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IPACHTE Harnett County Department of Public Health 28529 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ISSUED TO: �P,�E�1— d �rsG SUBDIVISION Piro -*P r ZN C, LOT # N E W>< REPAIR ❑ EXPAN N ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: KD Proposed Wastewater System Type: 1a 12apucs5-� 0 t`f Projected Daily Flow: 360 GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes"lo Pump Required: ❑Yes ,,,�.[•lo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: C� SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance ther 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. The Improvement ermit 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: \4 0 snC—__5 l ,.s C® PROPERTY LOCATION: SUBDIVISION �a—nnP\N NNG LOT # Facility Type:���®'�L > _ New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes )K No Type of Wastewater System* :2 o - L/L:, i tJ Ys ; &rr (Initial) Wastewater Flow: 3� 6 GPD (See note below, if applicable ❑) 20;61 o �'y� (Repair) Installation Requirements/Conditions Number of trenches 1, Septic Tank Size t 0e>0 gallons Exact length of each trench �S 0 feet Trench Spacin : Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: , inches Maximum Trench Depth of: 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) MIDST 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 speciled is different from the type specified on the application. / accept the specifications of this permit. Owner/Legal Representa ' nature: Date: This Construction Authorization is subject to revo if the site Elan, 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.ksubject to compliant i(h the p "ons he Laws and Rules for sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: ` t L3 I )S` Constr 'on Authorization Expiration Date: �t l} 2 HTE# Permit # aS 5� Harnett1 Department 1f 1--',ttblic Health Site Sketch PROPERTY LOCATON: ISSUED TO: V)- dnG.n, �� to SUBDIVISION P, -,�N,j Gfxgs61m e LOT # Authorized State Agent: Date: dL��+�L �oyJO Date: ,j'5wL-5 o, -f 30 (— 6 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)_-'�665? Location of Site: Property Recorded: Water Supply: Public❑ Individual F1Well Evaluation MethodU,,Au er Boring ElPit F-1 cut Type of Wastewater: Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F I .1940 L Landscape Horizon E Position/ Depth # Slope % (In.) SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS Profile Class & LTAR .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943:, — .1956 Sapro Class .1944 Restr Horiz 'l. '�� CSL-, �r✓ °�1 �-� �. L Description Initial Repair SystemOther Factors (.1946): S st Site Classification (.1948) R5 Available Space (.1945) Evaluated By: System T Others Present: Site LTAR Ex11�3-() —�'j-meg'' 'L' -3O