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IPACHTE# /0 --S-' `c 7 Harnett County Department of Public Health 26185 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: C oQ!`..~r' ,~rl ISSUED TO: Act CkG~ °J' T. ~Q)*AQ r- SUBDIVISION LOT # NEW L?' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Otit (f ' 6 Proposed Wastewater System T pe: Projected Daily Flow: GPD Number of bedrooms: „3 Number of Occupants: L max Basement ❑Yes -~o - Pump Required: ❑Yes El No F~Mae required based on final location and elevations of facilities Type of Water Supply: 11 Community W 'Public ❑ Well Distance from well feet Permit valid for: f~~ five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: t ,~c~ SEE ATTACHED SITE SKETCH The issuance of this permit by 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 in to this permit and shall be met Systems shall be installed in accordance with the attached syste m layout. / ~ ISSUED T0: : c~ d~ a r S©r•o,~ ~C PROPERTY LOCATION: SUBDIVISION LOT # Facility Type: J-vJ f`t f/ l New ❑ Expansion ❑ Repair Basement? ❑ Yes No " asement fixtures? ❑ Yes ❑ No G ~ ~ Type of Wastewater System Q ( S (t ~ ~~•ti~- ~ (Initial) Wastewater Flow: GPD (See note below, if applicable l "o ~~e+~~aw v L ) -e e.. . (Repair) Installation Requirements/Conditions Number of trenches y Septic Tank Size Z0W gallons Exact length of each trench / feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over. b inches Maximum Trench Depth of: L~ 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. TDN vs. GPM inches below i e pp Aggregate Depth: inches above pipe Conditions: t inches total *"If applicable: / anderstand the system type speciTed is dil~erent from the type specified on the app11cdNfl. / accept the rpecifbtionr of this permit. 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 rnnstntinn duth-i-tinn i, a,h~a.r r„ u6.h .6„ ,..,,.,t.;,..., G. i __1 o.e._ - t_ _ - 1.- 1.T• _v........_......____.........,.., t,..,,,, Inc rims -6 - --g neaunent and utsposat and to me conamons or mis peVr Xt RI IALHtU 3111 MIlt1 Authorized State Agent: Date: r l C onstruction Authorization Expiration Date: / F /J HTE# / ° Permit # re r Harnett County Department of Public Health Site Sketch (}moo ac~ ISSUED TO: Aa0I,, Authorized State Agent: , Gn 7FI, 4 (.e- PROPERTY LOCATON: Coat ~r ~gI 1~ SUBDIVISION inT Lc w Y t Department of Environment, Health and Natural Resour" Sheet: Division of Environmental Health Property ID: On-Site Wastewater Secdon Lot 11: File SOMME )EVALUATION Code: ror ON-SITE WASTEWATER SYSTEM Owner. Applicant: Addmw Date Evaluated: Proposed Facility: Design Flow (.1949r Property Size: Location of Site: Property Recorded: ",Yates SuPPIT. 00 ❑ Individual ❑ Well ❑ Spring ❑ Cther Evaluation Method: uger Boring ❑ Pit Cut Type of Wastewater. Sewage [I Industrial Procem C] Mhed P R O P 1 1940 OIL MORPHOLOGY .1941 THER PROF1U L8 FACTORS CTORS L 9 4 I xx6c" Horizon Posidod Depth 91op~"U (tn) ,1941 .1941 3tructtv>r ConrlMaea Taxhas Nflrmlo .1941 soil wdneul Color .1943 Soil IN, .1976 33pre CIA" .1944 Re* Hoes Pto 18 Clan is LTAX 5it~ LT~1R Qhdr Factors (.1946k Sitar Cl&W&atlon (,1948X Evaluated W,_ Otltears Preserlit: