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IPACHTE# / 'V-5-33,7 Harnett County Department of Public Health 27843 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: v.7el f red• ISSUED T0: GaN ldW �� lv Ste. SUBDIVISION LOT # NEW REPAIR ❑ EXPANSION 11 Type of Structure: I1!J dt't / °X 6G Proposed Wastewater System Type: a r- Projected Daily Flow: -76 GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes ET—No Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yes [1 No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community L"Public ❑ Well Distance from well feet Permit conditions: Permit valid for: 21 ve years ❑ No expiration Authorized State Agent:: /CC V Date: ' a S (—R- f/ SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in y 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 TO: Grog-✓ t J-" PROPERTY LOCATION: WSJ' SUBDIVISION LOT # Facility Type: ZNew ❑ Expansion ❑ Repair Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System ** JV-J4... (Initial) Wastewater Flow: J3 -O GPD or (See note below, if applicable ❑) / (Repair) Installation Requirements /Conditions Number of trenches .-3 Septic Tank Size /00c) gallons Exact length of each trench /00 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. / 8 vky inches (Trench bottoms shall be level to +/ -1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Trench Spacing: 9 Feet on Center Soil Cover: G - 0- inches (Maximum soil cover shall not exceed 36" above the trench bottom) /t --ed e p Aggregate Depth: Conditions: J-11 4aw^l' /nt y ✓e-- e4 WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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: l understand the system type specified is different from the type specified on the app /ication. / accept the specipcationr of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subject to revocation 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 Authorized State Agent: with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit r, Date: Construction Authorization Expiration Date: AG� S/ SEE ATTACHED SITE SKETCH HTE# /I/-5- ,U-77C Harnett County Department Site Slietch Permit # d2 7 8 ` J PROPERTY LOCATON: �. eS4 R J- ISSUED TO: Cron/ C c� � � �r SUBDIVISION LOT # Authorized State Agent: ee Date: f 1 4 y 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: dublic❑ Individual ❑ Well Evaluation Method: AugerBorIng E3 pit ❑ Cut Type of Wastewater: ❑ Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other Description 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/ TextLi re .1941 Consistence .1942 Soil Wetness/ Color .1943 Soil D th (IN.) - .1956 Sapro Class .1944 Restr Horiz r JM`ine�rallog %/� L) o"�IVI z7 (f,14r b%Gnrf s1 Description Initial System Repair System Other Factors (.1946): Site Classification (.1948):1�f Evaluated By:�_ Others Present: Available Space(. 1945) / System Type(s) a Site LTAR ( v