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IPACH T E # s- D.! Harnett County Department lie Health Imorovement Permit A building permit cannot be issued with only an Improvement Permi� PROPERTY LOCATION: vrty ^�O ISSUED TO: i chcsc,L >U L CLS SUBDIVISION LOT # NEW REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S(ii ( 5 a=nLtCJ\ Proposed Wastewater System Type: 9u Q 1 o a 5G o 1 uc� i o rJ Projected Daily Flow: 3 ® GPD Number of bedrooms: Number of Occupants: Il� max Basement ❑Yes XNo Pump Required -�Mes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well l bO feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: \ Qi— S Date: \> ZZ -Al2— SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guara the issuance of other permits. The permit older is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the site plan, plat, or t 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. Reouired for Building Permit The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1958, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached syste layout. ISSUED TO: u PROPERTY LOCATION: ��Ls8u2y p �1 SUBDIVISION Ccr�ct;�yczy Pc,2\C., LOT # T� Facility Type: J )Sl New El Expansion El Repair Basement? El Yes �, No Basement Fixtures? El Yes �No Type of Wastewater System ** eUm�o 5S—°1e !�Qwa) Initial) Wastewater Flow: 6d GPD (See note below, if applicable ❑) eVT J-51 �e�d o CDv0—, \v.ly (Repair) Septic Tank Size f 6 o d gallons Pump Tank Size , D ©ci gallons Pump Requirements: ft. TDH vs. Conditions: Exact length of each trench JA) (�o feet Trenches shall be installed on contour at a Maximum Trench Depth of. l�Z inches (Trench bottoms shall be level to +/ -1/4" in all directions) GPM Trench Spacing: Feet on Center Soil Cover. inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: 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. 1 accept the specifications of this permit. Owner /Legal Represe ature: Date: This Construction Authorization is subject revo ' if the Ian, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Construct thorization is s ' ct ce ' the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: QL Date: �� a Constru'cl'6,Authorization Expiration Date: HTE# -' � ����� Permit # W-)3� d Harnett County Department of 11tiblic Health Site Sketch PROPERTY LOCATON: Co U ZD ISSUED TO: `j AP,r,4 SUBDIVISION C.oy- e-S &\Lz LOT # ` � Authorized State Agent�`�\� �`d `�d cXZ� Date: ���i, Mil r �cfp.lG1, � sI.E s () 8SJ1v \5�0 w M P\e r va- QQF>0 N 1F- A\%6 � i*.00.Qa'�1�7�{ PNQ ©S.Mr.NSI�s)� 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: 1j1 A Address: Date Evaluated: Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method: ger Boring ❑ Pit ❑ Cut Type of Wastewater: „f;- 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 .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz �r 7✓1 Z3 t- ® -2 SL z Description Initial S stem Repair System Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: Available Space (.1945) System T Site LTAR