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IPACHTE# ta-� �a3� Harnett County Department of Public Health Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: Ogt.. ISSUED TO: �Q.E �i: `Jm Y-( C6,%yCX44 SUBDIVISION LOT # 116 NEW)4 REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: rai=U c.5c' -A (1=0 Proposed Wastewater System Type: 2.su1 eoyG; Projected Daily Flow: Q" ci GPD Number of bedrooms: —Q11 Number of Occupants: max Basement ❑Yes X No Pump Required: ❑Ye Type of Water Supply: Permit conditions: s ❑ No May be required based on final location and elevations of facilities ❑ Community Public ❑ Well Distance from well 1 O C3 feet I f,91 Permit valid for: Five years ❑ No expiration Authorized State Agent:: Date: 1'a.. 1'i '� SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees t suance 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 inte 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. (Required for Building Perrrtit� 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: Z f6tZ- —, �crtC�� Cows- WLVc.�toty PROPERTY LOCATION: '�,S"NNP` SN SC-:w,oaL SUBDIVISION LOT # _ Facility Type: 'P4\ New ❑ Expansion ❑ Repair Basement? ❑ Yes ": No Basement Fixtures? ❑ Yes X No Type of Wastewater System ** `a�"lo V"-�y-r--%L q r, (Initial) Wastewater Flow: `�'� � GPD (See note below, if applicable ❑) a50fie 9-6ca y5S6Sv1 (Repair) Installation Requirements /Conditions Septic Tank Size 1 ®CJ© gallons Exact length of each trench feet Trench Spacing: Feet on Center Pump Tank Size lo�allons Trenches shall be installed on contour at a Soil Cover. (o inches `.F ra eso6o Maximum Trench Depth of: i'21. 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 Aggregate Depth: Conditions: inches below pipe inches above pipe inches total * *If applicable: l understand the system type spedfred is different from the type specified on the application. l accept the specilcations of this permit Owner /Legal Represents ' ' ture: Date: This Construction Authorization is subject to rev ' n if ite plan, 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 A zation is b'ect ith 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: Date: N - Co uctjon Authorization Expiration Date: HTE# Permit # x 5 v� w � y� G 9CA- i �EN SG���. �Z-9 } J I 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: :l j vLr�S Design Flow (.1949): al� ®� \ Location of Site: Property Recorded: Water Supply: Public[] Individual ❑ Well Evaluation Method Auggr Bbxing ❑ Pit ❑ Cut Type of Wastewater: a 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 + LS G i.s Y"�► G 5 v� Ns�v4 a U -) o Q, ,"i's 1 Cf*L -7 )a .0 aO ra: 2) b : su_ Fl� S5)-.P p s fl'2. �i � ► p�JC� --1' 2.�a� 1}1 5 C-L R 5 3 • IL 5 -CL VPn K jrL 5 D -' a Description Initial Systq61 Repair System Other Factors (.1946): Site Classification (.1948): 'q�) Evaluated By: Others Present: iy n Available Space (.1945) System Type(s) S f Site LTAR '� + + NrDjm S/ ND�