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IPACHTE#16-5-�2'7c� Harnett County Department of Public Health 29029 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: Otin, U —CO ISSUED TO: Pew 1—y0v-1 SUBDIVISION V) ta,en%6 et t. Q,NoCr, LOT # Li NEW REPAIR 0ANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SF'Q (,6'YxSS� Proposed Wastewater System Type: ?vv"e e 3 0 Projected Daily Flow: � 9.�DvGaow �sS6N) GPD Number of bedrooms: ''- Number of Occupants: C, max Basement ❑Yes ';�No Pump Required%�la'es El No El May be required based an final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well LIZ) Q feet Permit valid for: Afire years Permit conditions ❑ No expiration Authorized State Agent: Date:i 1I ) b SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issua e,p`other permits. The permit holde is resp nsible for <heding wisA appropriate governing bodies in meeting their requirements. This site is subject to "emotions if the site plan, rat, 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 renditions of (his permit. Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .19S7, .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: ` A v i Lyo r,. PROPERTY LOCATION: Cb -0 uSLLa 1 SUBDIVISION mF�n�6 R�G� Q *oGG LOT # Facility Type: S F� ��a "r�5� New ❑ Expansion ❑ Repair Basement? ❑ Yes X No Basement Fixtures? ❑ Yes .;E�No Type of Wastewater System** PU cw1P�0 aS°�tz R6wC�oar S' y�j 6x� (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) / Vy 2E> , v 8 `r( o W-0) 15-6 . (Repair) Installation Requirements/Conditions Number of trenches L Septic Tank Size tboo gallons Pump Tank Size \- o�ZsO gallons Exact length of each trench feet Trenches shall be installed on contour at a Maximum Trench Depth of: \o - olt-) inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: (t. TDH vs. GPM Conditions: Trench Spacing T Feet on Center Soil Corer: 6 inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 sXtem type specih'ed it different from the type specified on the application. / accept the rpecifnatiors of thir permit. Owner/Legal Representative Signature: Date This Construction An is subject to revoation if the site plan, plat, or the intended we changes. The Construction Authorization shah not be transhrnd when there n a change in ownership of the site. Thu Construction Aut orimlion is sub'ett to co with risiom of the Laws and Rules for Sewage Treatment and Disposal and to she conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: C1L- S Date: 1 214 o (Ruction Authorization Expiration Date: 1 HTE# «"5 3`i �% Permit # ai0arl Harnett County Department of Miblic Health Site Sketch PROPERTY LOCATON: 0 .Q ISSUED T0: L o _ SUBDIVISION MP,-%�r- R1066, LOT # X16 Authorized State Agent: Date: (' E R,.c tN6�r\ Mss; �E Lo�o,rEp . -"4*SoaQz-y L, rG �)vSTL\LLEfi, t1JIT)k)— \ z C �SlU c1. o l••�S'Y F IZPT 10 +s Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOD:✓SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: f<24k^ Design Flow (.1949):36 0�4\ Location of Site: Property Recorded: Water Supply: ublic❑ Individual ElWell Evaluation Method: bAu er B ng ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Sim: ❑ Spring ❑ Mined ❑ Other P R O F 1 .1940 SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS L E # Iand scope Position/ Slope % Horizon Depth (In.) .1941 Structure/ Texture .1941 Consistence Minesalogy 1942 Soil Wetness/ Color .1943 soil Depth IN. .1956 Sapro Clus .1944 Rem Honz Profile Class & LTAR 0 5L c�. raS�tiQ 'S3 )< su~ �2 N q S Description Initial Repair System Other Factors (.1946): Pf Systeul Site Classification (.1948): Available Space(.] 945) Evaluated By:(3)� System Type(s) M 0 Others Present: Site LTAR