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IPAC RRHTE# 1,C) - 5- 1 ~bOI RQ... Harnett County Department of Public Health Improvement Permit 2 6 2 8 7 A building permit cannot be issued with only an Improvement Permit h(~ PROPERTY LOCATION: hN w J ~-l ISSUED TO: Gps" B,\ r4 r-A SUBDIVISION Gw 4>ky--'5 LOT # 5` NEWX REPAIR ❑ EkPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: NC=O ('-1d r5t-,i 1 Proposed Wastewater System Type: Qurre~o Projected Daily flow, GPD Number of bedrooms: 3 Number of Occupants: C max Basement ❑Yes 'X No Pump Required-"Ryes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community `K Public ❑ Well Distance from well 100 feet Permit conditions: Permit valid for X Five years ❑ No expiration Authorized State Agent:: Date, 'o la SEE ATTACHED SITE SKETCH The issuance of this permit by e 21thepartment in no way guarantees the i anc other permits The permit holder is responsible for checking th ith 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 rmit shall not be affected by a change in ownership of the site. This permit is subject to compliance wi the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit th . Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules 1950, .1952, .1954, .1955, with the attached system layout. .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance ISSUED T0: Go,ct-J ~oB~*~so r~1 PROPERTY LOCATION: Hwy 2.\c) SUBDIVISION Q,,,,E~ ('bass LOT # 52 Facility Type: Sic` 0 New ❑ Expansion ❑ Repair Basement. ❑ Yes `t54 No Basement Fixtures? ❑ Yes '54, No Type of Wastewater System" Pv cn~p o aS "loo Div SyY~M (Initial) Wastewater Flow: 36O GPD (See note below, if applicable Pv MP \ u ZtSXo ~~o. S yss r r (Repair) Installation Requirements/Conditions Number of trenches ) Septic Tank Size i o oc> gallons Exact length of each trench a3C~ feet Trench Spacing: Feet on Center Pump Tank Size ~ o©o gallons Trenches shall be installed on contour at a Soil Cover: ► a inches Maximum Trench Depth of: a1-'t inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +1-114" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. _ GPM Conditions: MC-GC ON ~G 1 a A~~ZE L_ Pr t_S S inches below pipe Aggregate Depth: inches above pipe S " 115 p inches total WATER LINES (IN(LUDING 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 tr tpeci/- is different from the type ,rpecifled on the application. / accept the rpecilcationr of this permit. Owner/legal Representative Si re: This Construction Authorization is subject to revocatio a sit an, plat, or the intended use changes. The Construction Authorization shall not be transferred whe Construction Authorization is sub to compliance t e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit Authorized State Agent: R6V-','5 Date: 10~1. No Con ction Authorization Expiration Date: 0 ~ Date: there is a fS I in ownership of the site. This SEE ATTACHED SITE SKETCH HTE# D - 5 -ZS o0~ 22 Permit # Harnett County Department of F~iblic Health Site Sketch PROPERTY LOCATON: Hwy `4_1 0 ISSUED T0: A ng 1~~c9 r,) SUBDIVISION C wEt A~-5 LOT # S_ Authorized State Agent: r~ ~L vF~L ~oL~~s~OcE Date: SO~I'10 T~ ly ~3b LtiOx~~ .a . f vPn~ ~P<1k~` L-lorup2 Lam. , tvtsion of Environmental Health , n-site Wastewater Section SOILISITE EVALUATION for ON-SITE WASTEWATER SYSTEM Property ID: ,r^ Lot # l File tl Code: Owner. AW[cant Address: Proposed Fadlily r,-C C` C-\ Design Flow (.1949r %Q Location of Site: Water Supply: A Polk (j Individual ( ]W611 Evaluation Method: (~,(Auper Boring [ ) Pit Type of Wastewater: Sewage Induahial Process Description Initial S stem //Repair system Available Space (.1945) System Type(s) ' Site LTAR t t "A Other Factors (.1946): Site Classification (.1948): P 5 Evaluated By: Others Present: Date Evaluated: Property Size: Property Recorded: Soft ( ) Cut M bred [ 109W 1~, Q301 , - D~LA\