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IPACHTE# - ~-3-, Harnett County Department of Public Health 2581 4 provement Permit ISSUED TO: ~ A building permit cannot be issued with only an Im rovement Permit PROPERTY LOCATION- t~ ar S c ncJ SUBDIVISION NEW C REPAIR ❑ EXPANSION ❑ _ steT sen I Type Proposed Wastewater _astewater S Propose I _ 'Ir~ Site Improvements required prior to Construction Authorization lss aOT Ce# C y pe: Projected Daily Flow Q c~wr , Number of bedrooms: v GPD Number of Occupants: Basement []Yes ©40- _ max Pump Required: Lay'e~s ❑ No Type of Water Supply: ❑ Communi ry ❑ May be required based on final location and elevations of facilities 9 ,rl b Permit conditions: _ u lic El Well Distance from well feet Permit valid for e years ❑ No expiration Authorized State Agent:: Z.00 The issuance of this permit by th ealth Department in no way guarantees s the issuance of other permits. The Datermit holder is rZP ozsible [ site is subject to revocation if the site plan, plat, o r the intended u h ACIfED SITE SKETCH se c eship with appropriate governing bodies the Laws and Rules for Sewage Treatment and Disp sal and to conditions of this permit. i anges. The Improvement Permit shall not be affected by a change in ownership of the site. This permit meeting their o in ~ requi rements. This . b s su ject compliance with the provisions of Construction Authorization The construction and installation requirements of Rules .1950, .1952, _1954, .1955, _1956, L 9RetTU9i~ andr.IB591deniocorp (mit with the attached system layout. ISSUED TO: PROPERTY LOCATI N: facility Type: n SUBDIVISION Basement? ❑ Yes ❑-I' No E7--New Expansion ❑ Basement Fixtures? ❑ V by references into this permit and shall be met. Systems shall be installed in accordance Repair LOT # Gy_ Type of Wastewater System** es ❑ (See note below, if applicable (Initial) Wastewater Flow: ~ Installation Requirements/Conditions ,,.._,o 66 (Repair) Septic Tank Size /dCw-___ Number of trenches _ q -T- gallons Exact length of each trench ~0 Pump Tank Size ~ Ctcw gallons feet Trenches shall be installed on contour at a Maximum Trench Depth of. /6 Zq (Trench bottoms shall be level to +1.114, inches Pump Requirements: in all directions) ft. TDH vs. GPM llv t, Y c , yl S 4,r- I RwJ~ A, 4-1 - - 5C GPD Trench Spacing: Feet on Center Soil Cover. _ 67/R inches (Maximum soil cover shall not exceed 36" above the trench bottom) _ inches below pipe Aggregate Depth: inches above pipe ~ inches total **If aoDlicable / underrta~d the sy tem type rpecided a diNerent from the type Ipecided an the app/ication. /accept the r ecilcati Owner/Legal Representative Signature: p °OJ of thin permit. This Construction Authorization is subject to revocation if the site plan, plat or the intended use cha Date: nges. The Construction Authorization sha0 not be transferred when there is a change in Ow Construttion Authorization is subject to tom e with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit nership of the site. This SEE ATTACHED SITE SKETCH Authorized State Age Date: Z2 a(; C, Construction Authorization Expiration Date: Z z 2 c HTE# -Q 9_S-- ;z a:t7, Permit # q Harnett (olinty 11)ePa"tlnent of 1'ilblic Health Site Sketch ISSUED T0: PROPERTY LOCATON:Alcw SUBDIVISION LOT Authorized State Agent ~ l f Date: ~ SJ (c` L-r -~T- t~ j'aI ITc.ir~ I v s OAy l g ~ Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Z( ~t Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: lic ❑ Individual ❑ Well Evaluation Method: uger Boring ❑ Pit 0 Type of Wastewater: Sewage ❑ Industrial Process ❑ Sheet: Property ID: Lot File Code: Property Size: ❑ Spring ❑ Other cut Mixed 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 Mineralogy .1942 Soil Wetness/ Color .1943 soil IN. Depth .1936 Sapro Class .1944 ReAr Horiz Profile Class & LTAR / t a c:- / _ _ Y~ sic is< < rflP r' .1r Description Initial S stem Repair System - Other Factors (.1946): Site Classification ( 1948): ~f Available Space(. 1945 . E l t d B System s va ua e y:/ Oth P Site LTAR ers resent: