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IPACHTE# 10 75--2sS 1 Harnett County Department of Public Health Improvement Permit 2 6 3 5 8 A building permit cannot be issued with only an Improvement P it PROPERTY LOCATION: PAC-'C~62,. ),5 7 ISSUED T0: mOS ~t''1 titi-~--S SUBDIVISION LOT # NEW REPAIR ❑ EJ~PANSION ❑ Type of Structure: SFO ) '`3a- } Proposed Wastewater System Type: Al - Projected Daily Flow: 3 © GPD Number of bedrooms: Number of Occupants: `o max Basement ❑Yes No Site Improvements required prior to Construction Authorization Issuance: 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 1b0 feet Permit valid for: f`-" live years Permit conditions: ❑ No expiration Authorized State Agent:: lv;f Date: 1) INC) SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance of o permits. The permit holder is esponsible 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 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 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, .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 T0: cho'Ct-1~ 1~ti5 PROPERTY LOCATION: $C "-11--L SUBDIVISION LOT # Facility Type: 34~ / New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes "5~ No Type of Wastewater System** C-01.4'J 0 P4 P.L.. (Initial) Wastewater Flow: 3ro0 GPD (See note below, if applicable CO 1-1 -Q G4,,47~ \ C N,0', I- (Repair) Installation Requirements/Conditions Number of trenches a Septic Tank Size t ac' c) gallons Exact length of each trench 1 3).Q feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. V --O inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: C1 Feet on Center Soil Cover: C inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe a inches above pipe a- inches total WATER LINES (INCLUDING IRRIGATION) MUST BE 1OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: l under fond the system type specified is different from the type specified on the application. l accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is-m~' ' revo-~c.a.t,io.,n_ if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This Construction Authorization is suhje Vo complianFt~^wzLfithe~prgisions Dews and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: t~ -a } a Constr *n Authorization Expiration Date: > > 15 HTE# id Permit # x,35$ Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: ISSUED TO: 11 M 1 -►-5 SUBDIVISION LOT # Authorized State Agent: l~5 1o L~4 E3t, T 01„~S9o~ Date: i'~~b Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITE EVALUATION for ON-81TE WASTEWATERSYSTEM Sheet: Property ID: Lot File * Code: Owner. Applicant: Address: Date Evaluated: Proposed Facility: `3 -3 Ebz o 5 Design Flow (.1949): 3 4) 5 ~ Property Size: Location of Site: Property Recorded: WatetSupplr BlAugerBoring Public ❑ Individual Well 13 Spring El Other Evaluation Method: ❑ Pit Cut Type of Wastewater. Sewage ❑ Industrial Pwss ❑ Mixed. P R O F 1 1940 09.,MORPHOLOGY .1941 THER PROFILE FACTORS L 9 q La uhmpr Positiad 91opir Hmizue Depth 00 11941 shuatord Tem n .1941 Colwdew Wamlo .1941 Soil Wdand Color .1943 soil DkA IN. .1956 31pre Clan .1944 Re* Horn. P Mi Clan R LTAX '53 Y, SCL't VQ, [L -1 C~ 5 L v F-r k, NS w v1s~ J-C ++~w~pvop ~w Rapair 3y~ Other Factors (.1946k Availabl®9 Ap , t94! site ClaaaiBcation (.19482 j Evehwted By: s 'tiro Wool) OthersPrexnlr - Site LIAR Cr ~Y, : r