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IPACHTE# I-r525:lzai'11 Harnett County Department of Public Health 28797 Improvement Permit A building permit cannot be issued with only an Improvement Pe it v PROPERTY LOCATION: Rr�Gn— ISSUED T0: T�n�`J S 1 W 1 t—c �6 SUBDIVISION LOT # NEWW '' REPAIR ❑ EXPANSION ❑ Type of Structure: MAN . yit o arm k � ) Proposed Wastewater System Type:ume l� QSJ r V—QZjC7t Ud Projected Daily Flow: 3r --o GPD Number of bedrooms:.3 Number of Occupants: max Basement ❑Yes "Wo Site Improvements required prior to Construction Authorization Issuance: S rs bm Pump Required les ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community '14 Public ❑ Well Distance from well M Q feet Permit valid for �X Five years Permit conditions: ❑ No expiration Authorized State Agent: Date: 5 I'L 11b SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the f 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 Impre�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 .1958..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. ys\ 1 ISSUED TO: 1"Q; 5'5 PROPERTY LOCATION: ((� SUBDIVISION LOT # Facility Type: M P �� o�E `� New �9 Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System** Ply erg e )10 VLl v tl r t Sys (Initial) Wastewater Flow: 34D 6 GPD (See note below, if applicable ❑) a Q'i V -q \ w --Z� lU (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size 1 Drs n gallons Exact length of each trench c feet Pump Tank Size o mac? gallons Trenches shall be installed on contour at a Maximum Trench Depth of 'q aLl inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: h. TUN vs. GPM Conditions: Trench Spacing: Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe inches total WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: / understand the system type speciled is different ham the type spedled on the application. / accept the specileaoons o/ this permit Date: This Construction Authismation is subject to r if the Ian, plat. or the intended use changes. The Construction Authorization shall not be transferred when there u a change in ownership of the site. This Construction Authorization is.iubuct to comoba uh the D f�tha Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent �TtiC3 Date: Construct) uthorization Expiration Date: NTE# Ir. "5--5150v) Permit # 2Q-) Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: ROSSEO- 5 T1MAti1 ISSUED TO: N N L\e SUBDIVISION LOT # aA Authorized State Agent: OC��S��l� 6t DoH �x� Date: 1 S--117 6rcl (,%0 W E, 1-1 69 S PpL-a ¢,eSsGL— 4 9�9 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: bd \ Proposed Facility: 't) gD(ui Design Flow (.1949):3 �P i Location of Site: Property Recorded: Water Supply: ublic❑ Individual ❑ Well Evaluation Method:�4uger o g ❑ Pit ❑ Cut Type of Wastewater: qswage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R OOTHER F 1 L E # 1940 Landscape Position/ Slope% Horizon Depth (In.) SOIL MORPHOLOGY 1941 PROFH.E FACTORS Profile Class & LTAR .1941 Structural Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth IN. .1956 Sapro Class .1944 Rear Hom 6 •� SIC c', �"Gl. � S� ' lo�)cL"� z� 3 � y G sz vFiL N3�� 3b 5*Y C -L 'l 55) Description Initial R it System Other Factors (.1946): Syst Site Classification (.1948): Available Space y Evaluated By: System Type(s) p O -0 Others Present: Site LTAR