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IPACHTE# o°~-s'4 Harnett County Department of Public Health 2 5 3 4 9 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 4()] ISSUED TO: ~1 L~ S>asn~ SUBDIVISION , , , , s LOT # NEV~'g REPAI ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: "7) FO ~4.' -+~'~3 b Proposed Wastewater System Type: Cog-4 v 6x-4-< v o N A L, , Projected Daily Flow: LO GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes 'KNo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t ' 0 feet Permit valid for Five years Permit conditions: _ ❑ No expiration Authorized State Agent:: Date: -11 N 1 0'2\ SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance o ermim 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 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. Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1952, AS4, .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: NI~'-- \4~ \L-i_-c%, r-S PROPERTY LOCATION: L-1 b 1 SUBDIVISION \A Facility Type: e: 5-q7(0 t-'"~3$J LOT # Qs , ty yp :9, New ❑ Expansion ❑ Repair Basement? ❑ Yes 'R No Basement Fixtures? ❑ Yes No Type of Wastewater System** ( ~zVE ti.ZC.c~ sy aL- (Initial) Wastewater Flow: 3 LO GPD (See note below, if applicable C-0 C4 \c3,.rP+t„^ (Repair) Installation Requirements/Conditions Number of trenches 2). Septic Tank Size l o©a gallons Exact length of each trench S feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: '~-4 inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: 'I Feet on Center Soil Cover Q, inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: G inches below pipe inches above pipe 11. inches total **If applicable: / underftand the ryftem type specified is different from the type fpeci6ed on the app/ication. / accept the .rpecifmwa of of thin permi.. Owner/legal Representative Signature: Date: This Construction Authorization is subject tion if the site n, 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 complance kt e o e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: -7 111 t) Authorization Expiration Date: HTE# Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: Lt ISSUED T0: SUBDIVISION 1LL1D.w,3 LOT # Authorized State Agent,: 4S~buv~t,"Totvx~p~ Date: 1 a _ aw, ueparunem ul CIM101111t1.R, nt.dlUl, d11U IVdtUldl MebuUlt uz, JI 1t:"j. Division of Environmental Health Property ID: On-site Wastewater Section Lot File SOILiSITE EVALUATION Code: for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Proposed Facility: (a EOqg~,at% Ntt~E Design Flow (.1949):3` Location of Site: Water Supply: h [ J Public (J Individual 'ell Evaluation Method: iger Boring J Pit` Type of Wastewater: wage ( J Industrial Process Date Evaluated: Property Size: Property Recorded: [ ] Spring ( ] Cut ( ] Mixed [ I Other P R o F SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS 1 L E 0 .1940 Landscape Position/ SI % Horizon Depth IN.) .1941 Stricture/ Texture .1941 Consistence Mineralogy .1942 Soi♦ Wetnew Color .1943 Sol De IN.) 1968 Sapro Class ; .1944 f Restr Horiz Profile , Ctaas 8 LTAR Description Initial Sy m Repair System Available Space (.1945) System Type(s) Site LTAR Other Factors (.1946): Site Classification (.1948): r- Evaluated By: 0 1 Others Present: S /tom