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IPACHTE# I (�—`J3`17(0 Harnett County Department of Public Health 29102 Improvement Permit A building permit cannot be issued with only an Improvement Permit (� g� PROPERTY LOCATION: W aLa—\JC'k5 S� ISSUED TO: t tLya )C. COIa G NC • SUBDIVISION Sw C� -rt P.TFSL LOT # 44 NEW>< RE PAIR E3 ION ❑ PSite Improvements required prior to Construction Authorization Issuance: Type of Structure: S V ) `LAS xLi Proposed Wastewater System Type: `•5°/o c+.T n..t Projected Daily Flow: "%() GPD Number of bedrooms: =i Number of Occupants: max Basement ❑Yes �2No Pump Required: ❑Yes � No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent: Date: 10 -" 1 b SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the iuua er permits. The permit holder is lesponsiblelfour chocking 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 Improveme mit 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 commission and installation requirements of Rules .1950, .1957, .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 p ISSUED TO: A f--��1tr Q`0"� N L •, PROPERTY LOCATION: � to LV LPS P.D SCO �"i x"� SUBDIVISION 5w CG: tP4En_ LOT # 41t' Facility Type: �ew ❑ Expansion ❑ Repair Basement? ❑ Yes 'J;� No Basement fixtures? ❑ Yes �KNo Type of Wastewater System** b/o 9.GoV GTS 0 sv S-ys--VC— (Initial) Wastewater Flow: ""13 6 GPD (See note below, if applicable ❑) ^� e o Installation Requirements/Conditions Septic Tank Size Lbp0 gallons Pump Tank Size gallons Pump Requirements: h. TDH vs. Conditions: 2-P-0" (Repair) Number of trenches 1 Exact length of each trench D feet Trenches shall be installed on contour at a Maximum Trench Depth of. L"fQ' (>© inches (Trench bottoms shall be level to +1.114•• in all directions) GPM Trench Spacing: c, Feet on Center Soil Cover. 36-""io inches (Maximum soil 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. inches below pipe inches above pipe inches total **If applicable: / undeataad the r}rtem type spedfled it different from the type rped6ed on the app/icat/on. / accept the rpedffcationr of thin permit Owner/Legal Representative Signature: Date: This Construction Atithomation7r1libledorevocation if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Constmttion Authorizationo compli a ions 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: SO Col ction Authorization Expiration Date: HTE# Permit # 3-01) 0—,4, Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: t L Lv&i-& ISSUED T0: ��� GO ^ ,�v L SUBDIVISION SwGG—"ter ESL c� LOT # �l Authorized State Agent?35 of 1vflL 1oLsaDoSl Date: LB �6 1b ' 1 2EiA,Q ) r Ate.. I 146 Nousb �,� f 0u� G� Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOH./SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: f'13SX1 Design Flow (.1949): LA Location of Site: Property Recorded: Water Supply: -'Wublic❑ Ind'dual El Well Evaluation Method:[]Augf �Boring it ❑ Cut Type of Wastewater: 4'1 Sewage industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F 1 .1940 SOIL MORPHOLOGY .1941 OTHER PROFH.E FACTORS L E # Landscape Position/ Slope % Horizon Depth (In.) .1941 Structure Texture .1941 Consistence MineralogyColor .1942 soil Wetness/ .1943 Soil IN. .1956 Sapm Cbtss .1944 Reur Hmiz Profile Class & LTAR L5 a C-6 G L � 1 s vfb Description Initial Repair System Other Factors (.1946): S st Site Classification (.1948): Available Space(. 1945) Evaluated By:.� System Type(s) Others Present's Site LTAR 5