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IPAC RHTE# ���-=� Harnett County Department of Public Health 2 8 1 9 3 Improvement Permit A building permit cannot be issued with only an �Improvement Per jt PROPERTY LOCATION:h VA'\"4 � A v 2G\=-, 1.D ISSUED TO: 0t^GS`ru c SUBDIVISION S GSso ,� LOT # `r NEW REPAIR ElNSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: � 5� C N- -13l Proposed Wastewater System Ty e: P.tme r ouG'' act Projected Daily Flow: �C3 GPD Number of bedrooms: Number of Occupants: max Basement []Yes No Pump RequiredlxYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: X Five years Permit conditions: ❑ No expiration Authorized State Agent:: � t�..�� Date: 3I f— I l5 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees to ' ce 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 ImfurINcoent 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 (Rehired 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� � 0 "-,t - '-45 � C, PROPERTY LOCATION: � 1-4 LS 'z.CA 11 SUBDIVISION 5 -� C---y:s,a N LOT # Facility Type: 5 7X New ❑ Expansion ❑ Repair Basement? ❑ Yes `�( No Basement Fixtures? ❑ Yes 'X No Type of Wastewater System** P\) ,n 0 2-SO/D Q clz) i G 10 (Initial) Wastewater Flow: 3GC} GPD (See note below, if applicable py P _ f o (Repair) Installation Requirements/Conditions Number of trenches .3 Septic Tank Size 1©®® gallons Exact length of each trench q Pump Tank Size a o ®® gallons Trenches shall be installed on contour at a Maximum Trench Depth of- N'S Pump Requirements: ft. TDH vs. Conditions: I zv�GCs� se SC:.0=- S ,se— sLG— (Trench bottoms shall be level to +/-1/4" in all directions) GPM feet Trench Spacing: feet on Center Soil Cover: inches inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: �t WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. 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: /understand the system type so led is different from the type speciped on the app/icatiom / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is su ' to revocatio 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 isms to compTha—iZ ' h the ' ions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: �' y Construction Authorization Expiration Date: 3 HTE# '5L-rIL41L Permit # Q-8 I Y3 Harnett County ]Department of Ptiblic Health Site Sketch PROPERTY LOCATON: ISSUED TO: SUBDIVISION � t=�soN LOT # Authorized State Agent: Date: -3 t 130 1 1R 40 tA 0 r° .00 ®N 2-) 9- 1 N 57 L I- 1?,,BQ,qF- -TOP OtNE: of P-VC"(4-- TO P,--) QVF-5-,�,QN M5`">1--)-JX'1)C1/ I L Q ), cr NO oN LyI 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: ❑ Public❑ Individual ❑ Well Evaluation Method: F1 Auger Boring ❑ Pit ❑ Cut Type of Wastewater: ❑ 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 Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz -v� c, z 5cL Description Initial Repair System Other Factors (.1946): S stem Site Classification (.1948): Available Space(. 1945) Evaluated By: / System Type(s) D1 Others Present: Site LTAR I' ///