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IPACHTE# o-A Harnett County Department of Public Health Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION- M oo " G P, n ISSUED TO: P:1 17- U `tom SUBDIVISION NEW' REPAIR ❑ EXPANSION Type of Structure: M i",' , ) '3"L_ Proposed Wastewater System Type: C,~,,,c ~~sG~st~f Projected Daily flow: 4 4` ) GPD Number of bedrooms: 1k Number of Occupants: max Basement ❑Yes f~ No 25307 LOT # Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yes %1S1 No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ❑ Public X Well Distance from well 50 feet Permit conditions: Permit valid for. Authorized State Agent: The issuance of this permit by the Health Department in no way guarantees the a ce 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: 4 i Opt SEE ATTACHED SITE SKETCH of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Dement Permit 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, .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: Utzvc ua~z~ PROPERTY LOCATION: SUBDIVISION LOT # Facility Type: ~d~ Cap"X~o~ New ❑ Expansion ❑ Repair Basement? ❑ Yesj No Basement Fixtures? ❑ Yesl No Type of Wastewater System** C.* " .4 ter vd t ~"k (Initial) Wastewater Flow: 410 GIRD (See note below, if applicable (Repair) Installation Requirements/Conditions Number of trenches a Septic Tank Size S ©CC) gallons Exact length of each trench `6 a feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. to--1`,, inches Maximum Trench Depth of: QL4-30 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: Aggregate Depth: inches below pipe inches above pipe a inches total **If applicable: /understand the ryrtem type rpecibed is different from the type ,rpecijed on the application. / accept the .rpecif1wim of thif permit. Owner/Legal Representative Signature: Date: 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 ownershio of the site. This construction Authorization is subject to compliance Authorized State Agent: Five years ❑ No expiration Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Date: ~i a oq Construc nn Authorization Expiration Date: -,3111 HTE# Permit # Harnett (bounty Department of M blic Health Site Sketch PROPERTY LOCATON: ISSUED T0: SUBDIVISION LOT # Authorized State Agent: (4uw OZ }4+- Date: 41 31 n C , Cc)s.N6~S~dNaL 0.2E~ &W, D"+tv\ Y~ C~ fl'~vM1~ N P-0 Division of Environmental Health Property ID: On-site Wastewater Section Lot File SOIL/SITE EVALUATION Code: for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: \ o)~° Proposed Facility: ~i ~EA4~N` }ac n,~ Design Flow(. 1949): Location of Site: c-< Water Supply: (J Public [ J Individual ~Q Well Evaluation Method: Auger Boring [ ]`Pit Type of Wastewater: - - Sewage (j Industrial Process Date Evaluated: Property Size: Property Recorded: ( j Spring ( J Cut [ J Mixed [ I Other P R o F SOIL MORPHOLOGY lsat OTHER~ - PROFILE FACTORS t L E # Landscape PositioN,-- . Slope% Hodion Dopth (IN.) 1941 " -Structure/ Texture 4941 'Consistence _ Mineralogy .1942 sal ; . Wetnessf'. 4 color 1943 ; SON" i Depth' IN.) .1956 Sapro-` Class , ,1w, Restr.; . . lioriz Profile l Ctsis3 & LIAR b-tit, G 5 v s Sl~ Description Initial System epair System Available Space (.1945) System Type(s) c C? rIj Q_'0" I Site LTAR C1 Other Factors (.1946): Site Classification (.T9 Evaluated By: Ps Others Present: ~S~