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IPACHTE#/h—s —3i3�b Harnett County Department of Public Health 28991 Improvement Permit A building permit cannot be issued with only an Im rovement Permit PROPERTY LOCATION: ISSUESUBDIVISION LOT # NEW 521" REPAIR CJ. _ _ EXPANSION ❑ Type of Structure: �—j� Proposed WastewaterSystem �TTyyppe: �`% Projected Daily Flow: < Xd&V GPD Number of bedrooms: Number of Occupants: max Site Improvements required prior to Construction Authorization Issuance: Basement ❑Yes No Pump Required: ❑Yes ❑ No Ma �a required based on final location and elevations of facilities Type of Water Supply: ❑ Community f53 Puhlic ❑ Well Distance from well � feet Permit conditions: Permit valid for Five years ❑ No expiration Authorized State Kgan .. L V Date: K 'LY / SEE ATTACHED SITE SKETCH The issuance of this persaitliodefficalth Department in no way guaramees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revoci 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 .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 TO: �� '—� �J/L-- PROPERTY LOCATION:Cy�bSt2(J `� SUBDIVISION LOT # Facility Type: P New ❑lExpansion ElRepair Basement? ❑ Yes No Basement Fixtures? ElYes A Type of Wastewater System`* ZVO16 Z„sQ2— (Initial) Wastewater Flow: (See note below, if applicable ❑) Zsl v I Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size 6 D o gallons Exact length of each trench feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TON vs. GPM Conditions: 360 GPD Trench Spacing: (— Feet on (enter Soil Cover. O inches (Maximum sail cover shall not exceed 36" above the trench bottom) Aggregate Depth: 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. 6 inches below pipe 2 inches above pipe inches total **If applicable: / undersand the system type spedlled is different from the type spedfled on the app/icatioa / accept the spedficatims of this permit. Owner/Legal Representative Signature: Date: This Constmction Authorization is subject in revocation if the site plar, plat or the intended use changes. The construction Authoneation shall not be transferred when there is a change in ownership of the site. This tomtmmon Authoritarian is subject to compliance with the prowmons 01 the laws and Rules for Sewage Ireatment and Disposal and to the conditom of this permit At nl I91cnCU slit Mticn Authorized Stat crit: Date: "/FJ Construction Authorization Expiration Date: g -4.Y -Z/ HTE# /�— S-373 S S Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON:0 ISSUED TO: 94i>- S Z�C,65-03J SUBDIVISION LOT # Authorized State A Z z4 2em Date: iii 'L G —( 6 �ku 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: Proposed Facility: -,11 * Design Flow (.1949): �f b Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method:❑ -AU­ger Boring ❑ Pit ❑ Cut Type of Wastewater: .9 -Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Other ❑ Mined P R O F I .1940 SOIL MORPHOLOGY .1941 OTHER -PROFILE FACTORS L E # landscape Position/ slope % Horizon Depth (in.) .1941- Structure/ Texture 1941 Consistence Mmeralo .1942 Soil Wetness/ Color .1943 Soil Depth IN, .1956 Sapm Class .1944 Reso Horiz Profile Class & LTAR I J L3 y, e Z.) s 6z dam P kr4 Description Initial Repair System Other Factors (.1946): System Site Classification (.1948): Available Space(. 1945) Evaluated By: p System Type(s) Zxr1. Others Present Site LTAR . y,