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IPACHTE# 10 Harnett County Department of Public Health Improvement Permit 2 6 2 9 8 A building permit cannot be issued with only an Improvement Permit Q- PROPERTY LOCATION:_ Q ,,L, ► ISSUED TO: ~SFaM~ p.y SUBDIVISION amass If1&~tk J~Cz F- LOT # V0 NEW ~X REPAIR P PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 15 Proposed Wastewater System Type: Qoa-4eA-c-,~a ,t p,JL Projected Daily Flow: Co O U GPD Number of bedrooms: 5 Number of Occupants: I Q max Basement ❑Yes No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community 'A< Public ❑ Well Distance from well IOC) feet Permit valid for. Five years Permit conditions: _ ❑ No expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the issu site is subject to revocation if the site plan, plat, or the intended use changes. The Impr the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. Date: sb 6~1d SEE ATTACHED SITE SKETCH other permits. The permit holder is r ponsible for checking with appropriate governing bodies in meeting their requirements. This Went Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .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: = C--, y PROPERTY LOCATION: C)LflL~~) Facility Type: S V.b (53'.x c'l-) Basement? ❑ Yes )i~ No Type of Wastewater System" _ (See note below, if applicable Basement Fixtures? C.6 NVE-~ s0u SUBDIVISION Ross C1c.~Q,_ ~E LOT # New ❑ Expansion ❑ Repair ❑ Yes No (Initial) Wastewater Flow: b~ GPD Cc,t-jl to,)P.t_ (Repair) Installation Requirements/Conditions Number of trenches 4 Septic Tank Size ► 5o gallons Exact length of each trench `l0 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: S%- Q44 inches (Trench bottoms shall be level to +1-114" in all directions) Pump Requirements: ft. TON vs. GPM (onditions: Trench Spacing. Feet on Center Soil Cover. )I inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: a inches above pipe inches total WATER LINES (INCLUDING IRRIGATIONS MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. `*If applicable: / underrtand the .ryrtem type rpeciled if different from the type rpeciled on the application. /accept the tpecircationr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject tion 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 Construction Authorization is subject to compliance the s of t1sQaws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 10 4b `v Construction Authorization Expiration Date: o HTE# Permit # a6aq*i3 Harnett County Department of I'liblic Health Site Sketch ISSUED TO: Authorized State Agent: PROPERTY LOCATON: O Lc,47x0 SUBDIVISION Kass Mc,R LOT ~5 (ouv~ ToLxsflc~C~~ate: 14~a6 l y -11, Department of Environment, Health and Natural Resources Shed: Division of Environments! Health Property ID: On-Site Wastewater Section Lot a: : SORJBM EVALUATION Fib for ON-SIi Code: TE WASTI6WATER SYSTICM- Owner. Applicant: Addre= Data Evaluated: Proposed FxilItr. 5 Design Flaw (.1949): 4-0 0 :>C - Property Size: Locadon of Site; Prop" Recorded: Watt;t Suppt7! El ~Publk ❑ Individual [I Well Spring Evaluation Methock Auger Boring ❑ Pit Cut Type of Wastewater. Sewage ❑ Industrial Process Mixed P R O F SOIL MORPHOLOGY OTHER 1 .1940 .1941 PROFRd FACTOR L [ardkap~ Horizne .1942 M Slops t~ • 1941 .1941 son ,1 i~ struensrd Comistmc. WeOfen/ soil Tex" Mt-6 Color IN. 0`~ I s ~(F-~ es~~P 3~ i 4 Ca s~t_ T"cz 55)%AY ~ O G ~ vcr~ I~ ~ - LA ❑ Other 1936 .1944 I AV& Re* Clan t.` P5 g Iitem VIM Factors C I Wd) Site C1eWcation (.1948k P5 Eveh>ated By: vt Others Prem*