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IPACHTE# Eo-s Harnett County Department of Public Health Improvement Permit 2 6 2 5 3 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: ?o"o~2os (Z-D ISSUED TO: c x SUBDIVISION C- K" 4 a. "L azo rr S LOT # ~y NEW REPAI ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5Vp L Proposed Wastewater System Type: 9 U 9 7ta a,S °/a Rt~ov Cj(, o r1 Projected Daily Flow: 'J~o© GPD Number of bedrooms: Number of Occupants: -4' max Basement ❑Yes 'X No Pump Required:_;!~s ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well ld Q) feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: $ It SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the ce of other permits. The holdeTis responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation 4 the site plan, plat, or the intended use changes. The Impr ement 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, .1956. 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: Facility Type: 5r%~ X New Basement? ❑ Yes 'X No Basement Fixtures? ❑ Yes Type of Wastewater System" P U rn P -To '),V/ o~ (See note below, if applicable PROPERTY LOCATION: Par 30VSLoS~. P-.D SUBDIVISION ~o-ot-~ >\y S6 c~soN S LOT # *-1 El Expansion El Repair -,a No PUMP~a 3-s% P"-0'J ;'C) 0 iJ (Repair) Installation Requirements/Conditions Number of trenches I Septic Tank Size tac5 G gallons Exact length of each trench O feet Pump Tank Size o o gallons Trenches shall be installed on contour at a Maximum Trench Depth of: N I inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: (Initial) Wastewater Flow: 3 ~O GPD Trench Spacing: Feet on Center Soil Cover inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. 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/ication. / accept the specifications 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 chance in ownershin of the cite This Construction Authorization is subject to comp i u h thtprovics 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: 'a 1~ Cons ion Authorization Expiration Date: 9 NTE# Permit # 2i, ISSUED TO: ::YP, Authorized State Agent: Hamlett ConntN Department of Miblic het lth Site s"ketch PROPERTY LOCATON:Po N pEa~SA tZ~ N~• _ SUBDIVISION GP.cw t-~,~ p SEysoNs LOT # 411 _ Qb\~S L-NvE1t 70LY-s'00(~)Date: 10 lp d pone iT~~~/ t REDv I N ~ _ 9" C 4 6 'xGO' C) 20 p' SC~2~ >\t ~ ~-uw(~ fJ~L Department of Envimununk Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOWSrM EVALUATION for ON-S1TZ WASTZWAT19IR SYSTEM Owner. Applicant: Addrew Date Evahtated: Proposed Facility; 3 eW Qcxr r-\ DeSIP MOW (.1949): 35 e Lagdou a[ Si)0; ProPM# keoorded: Shed: Property ID: Lot N: File Ih Code: Property Size: water $upor; 00 ❑ Individual ❑ well ❑ spring Evaluad= Method: uger Boring ❑ Pk Cut Type of Wastewater: ewap ❑ Industrial Process Mb" ❑ Other P It O P 1 1940 OULMORPHOLOOY .1941 THER PttOFILa FACTORS L 9 M larAmpa Poaltioal 91opo9t+ Horizon Depth (Ia) .1941 stuat" Texture .1941 Coautaleawat Mtnndo .1941 sot webmw Color 1 t3 soil MvA IN, .1936 sapru Clan .1941 Re* Hais. PtotM CtW LTAt 3 cr tom, G s ^IS-~~u~ ~v~ . fcoo- I ► v.=, ~ I I I 1 ' s sc [VA~ 1 C-36 1 f I Ld"K4,FR4001 umm Rap* syatm Othr Factors (.1946) Lsymhft site ClLweadon (.1948) e Avalbtle Specs .194! Everted By qn 3 Airs rypefs) Vna J-:i Ca p vnF sit. LTAR w Of}IQlPreint