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IPACHTE #1�.-5 4 Harnett County Department of lic Health '. 1 A building permit cannot be issued with only an Improvement Permit pp {� PROPERTY LOCATION: M I-,Qg O)m V 2 Ro ISSUED T0: SUBDIVISION JR SWa ®.as ?o i LOT # Iti`7 NEW)< REPAIR,❑ ANSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 577 153.: n35� Proposed Wastewater System Type: Q­5 °10 QG.O U CX 1 d f3 Projected Daily Flow: IG © GPD Number of bedrooms: 3 Number of Occupants: max Basement [--]Yes XNo Pump Required: ❑Yes ❑ No XMay be required based on final location and elevations of facilities Type of Water Supply: El Community � Public E] Well Distance from well 1.6 O feet Permit valid for: Five years Permit conditions: d ❑ No expiration Authorized State Agent:: Zt -.105 Date: 1 1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Departm t in no way guarantees t ce of other permits. The permit holder is re.ponsible 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 Impr lent 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, .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: S—MTAC N L � U 1 z.�£�L -a` PROPERTY LOCATION: n I C.g_0—r0 1.,4 £2 �D `} SUBDIVISION PA'loeas ?0 % r J1 LOT # 14� Facility Type: 5�fl �'`3�/ New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes 'XNo Type of Wastewater System ** a.sVe, REavcn oN S Ys-t'G.res (Initial) Wastewater Flow: 3Vc0 GPD (See note below, if applicable ❑) pv me 0 aS Yo 9,f_O u Uft 0 t1 (Repair) Installation Requirements /Conditions Number of trenches I Septic Tank Size 1000 gallons Exact length of each trench 1 SO feet Trench Spacing: Feet on Center Pump Tank Size WOO a gallons Trenches shall be installed on contour at a Soil Cover: G -c%A inches 1 tvEE °� Maximum Trench Depth of: M -3(- 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 inches below pipe Aggregate Depth: inches above pipe Conditions: If PQMIP 1'S �4f. EoEA Sw,�GU x-N L RuD e10 NCL �% e,EflS 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 to revocation if t site 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 Authorization is jpbje`ct to compliant' a prop cf the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: aA 113 action Authorization Expiration Date: ti 1�Z HTE# Permit # ;,G549 H(arnett County Department of lltblic Health Site Sketch PROPERTY LOCATON: ISSUED T0: rasa SUBDIVISION peso N<, Ot N"i LOT # IIA-1 Authorized State Agent: 14-5 6AICOVTO Date: 5)�' 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: s Os Design Flow (.1949): _36 Location of Site: Property Recorded: y° Water Supply: Public❑ Individual ❑ Well Evaluation Method:bkAuger BDring ❑ 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 3 L; \F iT Description Initial Systqn Repair System Other Factors (.1946): Site Classification (.1948): - Evaluated By: (11' Others Present: — Available Space (.1945) L System Type(s) 3"0 24) P hf+^ Site LTAR