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IPACNTE# 15-5=370—) 0 Harnett County Department of Public Health 28547 Improvement Permit A building permit cannot be issued with only an Improvement Permit n PROPERTY LOCATION: ISSUED TO: -04 gV' St OP+vJ SUBDIVISION — LOT # NEW REPAIR ❑ EXPION ❑ Type of Structure: Proposed Wastewater Systgm Type: �-S�l a vCI. a�N Y 5vGi . Projected Daily Flow: GPD Number of bedrooms: 3 Number of Occupants: 6 max Basement ❑Yes Xlo Site Improvements required prior to Construction Authorization Issuance: Pump Required: ❑Yes ''tfo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well I CA feet Permit valid for. Aive years Permit conditions.— ❑ No expiration Authorized State Agent:: � � Date: a0t 11315 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees t other permits. The permit holder is responsir chttking with appropriate governing bodies in meeting their requiremmtx This site is subject to revocation if the site plan, plat, or the intended use changes. The Imp owns 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 Rues .1950, .1953, .1954, .1955, .1956, .1957, .1958. and .1959 an incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout ISSUED TO: PROPERTY LOCATION: Y�vc!k' cG to L SUBDIVISION LOT # a Facility Type: Gc\� Ley x53 X New ❑ Expansion ❑ Repair Basement? ❑ Yes �X No Basement Fixtures? ❑ Yes JZNo Type of Wastewater System** S°�° 9'zo VGs a 0r,4 S%ss6.M (Initial) (See note below, if applicable ❑) o Q.� /d QED a c.: s w (Repair) Installation Requirements/Conditions Number of trenches 3 Septic Tank Size y t!D e gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: Exact length of each trench 7 S' feet Trenches shall be installed on contour at a Maximum Trench Depth of: inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM Wastewater Flow: 3G.o GPD Trench Spacing: Feet on Center Soil Cover. G^la-- inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: 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. inches below pipe inches above pipe inches total *If applicable: / understand the rystem type ipeciGed it different from the type specified on the apph?arion. / accept the specif ations of this permit we Date: not Construction Authorization il, s ea to compliaoLo�Lhhe�ions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. Authorized State Agent: -!!!!� ��� '2k - Date: Authorization Expiration Date: SEE ATTACHED SITE SKETCH NTE# 5 rj-3n0--7e) Permit # "45y% Harnett County Department of I'ublic Health Site Sketch PROPERTY LOCATON: G)LL , 1 ALL i ISSUED TO: �e'� S �^t SUBDIVISION — LOT # Authorized State Agent: Date:, Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIL/SITE EVALUATION for ONSITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility, Q DZ^ Design Flow(.1949):7V5 M� Location of Site:11� Property Recorded: Water Supply: - Irxublic❑ Ind'vidual ❑ Well Evaluation Method: [I Auger BoringPit ❑ Cut Type of Wastewater: 11 Sewage ndustrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Other ❑ Mixed P R O F 1 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/ Cot" .1943 Soil Depth IN. .1956 Sapro Class .1944 Restr Honz VL V6 2 '♦'�" -Il Ci S � rvrj��J G dLW \Ik\Aiv( C PS Description Initial Rep it System Other Factors (.1946): S ;i Site Classification (.1948):0.5 Available S ace (.1945) Evaluated By:o� S stem T e(s) % Others Present: Site LTAR •7h �`"+