Loading...
IPACHTE #_ 1g -J'- -73 7 56 Harnett County Department of Public Health 27974 hDrovement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: T�(-.r ISSUED TO vin �c�t/�e �L'� SUBDIVISION e-,T �i,,5� LOT # a NEW REPAIR 11 EXPANSION 11 Site Improvements required prior to Construction Authorization Issuance: Type of Structure: s-F �. 0 6 c Proposed Wastewater System Type:c2S`4 C CCXuc �N.f rte•.. Projected Daily Flow: __'i$�% GPD Number of bedrooms: y Number of Occupants: max Basement ❑Yes BIN 0 Pump Required: ❑Yes 21' No ❑ Ma be required based on final location and elevations of facilities Type of Water Supply: El Community Public ❑ Well Distance from well feet Permit valid for: [wive years Permit conditions: ❑ No expiration Authorized State Agent:: w_ /VL 4e/i Date: 7 / /lz6ry SEE ATTACHED SITE SKETCH The issuance of this permit b the Health Department in no way 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. �1 / / ISSUED TO:s /n l aAI7"ruc r`• °d^ PROPERTY LOCATE : 7l o�� SUBDIVISION ^ if�fzec LOT # 2,16 Facility Type: ,lfl� New ❑ Expansion ❑ Repair Basement? ❑ Yes 12'No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System ** 0 J— 7o )C 42 uc.. -y v (Initial) Wastewater Flow: � e GPD (See note below, if applicable ❑) (Repair) Installation Requirements /Conditions Number of trenches A Septic Tank Size /000 gallons Exact length of each trench _� feet Trench Spacing: 9 Feet on Center Pump Tank Size gallons Trenches shall be installed gn contour at a Soil Cover: G -Ir inches Maximum Trench Depth of. /&Z &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 M Aggregate Depth: inches above pipe Conditions:_ l �: n ��-� f� ���Gi�,� c�✓� < tic s� e �/2�� inches total WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. 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 lication. / accept the specifications ofthispermit. 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 compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH C XX Authorized State Agent: �� Date: 7 I Construction Authorization Expiration Date: 2 /, Ac/ 7 HTE # IV-r-55726 Permit # a7 9 7 7 Harnett County Department of Public Health Site Sketch 1 ( PROPERTY LOCATON: ISSUED T0: ✓1 c trx `F .��• SUBDIVISION LOT # c Authorized State Agent: . m Date: % / / °!y 1 ,33 �-1 - i f j s d ° Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIL /SITE EVALUATION for ON -SITE WASTEWATER SYSTEM 3� Owner: Applicant: �/ ��� Address: Date Evaluated: Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: 121/public❑ Individual ❑ Well Evaluation Method:Q/Auger Bgring ❑ Pit ❑ Cut Type of Wastewater: [:!�j Sewage ❑ 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 .1942 Soil Wetness/ Color 1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz t> X'IF %Mineralogy Description Initial System Repair System Other Factors ( 1946): Site Classification (.1948): Evaluated By: L T Others Present: Q� Available Space (.1945) System Type(s) S- of = Site LTAR Cl— t>