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IPACHTE# / - a � Harnett County Department of Public Health Improvement Permit 27213 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 1;7 , ISSUED TO l :, SUBDIVISION LOT # NEW L�!f a R AIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Proposed Wastewater System Type: Y 4o tZSJ tJ'Z Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: — max Basement ❑Yes o Pump Required: ❑Yes ❑ No V/ M,aY be required based on final location and elevations of facilities �,% Type of Water Supply: ❑ Community ;'Public ❑ Well Distance from well feet Permit valid for. L-�1'Five years Permit conditions: n a a 6 4-y ^'4 e..,, '0 y` =k ["' ❑ No expiration Authorized State Agent= ®— %( Date: 14 '-'ZZ ^ /L SEE ATTACHED SITE SKETCH The issuance of this permit b tl Health Department in no way guarantees the issuance of other permits. 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, .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: i1C i PROPERTY LOCATION: � ;- SUBDIVISION LOT # Facility Type: 12/New Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes L>" No Type of Wastewater System ** V 'g"uC at, '�s (Initial) Wastewater Flow: 3 GPD (See note below, if applicable ❑) U k 1 2i5�1c 0 ld (Repair) Installation Requirements /Conditions Number of trenches Z Septic Tank Size /060 gallons Exact length of each trenc / Z40e `0 tom'. feet Trench Spacing: Feet on Center Pump Tank Size /j CIO 0 gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of. Z 'z` � V 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 IOFT. FROM ANY PART OF SEPTI( 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 app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: pate: This Construction Authorization is subject to revocation 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 is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. Ott A) IAUItV Mit SKETCH X Authorized State A t: Date: Construction Authorization Expiration Date: 1 0 -'Z 2. L1 ""1 HTE# 17,- -21119 Permit # 27Z/.3 Marnett County Department of Public He4rdth Site Sketch jqq 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)34- Location of Site: Property Recorded: Water Supply: . ___011r'ublic❑ Individual ❑ Well Evaluation Method: ❑ -- uger Bo g ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F 1 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 b -IS JL,t,5 J6 JN � � bl7vt. Description Initial S ste Repair S stem I Other Factors (.1946): Site Classification (.1948): 1 Evaluated By: Others Present: Available Space (.1945) V V System Type(s)l Site LTAR ''f