1N %N)-A- SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance of othe its. The permit holder 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, .1957, .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: C.Ur1N%EaLQ,,4p �Xoe+e -5 r+ C, PROPERTY LOCATION: rApsa�s j. SUBDIVISION 'N SdOOCX9 LOT # dot Facility Type: 5';7D �I-'+-7 X�, f l� L New ❑ Expansion ❑ Repair Basement? ❑ Yes X No Basement Fixtures? ❑ Yes XNo Type of Wastewater System" 2Z °/a (Initial) Wastewater Flow: `:.LQ GPD (See note below, if applicable ❑) 2��V/® 9NC--�Z) y c.:-� � tl (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size i ® O 0 gallons Exact length of each trench G ° feet Trench Spacing: `� Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: C, inches Maximum Trench Depth of: N1 "4ti 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 Aggregate Depth: Conditions: 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. inches below pipe inches above pipe inches total * *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subIRF amn if the 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 ct ii�u to comp' ce with V4gLvisigns of,*Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: Z Construction Authorization Expiration A building permit cannot be issued with only an Improvement Pe mit ISSUED T0: �vm LPG PROPERTY LOCATION: M Pct �.S ��OC�Gs �t�C. SUBDIVISION LOT # a9 NEW REPAIR ❑ �Ll��'��y E NSION El Site Improvements required prior to Construction Authorization Issuance: � Type of Structure: �fl Proposed Wastewater System Type: 0-S °f4 .QuCSC,ON yT '4N Projected Daily Flow: '3S;!,® GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes >< No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well O feet Permit valid for: AFive years Permit conditions: --'-. - ❑ No expiration Authorized State Agent:: Date: Q1N %N)-A- SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance of othe its. The permit holder 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, .1957, .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: C.Ur1N%EaLQ,,4p �Xoe+e -5 r+ C, PROPERTY LOCATION: rApsa�s j. SUBDIVISION 'N SdOOCX9 LOT # dot Facility Type: 5';7D �I-'+-7 X�, f l� L New ❑ Expansion ❑ Repair Basement? ❑ Yes X No Basement Fixtures? ❑ Yes XNo Type of Wastewater System" 2Z °/a (Initial) Wastewater Flow: `:.LQ GPD (See note below, if applicable ❑) 2��V/® 9NC--�Z) y c.:-� � tl (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size i ® O 0 gallons Exact length of each trench G ° feet Trench Spacing: `� Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: C, inches Maximum Trench Depth of: N1 "4ti 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 Aggregate Depth: Conditions: 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. inches below pipe inches above pipe inches total * *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subIRF amn if the 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 ct ii�u to comp' ce with V4gLvisigns of,*Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: Z Construction Authorization Expiration �S/ Cl iT hSyVOCZ0 wk,-/ 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: c��, Design Flow (.1949):W Location of Site: Property Recorded: Water Supply: . Public❑ Individual F1 Well Evaluation Method:�uger 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 L E # .1940 Landscape Position/ Slope % Horizon Depth (In.) SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS Profile Class & LTAR .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color 1943 Soil Depth (IN .) .1956 Sapro Class .1944 Restr Horiz .:3- Ge�� 55 lP �5 5 �x B� V- 562, 'Rcl P5 Description Initial S ste Repair System Other Factors (.1946): Site Classification (.1948): PS Evaluated By: Others Present: Available Space (.1945) System T e(s) X73; v 2 C Site LTAR , 5 .:3-