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IPACHTE# o3- 9 Harnett County Department of Public Health 27690 Improvement Permit A building permit cannot be issued with only a Improvement Permit � PROPERTY LOCATION: �o n2fa05 S, �,Z ISSUED T0: SUBDIVISION SGP.,0so5 LOT # 14 NEW`S< REPAIR ❑ EXPA�ON El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: CGS' Proposed Wastewater System Type: Projected Daily Flow: '3� ® GPD Number of bedrooms: Number of Occupants: J�; max Basement ❑Yes >< No Pump Required: ❑Yes �allo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community >< Public ❑ Well Distance from well iO® feet Permit valid for: XFive years Permit conditions: ❑ No expiration Authorized State Agent:: � �� \ tz4c Date: \ 1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the isss f other permits. The permit holder is respoi ible 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 Improve s`rmit 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: Facility Type: 4 5�x� S New Basement? ❑ Yes No Basement Fixtures? ❑ Yes Type of Wastewater System ** 0` o (Z,-6 1,1 (See note below, if applicable ❑) Installation Requirements /Conditions Septic Tank Size L ®® d gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: PROPERTY LOCATION: Porx3C,(1QbN SUBDIVISION LOT # Gi) ❑ Expansion ❑ Repair XNo �3'13—m (Initial) Wastewater Flow: 3,® GPD (Renairl Number of trenches Exact length of each trench 1's0 feet Trenches shall be installed on contour at a Maximum Trench Depth of: 3'� 3:� inches (Trench bottoms shall be level to +/ -1/4" in all directions) GPM Trench Spacing: ':� Feet on Center Soil Cover: a--)- G 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 specipcationr of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subject to—Myocktion if 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 Construction Authorization is subject to comokce wit(;i t o s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: !S Date: 1O P 3 o ruction Authorization Expiration Date: 1 a '� )f HTE # �3_� ��`a� Permit #"� °t b M 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): 3� GSA Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method Aug off=ing ❑ Pit ❑ Cut Type of Wastewater: 'K 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/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color 1943 Soil De th (IN.) .1956 Sapro Class .1944 Restr Horiz r L.� Fh C Description Initial S ste Repair System Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: Available Space (.1945) System Type(s) -. Site LTAR d C r