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IPACHarnett County Department of Public Health 2820-11, Improvement Permit A building permit cannot be issued with only an Improo ment Permit PROPERTY LOCATION: 'SGV 0') G A ISSUED TO: ® �l ® � ��� '�%�S SUBDIVISION 'M cZ o v Gs>,t o Y z.,tac.t; LOT # S j NEW REPAIR ❑ E ANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Q Proposed Wastewater System Type: LL %O/ o Ors m Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes --T� No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community -X Public ❑ Well Distance from well L feet Permit valid for: Ove years Permit conditions: ❑ No expiration Authorized State Agent:: Date: 3 I A, v, SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarani ie issuance of other permits. The permit holder is res onsible 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. nprovement 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, .1957, .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: `��mEL�utzc� PROPERTY LOCATION: M�0U c>aj--o SUBDIVISION f�cQoucsaL�o cG LOT # t1 Facility Type: 5K0 �b�" ��' �� New ❑ Expansion ❑ Repair Basement? ❑ Yes IS'\ No Basement Fixtures? ❑ Yes -XiNo Type of Wastewater System** ° ay C -<'U'.4 'S ---) (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) J 3-. �L o U C,i ) cT t'i (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size 1 d ®G gallons Exact length of each trench i 1 Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench DeP th of.- ®— � Pump Requirements: ft. TDH vs. Conditions: (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) inches below pipe Aggregate Depth: inches above pipe 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 system type specified is different from the type specified on the app/icatiom / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization isiubiect to revocation if the site Dian, slat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chance in ownership of the site. This Construction Authorization is subject to comph `V4h the proms of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. Authorized State Agent: Date: Authorization Expiration Date: SEE ATTACHED SITE SKETCH HTE # �" 3S Permit # a 8 00 Harnett County Department of iblic Health Site Sketch PROPERTY LO(ATON: r')c,QOuC,rat.J Rn ISSUED T0: 6`.S �1nr^C;c U1ip SUBDIVISION vctxu) VLALOT # Authorized State Agent: 70.1,1<Ss) Date: ra I I 0 I ii IA n05 E �o e 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: J Water Supply: Public❑ Individual ❑ Well Evaluation Method Auger Boring ❑ Pit ❑ Cut Type of Wastewater: "IR 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 ©_IG Description Initial Repair System Other Factors (1946): p Systetv, iSite Classification (.1948): 0 5 Available Space (.1945) Evaluated By: 7 System Type(s) � Others Present: _.... Site LTAR