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IPACHTE# cam- E---'0 Harnett County Department of Public Health 25186 Improvement Permit A building permit cannot be issued with only an Improvement Permit ~~~i✓ -V PROPERTY LOCATION: ISSUED T0: SUBDIVISION ~~~~t~loa; Rp LOT # NEW`Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: cDVO t6 nS'~ Proposed Wastewater System Type: C~c , v ~n c d~ F~L Projected Daily Flow: 3077 GPD Number of bedrooms: 3 Number of Occupants: C, max Basement ❑Yes No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: El Community ❑ Public Well Distance from well feet Permit valid for. Five years Permit conditions: EA " A ❑ No expiration Authorized State Agent:: Date: 3 { 1 (77) SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the i3sBa~ce 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 Imp, of 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, .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 T0: Facility Type: SA-~ nom) N New Basement? ❑ Yes N, No Type of Wastewater System** _ (See note below, if applicable Basement fixtures? ❑ Yes Installation Requirements/Conditions Septic Tank Size gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: PROPERTY LOCATION: ~~'i~c getsc~ SUBDIVISION LOT # ❑ Expansion ❑ Repair No (Initial) Wastewater Flow: C~ GPD iEJvC~IU tv ~yScn(Repair) Number of trenches @ Exact length of each trench feet Trenches shall be installed on contour at a Maximum Trench Depth of. N inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM Trench Spacing: Feet on (enter Soil Cover. ~o inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe 1 inches total **If applicable: /understand the rystem type apeciled Is differeflt from the type rpeciled on the app/ication. /accept the fpeciFications of chit permit Owner/Legal Representative Signature: Date: ma t.onstrucuon Aurnonzation ii'subie~t, to revocano it the site an, 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 to comet isions laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: °`i -3 111 o tion Authorization Expiration Date: 3 ~t HTE# 0 r1--s --~).IE,©a. Permit # a6 H narnett County Depa linent of P'tiblic nealth Site Sketch ROPERTY LO(ATON: 'P)Y---t\AC-L ISSUED TO: SUBDIVISION LOT # Authorized State Agent: S 0~wE2 ioLxsoo Date: 7!~~~ t~ ~(N/ IsQ ac)L~ $ Division of Environmental Health On-site Wastewater Section SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Address: Proposed Facility: 3 ~C y~ Ho Design Flow(. 1949): ~03 Location of Site: v~ icon. Property ID: Lot File Code: Applicant: Water Supply: [ ] Public Individual Well AX'S Evaluation Method: Auger Boring [ ] Pit Type of Wastewater: 1-9sewage [ ) Industrial Process Date Evaluated: 5) Sjd) Property Size: Property Recorded: Spring Other [ J Cut [ j Mixed P R o IF SOIL MORPHOLOGY .1941` OTHER PROFILE FACTORS 1 L' E # 1940 Landscape Position/ Slope% Horizon Depth (IN.) 1941 Structure/ Texture A941 ' Consistence Mineralogy 1942: Soil Wetness/- Color .1943 Soil Depth (IN.) .1956 Sapra Class . ,1944` Restr Ho& Profile - Class. ' & LIAR j S O- Li" G 5,~, ~Fri- N5 ,4 PS LA ~BIL 5(.IL F2 S 4-3 D a~~ SD K F2 J5 c a G VFn NF Description initial ystem ,Repair System Available Space (.1945) System Type(s) ~S(C q, ~p Site LTAR 1i of Other Factors (.1946): Site Classification (.1948): Evaluated By: } Others Present:__- 1 'a-'IO lt'