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IPACHTE# 1 C7-5 -45 13~-\ Harnett County Department of Public Health Improvement Permit 2 6 2 6 6 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: z o s- - o ISSUED T0: Cv to SUBDIVISION Ye.S~ t,p,v~a:~ r1~t tnr \b NEW REPAIR ❑ EXPAN ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SF9 S3. ~ IN Proposed Wastewater System Type: Q-4 V Projected Daily Flow: 3<~,Q GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes >o Pump Required: ❑YesNo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 L feet Permit valid for. Five years Permit conditions: No expiration Authorized State Agent:: Date: 1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holder is respo Bible 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 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, .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 T0: _(-v m3EtLLA.19 trL PROPERTY LOCATION: ova y t~zr J viL1 SUBDIVISION eQ,~ Q LOT # _ Facility Type: SVQ New ❑ Expansion ❑ Repair Basement? ❑ Yes "X No Basement Fixtures? ❑ Yes NNo Type of Wastewater System- ~S°lo REOV y5-c G rc~ (Initial) Wastewater flow: 34, O GPD (See note below, if applicable c ssa/l Y-' v G t C7 W (Repair) Installation Requirements/(onditions Number of trenches Septic Tank Size L Q © O gallons Exact length of each trench" aQO feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. inches (Trench bottoms shall be level to +1-114" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: __.~)Feet on Center Soil (over: )la_ 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 LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. *If applicable: /understand the ryrtem type rpeci6ed is different from the type rpeciFied on the application. /accept the tpeci6cationr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to r (the site pl lat, or the intended use changes. The Conshuction Authorization shall not be transferred when there is a change in ownership of the site. This Construction Authorzation is rs~to complianclvy~the is of ws and Rules for Sewage Treatment and Disposal and to the conditons of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: °I Constift*#,n Authorization Expiration Date: ' C► HTE# 1 C7 5 ~5 ►3 Permit #G Harnett ('ountyT Department of Public Health Site Sketch ISSUED TO: C PROPERTY LOCATOW v , C'n k ) Q : ~N-s c- \-N ~ o ty LOT # _ ,~A 14 Authorized S MS LZ-E. Department of Environment, Health and Natural Resources Shed: Division of Environmental Health On-Site Wastewater Section Property ID: Lot H: SOIUSM EVALUATION File A: for ON -SIT& WASTZWATES SYSTEM Cade: Owner: Applicant: Addren: Date Evaluated: Site: ifir 3 Desigd Etow (.1949x , Properhr Size: PmPme Locationoft( c Propert~► Recorded: Water Sup* . Pubdo ❑ Individual ❑ Wed ❑ Spring ❑ other Evahration Methot Auger Boring ❑ Pit Cut Type of Wastewater. J Sewage ❑ Industrial Process C3 mud R O F I L E a ~DL 90ELMORPHOLOOY ~ .1940 Apr Horhua .1941 R PROFlU PAC Poeidad ~P) 1941 .1941 .1941 soil 043 910" % t Stud" Conwdom WetWW . soil , ' Texture 'UhWelo Cola BV L-- Y 5- IO~a • r- 5 . _ ~ ~ ---jo o' L 4A , 1..: I Othar Factory (.1940 Site ClaliBcadon (.1940 Evaluated Bye Others PM= t - 1936 .1941 ProtAf q" Re* CtM 'ler Hads. A LTA* '5 g 5