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IPACHTE# III S Li )3 Harnett County Department of Public Health 29523 Imarovement Permit A building permit cannot be issued with only an Improvement Permit �^�� PROPERTY LOCATION: ISSUED T0: (✓L`� f �cY �5 -(�D SUBDIVISION — LOT # C NEWWW>< RREEPAIR�� EAPANSIQN ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S S 61' Proposed Wastewater System T pe: — 0 576 VnNv's �/W1 Projected Daily Flow: 3 IZ5 a5GPD Number of bedrooms:�mber of Occupants: max Basement []Yes ><No Pump Required: []Yes ❑ No XMay be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Xti, Public ❑ Well Distance from well feet Permit valid for. Permit conditions: five years ❑ No expiration '�� �� J 5 Authorized State Agent: Date: � SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance o r Permits. The permit holder rs responi le 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 am incorporated by references into this permit and shall be met Systems shall be installed in accordance with the attached system layout. ISSUED T0: —C,-"; HTE# �' S_Lj lam% Permit # oZ�5a3 Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: N Lal D 5 ISSUED TO: P5 4 C=A,4; . Cd SUBDIVISION l LOT # G Authorized State Agent: ILN-'6qSOvfSa4Q7 Date: VC,a10 J Department of Environment, Health and Natural Resources Division of Environmental Health On -Site Wastewater Section SOIUSITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility:$r?CTiI. Design Flow(. 1 949):'l O�C'V Location of Site: Property Recorded: Water Supply: ublic❑ Individual ❑ Well Evaluation Method Aug onng ❑ Pit ❑ Cut Type of Wastewater: `sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F 1 .1940 SOI, MORPHOLOGY .1941 OTTIER PROFILE FACTORS L E # Landscape Position/ Slope % Horizon Depth (In.) .1941 Structure/ Texture .1941 Consistence Mmeralou .1942 Soil Wetness/ Color .1943 Soil IN. .1956 Swo Class .1944 Resp Honz Profile Clans & LTAR �o s�,x� �no1P to-)a��Q78 u5 PS 36 G l � ate; � � v�L �1•P C PS:i Description Initial Repa' System Other Factors(. 1946): S st Site Classification (.1948): e5 Available S ce .1945Ij_ Evaluated By: System T s dr Ur' Others Present: Site LTAR