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IPACHTE# 0`1 r-s--~'.a3-7 a Harnett County Department of Public Health 2 5 5 5 3 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ~ y ct~t sc y R o v,c) ISSUED TO: C.01-4 t -RhcO Q C_•+6t~n~N-T SUBDIVISION _ ~ dopgll.<1,C LOT # X75 NEW,X\ REPAIR ❑ E ANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SOU ('Al Proposed Wastewater System Type: v Lr 4Tyo s►1. Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes 4 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 1od feet Permit valid for. )<Five years Permit conditions: ❑ No expiration Authorized State Agent:: (~h Dater -1 -1 C) I SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holder is re ponsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation 4 the site plan, plat, or the intended use changes. The Improvement mit 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, .1957, .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 T0: CAv 1NE55 ~_F* V Q QE~EtitlQ ~rC PROPERTY LOCATION: ~yctt6Ry Facility Type: 5'W'0 C'~ 1~xS`l Basement? ❑ Yes -;K No Basement Fixtures? Type of Wastewater System** (:!,o -vE_"-, \ o", SUBDIVISION \,JooosN~cz~ LOT # 115 X, X New ❑ Expansion ❑ Repair ❑ Yes No (See note below, if applicable A J _ ~.S °~o ~EO u~-t gnu ~CX Ds~ 1►--• Installation Requirements/Conditions Septic Tank Size iooco gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. (onditions: pair) Number of trenches 5 Exact length of each trench ",D feet Trenches shall be installed on contour at a Maximum Trench Depth of: a`-1 inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM (Initial) Wastewater Flow: "NO GPD Trench Spacing: 9 Feet on Center Soil Cover. ~ a., inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe la inches total *If applicable: /understand the system type specified is different from the type specified on the app/ication / accept the spec16cationr of this permit Owner/legal Representative Signature: Date: This Construction Authorization is su vocation if th to 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 subject to coy mpli~ anceti vise the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: iLS Date: ction Authorization Expiration Date: -7 HTE# -5-3~~70 ~SSS 3 ISSUED TO: o-4 Authorized State Agent: YC) Aelq. Q,r-0Lecwo "pp" p. I ~jl~nsl' a.a D Q C 36 ,I W Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: N yczsF_rt ~t S2,D 1''~'"`'~ ~EY PM6*aS SUBDIVISION Wooos~\tLE. LOT # ti1S - ~9>,~~ "Coy res Date: `l,~ I a U1 y s~~ ``1 M&10UG 1A V Q_ ueparuttantui crnvnunttiaut. rwdtuiI, d11U wdiww na,VUit,aa .30M"t. Division of Environmental Health Property ID: On-site Wastewater Section Lot File M SOILiSITE EVALUATION Code: for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Proposed Facili(y: 4c~ mot, Design Flow (.1949): Location of Site: Water Supply: Public [ j Individual WeM Evaluation Method: Auger Boring Pit Type of Wastewater } Sewage Industrial Process P J R Date Evaluated: ' IVY cj Property Size: 1 Property Recorded: Spring [ j Other [ ) Cut ( ) Mixed W SOIL MORPHOLOGY OTHER F •1941 PROFILE FACTORS 1 .1940 .1942 L E Landscape horizon Poaldord Depth .1941 Strud" .1941 Consbtsncs Sod Wstr .1943 igm .1NW4 Profll~ 9 S % (IN.) I Texture minemlogy color son Swe Resir Cuss ML) Class kO b r t 3 LTAR c3 ~'y 7 7 - r O 2 `7 ~ 5 ~ an ti5l H'P Description Initial S stem Repair System Other Factors (.1946): - Available Space (.1945) Site Classification (.1948): 5 S stom Type(s) C'e, u Evaluated By, Site LTAR Others Present: