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IPACHTE#- `J(, Harnett County Department of Public Health 25931 Improvement Permit A building permit cannot be issued with only an improvement Permit PROPERTY LOCATION: ISSUED TO: '`t`T N V_SUBDIVISION LOT # NEW REPAIR El EXPANSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 'MN~_! . \A ocnC, (SL\-A>dty Proposed Wastewater System Ty e: _ -0 -r v &,4-, t d tit p, t.. Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: L+ max Basement ❑Yes X No Pump Required: ❑Yes ~No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ C Permit conditions: ommunity Public Li Well Distance from well t (!>0 feet Permit valid for: Five years 1-- ❑ No expiration Authorized State Agent:: -\-a5 Date: 3 in SEE ATTACHED SITE SKETCH The issuance of this permit by the Health 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, .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 T0: C "'TA)ccTC N'g_G'0 . PROPERTY LOCATION: a) v,E_ R.~ SUBDIVISION N NRC;s;. to ~\nwhgq LOT # Qi, Facility Type: M'w • ua<nck),, 11of. j New El Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes _><,No Type of Wastewater System** C o " f~ -C I c) rv r, (Initial) Wastewater Flow: al4 d GPD (See note below, if applicable C~o ~yS ~3 ~dN (Repair) Installation Requirements/Conditions Number of trenches _3 Septic Tank Size t ag 0 gallons Exact length of each trench C10 feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G"Q inches Maximum Trench Depth of: V2- 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: h. TON vs. GPM inches below pipe Conditions: r Aggregate Depth: inches above pipe ~S t Q 0,C) t C... S }tom i V inches total *If applicable: /understand the rystem type specified is different Irom the type specified an the 7pp11c,7pon. /accept the rpecilcationr of this permit. Owner/Legal Representative S' ture: Date: This Construction Authorization is subject to revocatro he site plan, t or the intended use changes. The Construction Authorization shall not he transferred when there is a cha~trroA;Aro~1.1 ship f the siteThis Construction Authorization is wbj t mpliance wi e p of the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SITE SKETCH Authorized State Agent: Date: 3I r Authorization Expiration Date: a.. HTE# l O-5 Co Permit # Q Sg3I Harnett County Depailment of I' tblic Health Site ketch PROPERTY LOCATON: 1~) u E ISSUED T0: SUBDIVISION nA2AG \-~nw DQ~ LOT Authorized State Agent: Q 6'.514 z-~V(~[2 TpLrsnp(~ Date: _ 1 r1 l~ W L L i.. S a,~ T-1. 5 4' D 2 TO I rLaA~ I10 10% / 3`7 O Department of Enviromnent, Health and Natural Resources Division of Environmental Health Sheet: On-Site Wastewater Section Property ID: Lot SOIUSPTE EVALUATION File for ON-SITE WASTEWATER SYSTEM Code: Owner. Applicant: Address Date Evaluated: 3 ) ".4 10 Proposed Facil : a Design Flow (.1949): A Location of Site: Py Recorded: ~~3" Size: Water Supply: 7t~erZg c Evaluation method: ❑ Indivi ❑ Well 0 pit o ❑ Sp ring 0 Other Type of Wastewater. ge ❑ Industrial procen ❑ M cut ,,W R O F I .1940 SOQ. MORPHOLOGY L E e a .1941 OTHER PROFILE FACTORS 0 Slope ~ Dop .1941 .1941 S .1942 soil huchow TOM" Comial oce Minenb w ~ 1936 Sao .1944 Rotjle a-Sla © Color IN. CIm Raw Cl m Horis &L TAA rC GL, C-'rL. 3rd ~ P rh ~k c_ J tt:± !t~ ~ 3- 'A o c-- :11A- unc Factors (.1946r Site Cf&skficadon (,1948): Evaluated By: Cs-' OdWo Present: