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IPACHTE#I(-s--5:6o'Harnett County Department of Public Health 28743 hDrovement Permit A building permit cannot be issued with only an Improvement Permit C— PROPERTY LOCATION: Crrwy T -s �w2d. ISSUE: YEvE JA0nR% SUBDIVISION LOT # 1 NE REPAIR e PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure:-5V-"Q%�"�' Proposed Wastewater System Type: Q:!5'/ 1X—) o> — Projected Daily Flow: 3`G GPD Number of bedrooms: 3 Number of Occupants: % max Basement ❑Yes No Pump Required: []Yes ein,No ❑ Na be required based on final location and elevations of facilities Type of Water Supply: ❑ Community JVK Public ❑ Well Distance from well feet Permit valid for. years Permit conditions:�_ i ❑ o expiration Authorized State Agent: '� -) Date: a 6 SEE ATTACHED SITE SKETCH The issuance of This permit by the Health Department in no way guarantees the issu tpf other permiB. The permit ho4 er 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 rhanges. The Improvem Permit shall not be affected by a change in ownership of the site. This permit is subject or compliance with the provisions of the taws 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, .19S4, .195S, .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: ��VE:- ) �caMyS PROPERTY LOCATION: ��63 RNJISIZ- `CD SUBDIVISION ILOT # I Facility Type: ` 9L�i�) New [I Expansion El Repair Basement? ❑ Yes '1�kNo Basement Fixtures? ❑ Yes o - Type of Wastewater System" .Seca �EDy�\t7 y5 KGs^ (Initial) Wastewater Flow: 360 GPD (See note below, if applicable ❑) 9"CO S (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size v gallons Exact length of each trench aOO feet Trench Spacing: 5 Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (--A inches Maximum Trench Depth of. inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/-1/4" 36" above the trench bottom) in all directions) Pump Requirements: h. TON vs. GPM inches below pipe Aggregate Depth: inches above pipe Conditions: S-ypT Pc N-�)SGZFP inches total WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. "If applicable: / ondeatand the rystem type speciled is different from the type spelled on the app/iadon. / accept the specilcations of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject cation the site plan, plat. or the intended use changes. The Communion Authorization shall not be transferred when there u a change in ownership of the site. This Construction Authorization is compha 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: Cons ion Authorization Expiration Date: HTE# 16-5 3�oa Permit # Harnett County Department of Pablic Health Site Sketch PROPERTY LOCATON: 210V -Tri ISSUED TO: SUBDIVISION LOT # 7 Authorized State Agent Sw�S W�lv(� i Ol9GC15� Date: 3y� Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOHJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: _ Date Evaluated: Proposed Facility: 3 SS7 Design Flow (.I949):360_'y Location of Site: Property Recorded: Water Supply:ublic❑ Individual ❑ Well Evaluation Me[A er Bon ❑ Pit E)Cut Type of Wastewater: ewage ❑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 Stmcture/ Texture .1941 Consistence Minenilogy .1942 Soil Wetness/ Color .1943 Soil Depth W. .1956 Sapro Class .1944 Restr Horiz - Q�,�S Description Initial Repair System Other Factors (.1946): Syst9m Site Classification (.1948):) Available S ace(. 1945) t EvaluatedBy:C\ System Type(s)) Others Present: SiteLTAR�-"��