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IPACHTE# Harnett County Department of Public Health 2 5 6 4 7 Improvement Permit A building permit cannot be issued with only aJ+y Improvement Permit PROPERTY LOCATION: o Ad 't, & ISSUED T0 ' : SUBDIVISION G f,', I:. , , -r a-J LOT # Z3 NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: ~ ` l Type of Structure: 1 0 t )e l 9 Proposed Wastewater System Type: n~S"fQ Projected Daily Flow: 6 'PD Number of bedrooms: _ Number of Occupants: max Basement ❑Yes o Pump Required: ❑Yes ❑ No fay be required based on final location and elevations of facilities Type of Water Supply: Permit conditions: ❑ Com nity ZI~ 'kk f~ublic ❑ Well Distance from well feet Pe tt valid or. ~re.~ ~wrt c C~1 c6 •e`the 4 ~e e years M t 4 t4 cr` P Q,4 , <r . be rr- q v,,-r f ❑ No expiration Authorized State Agent:: Date: & IIAOd SEE ATTACHED SITE SKETCH The issuance of this permit b ealth Department in no 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 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: PROPERTY OZ ON;: _C' c~e~-C/`~. A - SUBDIVISION %,irt LOT # 22 Facility Type: .5-,CD I!1/New ❑ Expansion ❑ Repair Basement? ❑ Yes 1;i No Basement Fixtures? ❑ Yes No Type of Wastewater System** c~~f ,QECI~~-=c,US (Initial) Wastewater flow: GPD (See note below, if applicable (Repair) Installation Requirements/Conditions Number of trenches / Septic Tank Size 100 0 gallons Exact length of each trench _l feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. -'30 inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Trench Spacing: 'Y Feet on Center Soil Cover. % 16 inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: _ p w ti r~o-~, c rrCT. inches below pipe inches above pipe inches total **If applicable: / understand the system type specified is different from the type specified on the app/icatW. / accept the specillcationr of this permit Owner/legal Representative Signature: Date: n mn vie piaa, prat, ur me mrenaeu use changes. ine constructmn autnorizahon shall not be transterred when there is a change in ownership of the site. This tonstructton Authorization is subject to com ' rice with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Aged Date: l ZzzcG Construction Authorization Expiration Date: HTE# a q -s =;3l3 y Permit # as` b q 7 Harnett County Department of IlUblic Health Site Sketch. PROPERTY LOCATON: ! o~~~ ~fc~ id ISSUED T0. ~ .~cQ SUBDIVISION Gr% e Q-xt~t! LOT # 3 Authorized State Agent: try t Wf Date: cc 5 lsj 3(,~f4, qQ H; 3 q q q q4 -7e rr- /k~e,~L h4 ~4 s~ I 5Q r• Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Applicant: Date EvaluaWl: f`f -7,16 1 Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: BPublic ❑ Individual ❑ Well Evaluation Method: Auger Boring ❑ Pit ❑ Type of wastewater: Q Sewage ❑ Industrial Process ❑ Shed: Property ID: Lot File Code: Property Size: ❑ Spring ❑ Other cut Mixed P R O F 1 1940 OIL MORPHOLOGY .1941 THER PROFILE FACTORS L E * I, Position/ Slope % Horizon Depth (1n.) .1941 Struchow Textu» .1941 Cooairtea ce Mimmlo .1941 Soil wdnew Color .1943 Sail DeA IN. .1936 Swo Claw .1944 Rm& Horiz Profile Clan a< LTAR AJ 11 - , J-i ~r ..C Other Factors (.1946): _ Site Classification (.1948ri Evaluated 13y:O Others Present: