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IPAC RRHTE# 0G-5-1~_1:~N(Z Harnett County Department of Public Health 25312 Improvement Permit A building permit cannot be issued with only an Improvement Perm' PROPERTY LOCATION: C-14>0L`1ESx:VL ISSUED TO: 1- ~a Cry SUBDIVISION C~ ossL~~ K LOT # _ NEWA REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S vz) (_5J= X3 `b Proposed Wastewater System Type: a5'7e 9,UOuG1 s6N Projected Daily Flow: GPD Number of bedrooms: a Number of Occupants: 4 max Basement ❑Yes NO 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 S~<3 feet Permit valid for Five years Permit conditions: ❑ No expiration Authorized State Agent:: 7- Q-, Date: 1-4 O SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance ermits. The permit holder respo 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 Improvement 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: GoaG.P, PROPERTY LOCATION: C-tt'>"(!>CC„lL IS9 0- ,~sri6S SUBDIVISION ~oSS> z ~~L LOT # Facility Type: c~ LSD3~' / New ❑ Expansion ❑ Repair Basement? ❑ Yes = No Basement Fixtures? ❑ Yes X No Type of Wastewater System** a5°~a ,C-S, ON (Initial) Wastewater flow: a40 GPD (See note below, if applicable ©9-le A P~~ cz~Ar;c~tvC (Repair) Installation Requirements/Conditions Number of trenches 5 Septic Tank Size y c gallons Exact length of each trench 44 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: la,, inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: M err tt"v m O F C," o~- c)w Pie V-a0 M NSU-r s11 N-C Trench Spacing: r~ Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: t1 ~ S ~E2M~ inches below pipe inches above pipe inches total **If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation i plan, pl 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 s compliance witrovi d Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: 4.3 Date: `t tiS ~61 Construction horization Expiration Date: 2 F HTE # 4G - S l~l-1 ~(L Permit # QL 531 Harnett Connt`T Department of Ptblic Health Site ketch. PROPERTY LOCATON: ISSUED TO: ~-EC - SUBDIVISION C-*,-,5L1 , }4- LOT # Authorized State Agent: Date: 1S Q L~ti~ of department ui mnvnunulenl, rlCdilll, d11U 14dtUldl MUt UU1l.eJ JI ICet. Division of Environmental Health Property ID: On-site Wastewater Section Lot File SOIL/SITE EVALUATION Code: for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Proposed Facility: I (3 ~~fG Design Flow (.1949): Location of Site: J\ Water Supply: Public Individual [ J Well Evaluation Method: Auger Boring Pit Type of Wastewater: N Sewage (J Industrial Process Date Evaluated: Property Size: Property Recorded: [ J Spring ( ] Cut [ ] Mixed [ ] Other P R a F SOIL MORPHOLOGY .1941` OTHER'` PROFILE FACTORS i L E # .1940 Landscape Position/ Slope% Horizon Depth' (IN.) 1941 Structure/ Texture 1941 Consistence Mineralogy .1942 Soil Wetness! Color _ ,,1343 Soil Depth (IN.) .1956 Sapra Class 1944` Restr Horiz Profile Class , & LTAR L •3 Description Initial System Repair System Available Space (.1945) System Type(s) "Ytct6D p4EtaEO.t 9cL~{ Site LTAR ' 3 Other Factors (.1946): _ Site Classification (.1948): es Evaluated By: t:\ Others Present: SEE ?aoe()r,*,l .