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IPACHTE# b Harnett County Department of Public Health 28006 Imurovement Permit A building permit cannot be issued with only an Improvement Permit v PROPERTY LOCATION: C-� E41t.-V G 1 t L fl ISSUED TO: ' ld m C-- S LL -C- SUBDIVISION 0 0 1—, LOT # NEW REPAIR ❑ EX P SION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SJR Q [.}�'�3G Proposed Wastewater System Type: R.DUea N S-V5 6.310 Projected Daily Flow: f—y ® GPD Number of bedrooms: y Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well I(7VO feet Permit valid for: Five years Permit conditions.- -- - ❑ No expiration Authorized State Agent:: �� � �'� �`' Date: 5-)S) SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Departmenl in no way guarantees the issuan rmits. 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 Per all 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: �A o G PROPERTY LOCATION: SUBDIVISION (`� Xrho,s', LOT # N 4el Facility Type: SF�C,I— t�'7`3C�" )S� New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement xtures? ❑ Yes No Type of Wastewater System ** 2--'Qelz o C,Z �J Gi (Initial) Wastewater Flow: GPD (See note below, jf app ca bl ❑ cae ) n �S t d Q N (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size L©© 1Z) gallons Exact length of each trench CJ Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. 1", - 3 (�, (Trench bottoms shall be level to +/ -1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: feet Trench Spacing: 1 Feet on Center Soil Cover: I inches 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: / understand the system type specified is different from the type specified on the app /ication. / accept the specifications of this permit. Owner ego ative Signature: Date: This Construction Authorization is subject o ation if �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 ect to com`p%aag with t��ithe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: ���c ������ 8115 Date: C1 1-1529 Const"n Authorization Expiration Date: "I, HTE# Permit # 0% MM MFA C>-,, 6Q 2� N ll-'L 0 (L 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): tA) Location of Site: Property Recorded: Water Supply: ublic❑ Individual ❑ Well Evaluation Metho Aug Bor'ng ❑ Pit ❑ Cut Type of Wastewat r: ewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Other ❑ Mixed 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 Mineraloggy��j .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz j-� �( d —JO a3C� Description Initial Syste Rep 'r System Other Factors (.1946): Site Classification (.1948):,,5 Evaluated By: Others Present: Available Space (.1945) V System Type(s) Site LTAR