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IPACHTE#► 6-53`)�"% Harnett County Department of Public Health 28914 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: L. KW zb ,OG ISSU D TO: i \ Q nr-,R C5f1. 1 I—$ SUBDIVISION LOT # Ei NEW Ej REPAIR ❑ EXPANSION ❑ Type of Structure: 5C9 Proposed Wastewater System Type: `�Sa/e RES�VG� �if;M Projected Daily Flow: Lk q Q!) GPD Number of bedrooms: N Number of Occupants: max Basement ❑Yes No Site Improvements required prior to Construction Authorization Issuance: Pump Required: []Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ,,XPublic ElWell Distance from well 'i,© V feet Permit valid for. Fire years Permit conditions: ❑ No expiration Authorized State Agent: 7,� Date: / 1 Jo SEE ATFACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance cher permit. The permit holder is respomib a for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation a 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 requirements of Rules .19SD, .1952, .19S4, .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: kms— e2 cRal.� 1E6 PROPERTY LOCATION: L—Aw r2C Ci �� l SUBDIVISION LOT # S Facility Type: (5p x-5 New ❑ Expansion ❑ Repair Basement? ❑ Yes � No Basemj^t Fixt es? El Yes 'boo Type of Wastewater System** r. m, ca MEO-v G,i) o t SY27N C=,C% (Initial) Wastewater flow: � GPD (See note below, if applicable ❑) 0 1� o V—eD. SSS - (Repair) Installation Requirements/Conditions Number of trenches 5 Septic Tank Size 2 000 gallons Exact length of each trench SO feet Trench Spacing:Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of.inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Soil Cover: 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 system type speeded is different from the type specified on the application. / accept the specihcanims of this permit Owner/Legal Representative e: Date: This construction Authorization is subject to revocaation si Ian, plat or the intended use changes. The construction Authorisation shall not be transferred when there u a change in ownership of the site. This construction Authorization ati4 tRto co rmlianalnyi ' prorism laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: 125--1A5 Date: 7 Constru ' uthorization Expiration Date: _ HTE# "S 3�©�� Permit # ISSUED TO: Authorized State Agent: Harnett County Department of Public Health Site Sketch _ PROPERTY LOCATON: L vQ-6-4 �Q r o " SES SUBDIVISION—\\ / LOT # S �6 LlV l OL\�S�CI )Date: lQ Q� 6e -�,g0 LAW 26n cE 2p Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIWSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: p\ Proposed Facility—kbA V" Design Flow (.1949): �-�`j C\ Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method Auger Boling ❑ 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 GTS PROFILE FACTORS Profile Class & LTAR .1941 Structure/ Texture .1941 Consistence Mineralog .1942 Soil Wetness/ Color .1943 Soil Depth W. .1956 Sapro Class .1944 Restr Horiz 1,-3p S3t G Fti 5�� P� 3 7 G -1Q G SL�5 599 e- �a sIQ R S 3 3J � Description Initial Repair System Other Factors (.1946): ,�7 S st m Site Classification (.1945)y Available Space( 1945) Evaluated By:(Z,, System Type(s) -6v Others Present: Site LTAR --� 5 5��� ¢L I- v