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IPACHTE# VaHarnett County Department of Public Health 2 F 0 0 8 Improvement Permit A building permit cannot be issued with only an Improvement Permit ~ PROPERTY LOCATION: ► , N QE, Ro ISSUED TO: 1 L L CL P <L-,e- t Lo y"5 S SUBDIVISION PA •v s 01 14'~' LOT # NEW REPAIR ❑ EXPA,ION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 'S cV'O CS' 71, 3 ~ Proposed Wastewater System Type: Pv n,e-T a CON-4 E"M\'I"N Projected Daily Flow: ~v b GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes 'K No Pump RequiredXYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community "X Public ❑ Well Distance from well LOCH feet Permit valid for. Five years Permit conditjo ❑ No expiration Authorized State Agent:: Date: 6 1~ GLC SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holder res nsible 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 Pe 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 Permtit The construction and installation requirements of Rules .1950, .1952, .1954, AM, .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 TO: 12, ~~clic womyF PROPERTY LOCATION: ~,NvEt,y SUBDIVISION ?e5-,\0>JS o1 LOT # 51 Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes , No Basement Fixtures? ❑ Yes ;"o Type of Wastewater System' PU Q o Cat tv ,v i~ Jrr Pc L - (Initial) Wastewater flow: 3 ~oC7 GPD (See note below, if applicable _ Tv Me yo )5%, VkEOVG,-yON (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size ► b o o gallons Exact length of each trend feet Trench Spacin: Feet on Center Pump Tank Size d d O gallons Trenches shali be installed on contour at a Soil (over: )a inches Maximum Trench Depth of. \R -2-y inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +1-1/4" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. GPM h b I Conditions: Q~ Erg L,,~- sL- y 1, G;:5 M PG Aggregate Depth: C 'bE 1D r~~.ot~.S~~GSyS-~E.~,.1Ja RGv 1 8 ) w 1 PAL O cz, V\sp 1A.-\ 2 me es a ow pipe inches above pipe inches total **If applicable: /understand the ryrtem type .rpecided is different from the type rpeci6ed an the app/ication. / accept the fpecif1cat1onr of this permit. Owner/Legal Representative Signature: _ This Construction Authorization is subject to . a if Construction Authorization is subject to comolianct4mb i Authorized State Agent: Date: 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 a the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Date: y 01 0 Sian Authorization Expiration Date: 6 HTE# I Q - S Permit # a(-OC:)N Hal-nett Count` Department of Public Health Site Sketch ISSUED T0: li~ I LL Authorized State Agent: PROPERTY LOCATON: `-T, cS14 1~~ - SUBDIVISION VpTio zv5 Pay etc LOT # k 5(0L1vE.n N01 < i~ Date: Lk P 0 me ° Q, c-0 U L't 0 N 56 , A-x / C D C d! V t1~ 5 Department of Environment, Health and Natural Resources Sheep: Division of Environmental Health Property ID: On-Site Wastewater Section Lot SOIL/SITE EVALUATION File for ON-SITE WASTEWATER SYSTEM Code: Owner. Address: Applicant: y } ~ G Date Evaluated . Proposed Facility: 3ai„Y, Design Flow (.1949): 360 Property Size: Location of Site: Property Recorded: Water Supptp; M Public ❑ Individual ❑ Well ❑ Spring ❑ Other Evah>a#ion Method: Auger Boring ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process ❑ Nfixed P R O F SOIL MORPHOLOGY OTH 1 .1940 L ER .1941 PROFILE FACTOR3 Horizon E Position/ # slope % .1941 Depth .1941 .1941 Soil .1943 .1936 00 Shuenrr Co"daoce web" .1944 Profile soil Sapro Texdure Mineralogy Color DepS IN. Clay Restr Clap Hans &LTR s a C~'36 G ~S Ntc2 N5~ BPS. 3~"~ ~y~ F2 5~)s~ r~ ~ G VFe C) a,G G s ~i5SK 5CL_ ~2 55~5~ 1 t-a DOta'~O° In" Repair System Other Factors (.19M6~ Available S cs .1943 s 0 Site ClaNification 1948y F5 System Type(s) Sits LTAR Evaluated By: U~ Others Prese t n : Paves