Loading...
IPACHTE# 3--�>- S- -51- Harnett County Department of Public Health Imarovement Permit 27544 A building permit cannot be issued with only an Improvement Permit Co OPERTY LOCATION: ©cs ISSUED TO: �l �� � - 2;v Cr, a ."t SUBDIVISION cox, o sg' z LOT # NEW REPAIR ❑ ESION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SIF 0 c'-Q G Proposed Wastewater System Type: Projected Daily Flow: Lr3 GPD Number of bedrooms: L-i Number of Occupants: max Basement ❑Yes ,, No Pump RequirefAes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well t o d feet Permit valid for: Five years Permit conditions: � ❑ No expiration Authorized State Agent:: ��`� V-611i6 Date: '5� I (,113 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuan ther permits. The permit holder is r sponsible 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 Improveme t 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 an 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: 'd 'G : 2, U C;S fl PROPERTY LOCATION: Q o cs YD ��. SUBDIVISION Q7 P. c-r-o sue' LOT # '-�3 Facility Type: ���� ��� New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes �VNo Type of Wastewater System ** Ri mQ 0 2 Sal6 G Q to c,;1 C? V� (Initial) Wastewater Flow: LIR Q GPD (See note below, if applicable ❑) YUTq,�7Ci 11; vC'3 1�(Repair) Installation Requirements /Conditions Number of trenches Septic Tank Size ) C::,bCJ gallons Exact length of each trench es feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: 1'� inches (Trench bottoms shall be level to + / -1 /4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: Feet on Center Soil Cover: (;— �. inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. inches below pipe inches above pipe inches total * *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit. Owner /Legal Representative- nature: Date: This Construction Authorization is subject to rev oca the site n, 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 Authorization is compliancehe `o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: �G Date: onstr ' n Authorization Expiration Date: -? 141 3�d HTE # Permit # 2�.` 5L4 M 1 11) 0 WS C- I Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIL /SITE EVALUATION for ON -SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: Design Flow (.1949): ,� Location of Site: Property Recorded: Water Supply: ,,Public❑ Individual Well Evaluation Method`:;] Auger Boring ❑ Pit ❑ Cut Type of Wastewater: `Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F I L E # .1940 Landscape Position/ Slope % Horizon Depth (In.) SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS Profile Class & LTAR .1941 Structure/ .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz �^ (,Texture .�5 3j( p Description Initial System Repair System Other Factors (.1946): Site Classification (.1948): Evaluated By: C Others Present: Available Space (.1945) \ ' _j System Type(s) Site LTAR