Loading...
IPACHTE# 12, °6`2r , Harnett County Department of Public Health Improvement Permit 27190 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 11'4 6G— ISSUED TO: 5N� c�G >o, �y�� p� SUBDIVISION LOT # NEW'K REPAIR ❑ EXP ION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5�Q x`73 Proposed Wastewater System Type: Vu e S 1 0 Projected Daily Flow: 3 GPD Number of bedrooms: 3 Number of Occupants: E' max Basement ❑Yes XNo Pump Required�Yes 11 No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community .Public ❑ Well Distance from well 10 (Z) feet Permit valid for: Five years Permit conditions: LJ No expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the issuance 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.. Date: _�O 3 1 11�1`. SEE ATTACHED SITE SKETCH permits. The permit holder is respon ible for checking with appropriate governing bodies in meeting their requirements. This ermit 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, .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: Is— Facility Type: Basement? ❑ Yes No Baserr Type of Wastewater System ** p u mP (See note below, if applicable ❑) f U CVIK Installation Requirements /Conditions Septic Tank Size t go o o gallons Pump Tank Size i O © 0 gallons Pump Requirements: ft. TDH vs. Conditions: O X2.5 PROPERTY LOCATION: n N �6 Vp SUBDIVISION Qur'4SE,--� LOT # _ New ❑ Expansion ❑ Repair ent Fixtures? ❑ Yes -49\ No 0 Llg- 6 9--G—D v CZS 1'J N S , (Initial) Wastewater Flow: 7 GPD o i GGPue--7'1,01N (Repair) Number of trenches k Exact length of each trench -7S- feet Trenches shall be installed on contour at a Maximum Trench Depth of. 3 b inches (Trench bottoms shall be level to +/ -114" in all directions) GPM Trench Spacing: �) Feet on Center Soil Cover: 1 2- 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 IOFT. 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 speciped is different from the type specified on the application. / accept the specifications of this permit. Owner /Legal Representative ature: Date: This Construction Authorization is subject to revocatio ' e site pl 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 su ' ompliance the ovi ' of aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: �Constrtn Date: 1 o a � thori zation Expiration Date: ) b HTE# Q-- 5- -3 � 5 Permit # 2n ) °t C) Authorized State Agent: BE lid 0 1-7S/ 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: 1�,, b3 �,vc s5 Design Flow (.1949): Location of Site: Property Recorded: Water Supply: �1[�Public❑ Individual ❑ Well Evaluation Method Aug r 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 43 il [D:et:h (IN. ) .1956 Sapro Class .1944 Restr Horiz r Description Initial SysterA Repair System Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: i3�s Available Space(. 1945) y r System Type(s) RV C4ti ° ' ' Site LTAR