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IPAC RHTE# t4—S'33y cS �a Harnett County Department of Public Health 27934 Improvement Permit A building permit cannot be issued with only an _Im,.Provement P it PROPERTY LOCATION: JE.ssC- ISSUED TO: C12 ")65 � can, �� 5 1—LC- SUBDIVISION LOT # NEW.K REPAIR ❑ XPANSION ❑ Type of Structure: rrl.e,,t Vkd C'^• f_ T U , Proposed Wastewater System Type: -'15'1 o -C q crs , olv Projected Daily Flow: —.4-140 GPD Number of bedrooms: 2— Number of Occupants: max Basement ❑Yes No Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yeslo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet Permit valid for: Five years Permit conditio ❑ No expiration Authorized State Agent:: �5 Date: S a Q 1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issu o her permits. The permit holder is responsilble 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 it 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: cil;�16SMa 1 LC— PROPERTY LOCATION: SUBDIVISION LOT # Facility Type: �� ®� C1 � � >r\ New ❑ Expansion ❑ Repair Basement? ❑ Yes l No Basement Fixtures? ❑ Yes NR No Type of Wastewater System" �S �o �2_� v C'-�t 0 " S1 >5 —) C K1 (Initial) Wastewater Flow: (See note below, if applicable ❑) e Installation Requirements /Conditions Septic Tank Size L eD © © gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: Number of trenches °` Exact length of each trench feet Trenches shall be installed on contour at a Maximum Trench Depth of: } 't "ate inches (Trench bottoms shall be level to +/ -1/4" in all directions) GPM a�O GPD Trench Spacing: Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. * *If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit. Owner /Legal Repr6i nature: Date: This Construction Authorization is subject to r ocz th Ian, 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 �a subject to compliance th a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: S Construc Authorization Expiration Date-'? HTE# N ce - 5 -` 31, V2- ISSUED TO: Authorized State Agent: Permit # —a:-) �3 4 Harnett County Department of Pablic Health Site Sketch PROPERTY LOCATON: L C— SUBDIVISION LOT (-zLi4G.4, I P) 0 G IZ- i-k <5 Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIL /SITE EVALUATION for ON -SITE WASTEWATER SYSTEM Sheet: Property ID: Lot #: File #: Code: Owner: Applicant: Address: Date Evaluated: Proposed Facility: Design Flow (.1949): Property Size: Location of Site: Property Recorded: Water Supply: to blic❑ Individual ❑ Well ❑ Spring Evaluation Metho� Augeg ❑ Pit ❑ Cut Type of Wastewater: °� Sewage ❑ Industrial Process ❑ 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 Depth (IN.) _ .1956 Sapro Class .1944 Restr Horiz k A Des Initial S ste Repair System Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: (.1945) Syst 2— C ite �j