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IPACHTE# N�),- S -��Mi33 Harnett County Department of Public Health Imurovement Permit 27169 A building permit cannot be issued with only an Improvement Perri PROPERTY LOCATION: SI _4G.P MQ ISSUED TO: cJ(1414 a mss; SUBDIVISION Y-V—,t -ai �+T2M 5 LOT # -- NEW 8( REPAIR ❑ IPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Proposed Wastewater System Ty e: P u m P 5 0 3-S° a Projected Daily Flow: L") ® GPD Number of bedrooms: L) Number of Occupants: max Basement ❑Yes XNo 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 100 feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: ~\ �� Date: 141 1-1, )a SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issu f other permits. The permit holde�ible 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 Improverntrit 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 Perni l 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: VA PROPERTY LOCATION: Pc,QZ PQ— SUBDIVISION �Ze= �aL��.t �'�.2sc� LOT # 5Z facility Type: S 'PQ `S3 New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo Type of Wastewater System ** Qym4) `c�.�.�'°�6 uG'S10�1 SJ5-gC'n (Initial) Wastewater flow: �_���, �_ GPD (See note below, if applicable ❑) y mP1;� v�AUUS\O�-i (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size LO o p gallons Exact length of each trench 40 feet Trench Spacing: CA Feet on Center Pump Tank Size x-0 ®® gallons Trenches shall be installed on contour at a Soil Cover: r6- °» inches Maximum Trench Depth of. l06 ° `3t 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 Conditions: inches below pipe Aggregate Depth: inches above pipe inches total WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. 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 tram the type specified on the app lication. !accept the specifications of this permit. Owner /Legal Representative ' nature: Date: This Construction Authorization is subject to rev e sit Ian, 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 sul�cl t compliance th ons a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: R.&A 5 Date: \01)-7,1')A Authorization Expiration Date: to HTE# Ia.-5 -�14 s3 Permit # 169 Harnett County Department of '� -tblic Health Site Sketch PROPERTY LOCATON: fl2 ISSUED T0: SA SUBDIVISION lZ.� nsi —Q.•� �2�nS LOT # Authorized State Agent: QG`� ®t-�v 'T ©1- ��-sCo Date: t 0 11"7 1 CL 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): is Location of Site: Property Recorded: Water Supply: ublic❑ Individual ❑ Well Evaluation Method Auger Bo ing ❑ Pit ❑ Cut Type of Wastewater: Na 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 .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz 1 Cl - c�- l✓ t` To � �7 g�Mineralogy eke; i it �SS� hat �y q, Q 1 !_ J 3�tt-:�'6 G s7 ?�, S Y- sC L_S£;, �'S S -1 2@ 1 Description Initial S ste Repair System Other Factors ( 1946): Site Classification (.1948): (' Evaluated By: C7 Others Present: Available Space (.1945) System Type(s) is =_ Q v ? Site LTAR S"