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IPACHTE# D~-s= 12a76W Harnett County Department of Public Health 2 5 51 2 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 7 rw 4-Ir /I ISSUED TO: Cam- ~ ~ +vt C/ SUBDIVISION LOT # t~ NEVI REPAIR ❑ XPANSION ❑ Site Improvements required prior t Construction Authorization Issuance: Type of Structure: 60 x a(n - c3 /3!L i~F Il (~/1r~c.t ~t~ cf L.~Jor ) m I- Proposed Wastewater System Type: U 7`s ,,,,__S - Projected Daily Flow: 6D GPD Q2~0 Number of bedrooms: 3_ Number of Occupants: (o _max Basement ❑Yes -,,4No Pump Required: 'As ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public Well Distance from well feet Permit valid for `~~T Five years Permit conditions: 2'c S"~~! Cr { 1 kI- f ~g t7 - Q A"-1-41 H L'7 S~yf ~j ❑ No expiration et h r p h cr- W kr _l'~^ AA d , P oil f 0v r /1 ,4r Z d-1 "Z,,, CA, Authorized State Agent: C/ 1z.1 Date: 0 l ,3"" 3 SEE ATTACHED SITE SKETCH The issuance of this permit by the health Department n. way guarantees the 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. 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 taws 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 payout. ISSUED TO: (,1 00A4?? =P' PROPERTY LOCATION: SUBDIVISION %rv ,n P 61C LOT # 1-60 Facility Type:- SAY(, s w ~P- 0<L_New ❑ Expansion ❑ Repair Basement? ❑ Yes ilg~_ No Basement Fixtures? ❑ Yes Type of Wastewater System" 7`, ~If'~- ~ c(~ E~t,~• S~ t ~cr ~ (Initial) Wastewater Flow: ~p ~ GPD (See note below, if applicable $Z) (Repair) Installation Requirements/Conditions Number of trenches _ A Septic Tank Size 102)D gallons Exact length of each trench feet Pump Tank Size I 30D gallons Trenches shall be installed on contour at a Maximum Trench Depth of. Aiy inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: Feet on Center Soil Cover inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total **If applicable: / understand the system type specified is different from the type specified an the app/ication. /accept the specifications of this permit. Owner/Legal Representative Signature: Date: 1. ---au- > -J- w -o~auvn n me Ine plan, pjar, or me mtenaea use cnanges. lne lonstrucnon Authorization shalt not be transferred when there is a change in ownership of the site. This Construction Authonzation is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this oermit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: Construction Authorization Expiration Date: HTE# ~Qq' 2, Permit # n)5 s"f Harnett County DepaAment of 1- t blic Health Site Sketch PROPERTY LOCATON: ~v r-a ISSUED TO: 0_ SUBDIVISION ro c c LOT # Authorized State Agent: Date: C, a~,, 5,~ 9h ` D Cl kwj Or ~fe Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner. Applicant: ©~1- -'~a t61 ~I 09 Address: Date Evaluated: - j J Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: Rf j>t .c ❑ Individual ❑ Well Evaluation Method: Auger Boring ❑ Pit ❑ Type of Wastewater Sewage ❑ Industrial Process ❑ Sheet: Property H): Lot File Code: Property Size: ❑ Spring ❑ Other cut Mixed P R O F I 1940 OIL MORPHOLOOY .1941 THER PROFILE FACTORS L E # Landscsips Position/ Slope % Horizon Depth (In.) .1941 Struch" Texture .1941 Consistence -Mineralogy .1942 Soil wetness/ Cola .1943 Soil Dapdi M4.) .1956 SWo Clan .1944 Ratr Hartz Profile Close & LTAR 2 5 -2, 5 G V l i- h , 0Y2 5t v~~ fC J o~L L u,~ ~ ~ C. Description Initial S stem Repair System Other Factors (.1946): p Site Classification ( 1948): r i Available Space .1945 . Evaluated By: Sydow , tr . Others Present: Site LTAR i