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IPACHTE#)�o-S3�1�M Harnett County Department of Public Health 29125 Improvement Permit A building permit cannot be issued with only an Improvement" It (� t� PROPERTY LOCATION: tJa,v E ISSUED TO: GpvSl.rO SUBDIVISION 1a%Sov:H \yo%)S-nNo:L 2,4— LOT# Q NEW X REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: _ W PFLG holt 56 Proposed Wastewater System Type: Cow mef--y tc sv 9.t_ Projected Daily Flow: S enn GPD Number of bedrooms: — Number of Occupants: L4 max Basement []Yes '�KNo 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. Ive years Permit conditions: ac ❑ o expiration Authorized State Agent: 'NS Date: Na s 1 b SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees ante of other permia. The permit holder Ipon ible for checking 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 mprovement Permit shall not be affected by a change in ownership of the site. This permit is subject in 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: CSS )'-4PJ ,^) �c E s PROPERTY LOCATION: S mfL j (c?.2 E SUBDIVISION ,2s Sn�nn 1ro0US 2\AL A2`L LOT # Facility Type: �P�C�IUUSE New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo Type of Wastewater System** Cat 4N Gryi T 0 N AL (Initial) Wastewater Flow: 100 GPD (See note below, if applicable ❑) r`syLt 1 «� t s A.L. (Repair) Installation Requirements/Conditions Number of trenches a Septic Tank Size L o oD gallons Exact length of each trench 50 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: N. TDM vs. GPM Conditions: Trench Spacing: Feet on Center Soil Cover: 6inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. ro inches below pipe a inches above pipe S� inches total **If applicable: l otAderrtand the tyttem type specified it different from the type rpecibed on the application. l accept the specff/cadons of this permit Representative Signature: construction Authorisation Authorized State Agent: or the intended use changes. The construction Authorisation shall not Laws and Rules for Sewage Treatment and Disposal and to the conditions of this Date: Date: Date: SEE ATTACHED SITE SKETCH HTE# R\ 1� Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: - Pf>a sj Q," v ISSUED T0: �s No >> �cCs SUBDIVISION Tit So vs 1 1Novss<i qtl �aQz4. LOT #_ Authorized State Agent: 5 SOLYSnS Date:'LI)� ZZPr,gx-0 \�21VE t 5a' 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: \4 �t4_ „Ov C- Design Flow (1949):10 d J� Location of Site: Property Recorded: Water Supply: PublicD Individual ❑ Well Evaluation Method Atter loping D Pit D Cut Type of Wastewater: 15 Sewage D Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: D Spring D Mixed D Other P R O F 1 SOIL MORPHOLOGY OTHER L .1940 Landscape Horizon .1941 PROFILE FACTORS E N Position/ Slope% Depth .1941.1942 (inJ Structure! .1941 Consistence Soil .1943 .1956 Wetness/ .1944 Profile L% TexNre MineraloColor Soil Sapro D IN. Class Restr Class 0 all G s Horiz &LTAR 7—(1 `,II�C cfT �� `gam C'L' 3n/ OQS C S3 -Y- 6([_ Wn s5l F f Description Initial Repair System Other Factors (.1946): Available S ace .1945) S ste Site Classification (.1948): �5 S stein T s) o- Evaluated B cr Y "�1 Site _TAR -� �_ ., — Others Present: