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IPACHTE#:6-5�MuL-'$ Harnett County Department of Public Health 28787 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: Po�a824)Sa ISSUED TO: L_y o -- 17 Q"v s 2,a(-szb � av G SUBDIVISION LOT # NEWWW'li' REPAIR p EIIPAN§ION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Ax g Proposed Wastewater System Type: aC-e 9C� V CS s O t1 yS�x Projected Daily Flow: 5 C Its GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑YesNo Pump Required: ❑Yes e �o El May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1-b Ci feet Permit conditions: Authorized State Agent: \� k The issuance of this permit by the Reil1A Depamnent in no way guarantees ce site is subject to revocation if the site on, plat or the intended use changes. The m the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. Date: Permit valid for. - KKfive years ❑ No expiration SEE ATTACHED SITE SKETCH of other permits. The permit holder if responshe for checking with appropriate go"ming bodies in meeting (heir requirements. This cement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of Construction Authorization (Required for Building Permjt) The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, AST. .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be instilled in accordance with the attached system layout. pp ISSUED TO: L --y0 (42,S PROPERTY LOCATION: SUBDIVISION LOT # Facility Type: S ;�:r9 t, ' `J J 'X New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes Type of Wastewater System** �S �� a R69 v r✓ s o - a S 7 S6,n (See note below, if applicable ❑) 5 m1 0 )<&D . SSS . (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size s ©oo gallons Exact length of each trench S Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: S�3 Pump Requirements: h. TDM vs. Conditions: (Trench bottoms shall be level to +/-1/4" in all directions) GPM (Initial) Wastewater Flow: GPD feet Trench Spacing: t Feet on Center Soil Cover. inches 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 milem type spealed is different from the type speriled on the app/intron. / arrept the rperilratiom of this permit. Date: This Construction Authorization u reroadon it 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 Constmction Authorization is whje�m complus Il ow the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: , }15 Date: y W-11 6 Cons ion Authorization Expiration Date: `d 1 0S HTE# _I (�) - 5 "3AL-iL l Permit # Harnett County Department of hiblic Health Site Sketch PROPERTY LOCATON: �0 �vGz95U 4 ISSUED T0: v t �oL2� ,N SUBDIVISION LOT # Authorized State Agent:�s�o , oL sic f Date: 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: 1 Proposed Facility: 3 902-M Design Flow (.1949): Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method'Au er 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 mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth IN. .1956 Sapro Class .1944 Restr Horiz L5 13o-Uk �lcstz •t! >13�1JQ 'LIS o-ao G L5 pct, -'J -tQ �o-3z, ST', It y 3k Fs"` o au G 52, vfiv KS) ILI% ssx 5c�'- )ZrL J"�q �5 CtC c, Description Initial Repair System Other Factors (.1946): Systevi Site Classification (.1948):p-') Available Space (.1945) j Evaluated By<r �( System Type(s) Lo- Others Present: — SiteLTAR •�