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IPACHTE# of,-~ Harnett County Department of Public Health 2 5 7 6 5 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ~Jte-9- ISSUED TO: ~ B auY r.s7C SUBDIVISION ~{ct tt AN ~PCtlr•~ LOT # a2i, NEW-X REPAIR El ~XPANSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5~0 ~6'" Proposed Wastewater System Type: C,o, r~~ ct~rsN f~C Projected Daily Flow: 3C O GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes ~o Pump Required: ❑Yes ❑ No 'KMay be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well TOQ feet Permit conditions: Permit valid for Five years ❑ No expiration Authorized State Agent.: R E~5 Date: \`oq SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the iss a 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 Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. Construction Authorization (Required for Bgilding 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: Q'o-'- C Facility Type: SC=ta ~69 ~cc~ New Basement? ❑ Yes No Basement Fixtures? ❑ Yes Type of Wastewater System' Lo .'t'rCL0N~ (See note below if applicable PROPERTY LOCATION: \A ~mG Q~o SUBDIVISION 'C-, 01 .r~N CAS LOT # DQ- 0 Expansion ❑ Repair No L "'4 G., %CS"A.1-- (Repair) Installation Requirements/Conditions Number of trenches a: Septic Tank Size t~ gallons Exact length of each trench 15 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: a2J inches (Trench bottoms shall be level to +1-114" in all directions) Pump Requirements: ft. TDH vs. GPM (Initial) Wastewater Flow: GPD Trench Spacing: Feet on (enter Soil (over: inches (Maximum soil cover shall not exceed 36" above the trench bottom) Conditions: A PA- eg 1-ar 1L V' ~ P, G A0" t-+2.' "Z~ I C- " Aggregate Depth: inches below pipe a inches above pipe inches total **If applicable: / understand the system type specired is different from the type specified on the app/inw n. / accept the rpeci6cationr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation 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 Construction Authorization is subject to complianca~with t e sio of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: ~~5 Date: I) o°I Con ction Authorization Expiration Date: " HTE# Permit # 2kS-6S HaI'nett County Depa linent of Public Health Site Sketch PROPERTY LOCATON: l2G Cl-9 ISSUED TO: SUBDIVISION LOT # as Authorized State Agent: t--"" (()Uw,-L-N0Ly-sc,S9 Date: I An lLi(" 110 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: Owftr. Address: Applicant: Date Evaluated: d: I c 1 2- f T ' / t N , 1 ~ 1~ ~ Proposed Facility: 3 acc~ Design Flo, (.1949(): 360 Property Size: Location of Site: Property Recorded: Water Supply: "Public ❑ Individual ❑ Well Evaluation Method: 0- Auger Boring El Pit ❑ cut ❑ Spring ❑ Other Type of Wastewater: [Sewage ❑ Industrial Process ❑ N,red P R O F I L 1940 I a ~ H SOIL MO . RPHOLOGY 1941 OTHER PROFILE FACTORS E # . s cape Position/ Slope % / CJ o~ ' orizon Depth (1n.) G ' (/5 .1941 struch a/ TeMsm (4 .1941 Consistence Mimalo .1942 Soil wetness/ Color .1943 Soil _DeRt IN. .1956 Sapro CIM .1941 Raw Hartz Profile Clan LT Alt ~ a 0 3~ ~ 5 j.S) kj S(L Fri r, 5) PS. ~ 3 Q-6 6 S VF2rv6~ ~1P VFR. n15 Det ri 'on system Other Factors (.1946): Available s ce .1jEF Site Classification (.1948): S seem a Evaluated BY;O Site LTAR Others Present