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IPACHTE#_I oHarnett County Department of Public Health 25910 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION:_ ISSUED TO: _ My c~ 1 M ac_v S J Gw9 cn „-r-~ SUBDIVISION LOT # \\5 NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SV~) (L"'- LA_p:) Proposed Wastewater System Type: CpH4-i sCtio Projected Daily Flow: 3~0 GPD Number of bedrooms: -3 Number of Occupants: max Basement ❑Yes X No Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well lbc~5 feet Permit valid for Five years Permit conditions: ❑ No expiration Authorized State Agent:: ~5 Date: t SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issua 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 with the attached system layout. into this permit and shall be met. Systems shall be installed in accordance ISSUED TO: Mo2y Nlac~ vE1oQn~ S PROPERTY LOCATION: Mp .~ZYg QO SUBDIVISION P6N So Facility Type: 5 VQ (46 ~1 a~ N ❑ E LOT # ew xpansion ❑ Repair Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System" Corvv6 vatvAL (Initial) Wastewater flow: 3i 0 GPD (See note below, if applicable C-o ",iC_r,,c to r,(r-~- (Repair) Installation Requirements/Conditions Number of trenches a Septic Tank Size S 0,:50 gallons Exact length of each trench '75 feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: la-S$ inches Maximum Trench Depth of: Q9-2)0 inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/-1/4" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. GPM inches below pipe Conditions: G 1-i~E nos i,e_ ~0 Aggregate Depth: a inches above pipe MP`I ENGCtf}A v~ 1" I-S\PS1_ ocL 11 1E5 S3~ inches total "If applicable: / anders£and the System type specified /s different from the type specified on the application. / accept the rpec1f1cations of this permit Owner/legal Representative Signature: Date: This (onstruction Auth0111a11111'1,1 tf 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 fonzreuction Authorization ist to complian rt o s of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: ~ S Date: 3 11 4 a ruction Authorization Expiration Date: ?ate HTE# Q- S- -;,~1 5 Permit # a~lO narnett County Del}ailment of h blic Hetalth ite ketch PROPERTY LOCATON: M Ae,Ns R ISSUED T0: Mc~, c. v opcY, ; SUBDIVISION ' sYErc-„ap LOT # s Authorized State Agent: (15L-1 V Ea.- -c(3 ~csfl Date: 3 VH~ %Q) , 55 y N.~ GP:~ Y,- v-- 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: ' a Proposed Facility: grc~r~oo,~ Design Flow (.1949): ~(-Ot3CO Location of Site: Property Recorded: Water Supply: rAuger lic ❑ Individual ❑ Well Evaluation Method: Boring ❑ Pit Type of Wastewater: wage ❑ hwustriai Process ❑ Sheet: Property ID: Lot File Code: Property Size: ❑ Spring ❑ Other cut Mixed P R O F I 1940 OUL MORPHOLOGY .1941 THER PROFILE FACTORS L E # LoWscape Position/ Slope's o Horizon Depth 00 L31~ .1941 Structure/ Texiure G S .1941 Consistence Mineraio J rr5 1941 Soil wetnew Color .1943 Soil Depth IN. .1936 Sapm Chu .1944 Restr Horiz Profile Chu do LTAR c a c J ~P 5 L,u .ajpuuu imtw Repair System Other Factors (.1946). System Site Classification (.1948): Available Space .1941 Evaluated By: 0 System Type($) Site LTAR g Others Present