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IPACHTE# { L} - 53311 Harnett County Department of Public Health 27937 Improvement Permit A building permit cannot be issued with only an Improvement Permit G PROPERTY LOCATION: �er��+� R t NG5 ISSUED TO: y� J SUBDIVISION 65 LOT # �►" NEW( REPAIR ❑ EXPANSION ❑ Type of Structure: P gNN )-k d c',E Q21% xtj `6� Proposed Wastewater System Type: AS°) 0 o -tr(, 0_,o Projected Daily Flow: `� u 0 GPD Number of bedrooms: Number of Occupants: _max Basement ❑Yes Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yes o ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ❑ Public Well Distance from well f C7 ci feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: al __c-z 1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no Z!fes the issuanc r permits. The permit holder is re ponsible 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 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: M Rrc C-CA VJ PROPERTY LOCATION: SUBDIVISION �"2--'D, LOT # °t- Facility Type: � �' � �A-o noCC�0' LA'0 New ❑ Expansion ❑ Repair Basement? ❑ Yes :�4 No Basement Fixtures? ❑ Yes �(No Type of Wastewater System (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) o ISL6,2) v --i � Ct sJ (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size i 0 d d gallons Exact length of each trench � d feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of. sc�q_ inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/ -1/4" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. GPM inches below pipe Aggregate Depth: inches above pipe Conditions: inches total 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. * *If applicable: /understand the r,y type rpeciFed is d /fferent from the type speci>ied on the app /icat /on. I accept the rpecificationr of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subject to revocatio to plan, plat, a intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Construction Authorization is subje�to liance with the p ' io s ules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: , , �" V 1�1S Date: S Construct) uthorization Expiration Date: HTE# ,�i - 'S -�3�) Permit # County Harnett Department of 1 Health Site Sketch jw,Vp - TIC L-1 �1s 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: a S CQ"-, Design Flow (.1949): �� 10��� Property Size: Location of Site: Property Recorded- Water Supply: ❑ Public[] Individual Well ❑ Spring Evaluation Method Auger Boring ❑ 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 D th (IN.) .1956 Sapro Class .1944 Restr Horiz 't 3 xsu r1 651 I a0:34C Six 5t'L ,oy2� 1 3 G S V1 lu`�/vP (6 33 sc fl '5?) Description Initial S ste Repair System Other Factors (.1946): Site Classification (.1948): S S Evaluated By:(-' ' Others Present: Available Space (.1945) System Type(s) a "> Site LTAR tt 't