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IPACHTE# 09 --5 :33%ci Harnett County Department of Public Health 2 5 7 9 6 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ~x s ISSUED TO: ~~*sdC z-~, KoM~S SUBDIVISION R~~a LOT # L6r, NEWX REPAIR ❑ EXP SION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: F fl t <<`~ Proposed Wastewater System Type: ~NJrctV`C \.U C'-i PSI Projected Daily Flow: 3 GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes a No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t Cab feet Permit conditions: Permit valid for. Five years ❑ No expiration Authorized State Agent:: Date: Is 3b o~ SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issu f other permits. The permit holder i responsi a 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, .1951, .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 TO: C_U Mib c„-ao )jAC) C' PROPERTY LOCATION: / SUBDIVISION '0, sw~coctA LOT # 1 O Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes _2~ No Basement Fixtures? ❑ Yes No Type of Wastewater System** (Initial) Wastewater Flow: 3 ~'6 GPD (See note below, if applicable Co N V U '~s P.- (Repair) Installation Requirements/Conditions Number of trenches 3 Septic Tank Size A,cood gallons Exact length of each trench ~d feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: t $-a;01 inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Trench Spacing: C1 Feet on Center Soil Cover C -inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: Conditions: Acct L~ `(Y1 ~s 6 1 C lira S s C, Sy s-E T-N inches below pipe inches above pipe 12. inches total **If applicable: / understand the sweet type .rpeciled it different from the type ,rpeciled on the app/ication. / accept the .rpeci(cationr of this permit. Owner/legal Representative Signature: Date: This Construction Authorization is subject to r tion if the to 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 Authonzation is ~kect to complian t v io f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: QC=s Date: 3a Con ion Authorization Expiration Date: to HTE# ©`1--5=~33~r-1 Permit # Qx,-~ i Harnett County DepaAment of 1- ~iblic Health Site Sketch PROPERTY LOCATON: P+Q ~S ISSUED TO: Cy r, Eft-F%N 0 1'\c, vv C--17 SUBDIVISION ~5~ ~ ona LOT # \0 Authorized State Agent: S 4tavEcz To Date: \~.13d) O~ $5, I att,E~ I zo'-~ A 46, Q i V 1gd' AS~f~Fo2o wPy Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIUSPTE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner. Applicant: Address: Date Evaluated: ~2Ic `1 Proposed Facility: Design Flow (.1949): 3b Location of Site: Property Recorded: Water Supply: Public ❑ Individual ❑ Wen Evalumfion Method. Auger Boring ❑ pit Type of Wastewater Sewage ❑ Industrial Pi+ocxss Sheet: Property ID: Lot File M: Cask: Property Size: ❑ Spring ❑ other cut Mixed P R O F 1 1940 OM MORPHOLOGY .1941 THER PROFILE FACTORS E M Poriad Slope % Horizon Depth (in.) .1941 Strucosal T43dw* .1941 Camietsaoe mindralm .1941 soil welnew Color .1943 soil IN. .19% sq" Gars .1944 RAW Hari: Proms Claee ♦ LTAR 6-4 vin ~s1 ~e Other Factors (.1946 Site Classification (.19487 S. Evaluated By. d-" Others Present