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IPACHTE#10°1-~~4o Harnett County Department of Public Health 2 5 5 9 4 \ os~, ISSUED T0: Cv MP l2.t~Pnct~ t~pc•ti S SUBDIVISION _CNinL~ttp, SEoson,> LOT # ro NEW'K REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Sc~0 Q~5-AL't\ ' Proposed Wastewater System Type: Q~ n+e 1 o Co, ,rst T sorro,L Projected Daily Flow: 3C O GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes XNo Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities Type of Water Supply: El Community Public ❑ Well Distance from well tC) O feet Permit valid for. ~ive years Permit conditions: El No expiration Authorized State Agent.: n Date: 8 11, 2z 4 O SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department it no way guarani issuance 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 intended use changes. 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, .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 TO: Cvm2Fiu-v,"y \A0cfN PROPERTY LOCATION: ?oc-O ~A5A V-is, SUBDIVISION CAnot_.,r p, Stnso cu 5 LOT # Co Facility Type: OLD^x New E] Expansion El Repair Basement? El Yes No Basement Fixtures? E] Yes ~ No Type of Wastewater System" ~oM-!70 Cor►4~tvs\ orJ o,i, (Initial) Wastewater Flow: 3~b GPD (See note below, if applicable vc~sC7 ►J (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size tvoo gallons Exact length of each trench O feet Trench Spacing: Feet on Center Pump Tank Size ~o gallons Trenches shall be installed on contour at a Soil Cover. 1d-a~ inches Maximum Trench Depth of. ' -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: Pa4zRQ2 Fv.Li- ~ Q ~'„fN~ C 'J $E 0,)s NI l~ inches total C`1 A~ Nc7s 6 ~ E.F~~ **If applicable: / understand the fvstem type specified it different from the type fpecided on the app/ication. / accept the speciflCd#onr of thif permit. Owner/Legal Representative Signature: Date: This Construction Aurhntintinn it mhiarf Hr--ti- if the w, -51' -1 111- -full -1-11 auuoi snail not oe transterrea when there is a change in ownership of the site. This Construction Authorization is abject to complian ith ,,ionhe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: PoN Authorized State Agent: - QS Date: % a* o4 ruction Authorization Expiration Date: L-VLZ HTE# 0:A -5--X~4-4 C) Permit # a55ct4 Harnett Count`T I)epartment of P blic nealth. Site Sketch PROPERTY LOCATON: Po N pC,rufy~ ISSUED T0: ~v rh .v a o M SUBDIVISION GAS OL1 N A SF_o>o,~ s LOT # ~o Authorized State Agent: qsUILV4 E.~~Ta Lvts3o Date: I t' ' asal" )c~NJ~ 1~7` ~s e E ~ -)5" d a z SlMq 4 Fto a, Q I 5;D LAN I Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIL/SITE EVALUA'T'ION for ON-SITE WASTEWATER SYSTEM Owner. Applicant: Address: Date Evaluated: Proposed Facility: - ~ Design Flow (.1949): c Location of Site: Property Recorded: Sheet: Property ID: Lot File Code: Property Size: Water Supply: Public ❑ Individual ❑ Well ❑ Spring Evaluation Method: Auger Boring ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed ❑ Other P R O F I 1940 OIL MORPHOLOGY .1941 THER PROFILE FACTORS L E # Landscape Position/ Slope % Horizon Depth (In.) .1941 Structure/ Texture .1941 Consistence Minenlo kv .1942 Soil wetness/ Color .1943 Soil Depffi (IN.) .1936 Sapro Class .1944 Restr Horiz Profile Chun do LTAR 5 LK)j k ~Sy- --~r-~ Va o~'37~ ' se-i_. T~ s5 P5 , ~5 Description Initial S st Repair System Other Factors (.1946): d Site Classificati 1948 t ce ,1943 on E l d ' Sys em Ty a System PU MP CCc. va uate : O ) O h Site LTAR '14 t ers Present: P6r Nd-, N(-- GDCr) 8F f?kWtZ ~7q IsP~~~Bi~ ti" fan CA.- a~1