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IPACNTE# il�, 5-3 ) -�G Harnett County Department of Public Health 28777 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 1--qa 2E NCS ISSUED T : S �EyE i G IOMs�7 SUBDIVISION LOT # NEWS REPAIR ❑ EXPANSION ❑ Type of Structure: 51e 9 (; 0 --7 S' ) Proposed Wastewater System Type: to S--auc r c3 'J 3 Gtr Projected Daily Flow: 3 6O GPD Number of bedrooms: _ 3 Number of Occupants: max Basement ❑Yes XNo Site Improvements required prior to Construction Authorization Issuance: Pump Required: []Yes -IWNo ❑ May be required based on final location and elevations of facilities Type of Water Supply: El Community � Public 11 Well Distance from well feet Permit valid for. Five years Permit conditions: ❑ o expiration Authorized State Agent:: Date: VI6 16 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the of other permits. The permit holder is respionliffle 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 requirement 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 TO: S ' EyE �t�Utrgs PROPERTY LOCATION: 1 �wcZG scy 29 SUBDIVISION LOT # Facility Type: SCO L5d ^ 7 S� New ❑ Expansion ❑ Repair Basement? ❑ Yes 22� No Basement Fixtures? ❑ Yes -C(No Type of Wastewater System** — Q0Syy eco'J z6Tn (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) a.S ca/0 KtZ5Z cn f o N(Repair) Installation Rete uirements/Conditions ( Number of trenches T Septic Tank Size T -o a 6 gallons Exact length of each trench 3 C) © feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: N t inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: k TDM vs. GPM Conditions: Trench Spacing: 9 Feet on Center Soil Cover. 6 inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE IOFF. 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 diftent from the type specified on the application. / accept the specification of this permit. Owner/Legal Representative Signature: Date: This construction Authorization is subjw1m revocation i site pian, 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 Authosiz; t to cornf:10 the prov of the Lam and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 4 1G ction Authorization Expiration Date: 4i G ) HTE# 16 -5-3-U7� Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: a t4Gnic.E ISSUED T0: SUBDIVISION LOT # Authorized State Agent: R1c� yivfit Ot Ks�dS Date: Np0St I aC) Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: %g9�'� Design Flow (.1949):: � Location of Site: Property Recorded: Water Supply:Public❑ Individual ❑ Well Evaluation Method:❑ Auger Boring [Pit ❑ Cut Type of Wastewater: /Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other 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 Minendogy .1942 Soil Wetness/ Color .1943 Soil Depth(IN-) .1956 Sapro Class .1944 Raw Horiz 6e,pGG �s s Lnlyc w-19 -7� L 3'Si P5 Description Initial Repair System Other Factors (.1946) - System/ .1946):S ste Site Classification (.1948):P�) Available Space (.7945) 14 Evaluated By: pr� System Type(s) a,,o QCT Others Present: Site LTAR 11