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IPACHTE# O`1Harnett County Department of Public Health 2 5 6 9 9 Improvement Permit A building permit cannot be issued with only a Improvement Permit PROPERTY LOCATION: eD ISSUED TO: PcL\n\El\.•~ Q o,~ ss P,~~ t1L_ SUBDIVISION Psi,'N ME'~\Mfr R+Ggt &S -s -.'I& LOT # 1 NEWX REPAIR ❑ EXPANSION ~ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: N qN Proposed Wastewater System Type: Co..r-rE..rS No c•r ;-,L- Projected Daily Flow: 3 roa GPD Number of bedrooms: Number of Occupants: ro max Basement ❑Yes No Pump Required: ❑Yes `K No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ` 4 Public ❑ Well Distance from well 100 feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent:: N"~f Date: 1 AA O SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the ' ce of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation H 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, .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: Pr~\~. t ,SAL- ESSr~~E ► t r PROPERTY LOCATION: 0Ev.ef ~q SUBDIVISION ~~-\rn Efltr\L RFP.L CSTA~C~ LOT # S- Facility Type: Mme.'Op"f_ ($A:-76J Basement? ❑ Yes I No Basement Fixtures? New ❑ Yes ❑ Expansion ❑ _22~ No Repair Type of Wastewater System** ~N~E. \v tv KL_ (See note below, if applicable 9-t0ucxco,4 S'7*-t"CEM (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size t ebc, c7 gallons Exact length of each trench J_v feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of 4'i inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: W P~-\E _ ~-r r M0" ncQC_)NL.A-% ©t'4 r\oS't 2'f~ 10 'iTwJ'1 (Initial) Wastewater Flow: GPD Trench Spacing: c1 Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: N~ v~\`\-, tF5 inches below pipe a inches above pipe l~ inches total **If applicable: / understand the system type specified is different from the type specified on the application. / accept the specifications of this permit Owner/Legal Representative Signature: Date: This Construction Authorization is su 1b e2t t vocation if the 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 F Construct on Authorization ie~to compwitt Rprovisi L the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH r, Authorized State Agent:> ~S Date: l 1 01 Co ction Authorization Expiration Date: l 1 HTE# Permit # aS~`I'I Harnett County Department of Public Health Site Sketch li PROPERTY LOCATON: Q t:a~,a ISSUED T0: ~M~ t_ 5~~i✓ U-C SUBDIVISION P2~ME~~~E. 2GAL Mc-_ LOT # s- Authorized State Agent\\~"~ R~ars~~~~E~t `CoLoC~ Date: to ttt d I a..~p UG S ~ C7 ~.l I ` l t ~ 4-- ~d f as ^6 , a. 5d' ~ c LL NHS 0 EA"'1 14 Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Sheet: Property ID: Lot File Code: Owner. Applicant: Address: Date Evaluated: Proposed Facility: 's g~cv",A~nC Recorded: Prop" 9): 34 a it' Property Size: Location of water Supply. Public p Individual ❑ Wen p Spring ❑ otha Evaluaion Method: Auger Boring ❑ Pit Cut Type of Wastewater Sewage p Industrial Process H Minced P R O F 1 L 1940 I b SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS E # an caps Poehioo/ Slope % Ho&os Depth (Ia) h .1941 shucdrd Texture I- .1941 Con"aece Miaeralo .1941 Soil wefnow color .1943 sod Depth IN. .1956 sgro Cim .1944 Reek Hail Prottle C11001 A LTAR 1 (o O- C Ls w ti )N r~ l.d s x s~ Fn s5 ~o~ 2 ~~3 c~ P~ 4 0 5g ~ F(ti LC)lg X64, 3" US ~ ~ a~% 4 aoG s vin. ~.s~ ~0-3a sgk s c.~ was 5 ~ v~ Q Q s_ <; -37 31 e sn S 5C23~ :;R,\<- S(,l Nil P rn 0-0 t-3 .5' i% r sysu~m U1hlxr Factors (.1946 g t°--- Site Classification (.1948r-f5 rc~ i~,~ Evaluated By: d-~ s Odd Present: