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IPACHTE# 1®-^5 1~~~8Z Harnett County Department of Public Health Improvement Permit 2 6 3 8 2 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 7 ) rA 6a N (Z.5) ISSUED T0: SUBDIVISION P~;' o,JS ~R a>>r~; LOT # NEW"f5e, REPAIR EI €XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: s~ Q ( 2> n3 Q) Proposed Wastewater System Type: Ca s`e•t 8 10 h.l. Projected Daily Flow: 3~o O GPD Number of bedrooms: Number of Occupants: JK~) max Basement ❑Yes ;KNo Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well E©i~ feet Permit valid for: -ZJ Five years Permit conditions: _ ❑ No expiration Authorized State Agent:: C1GHS Date: ~_'7I 1) SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuanc other permits. The permit hold' Trsponsible 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: PROPERTY LOCATION: -9A _ SUBDIVISION 9-9a-r0 LOT # N1 Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? II NS ~4 No Type of Wastewater System**~rEs~ts~vrro~t (Initial) Wastewater Flow: '~46 GPD (See note below, if applicable C-0:v-yE~ ~ o ~C 3~.t ~Q J rhQ) (Repair) Installation Requirements/(onditions Number of trenches a- Septic Tank Size 1 c®Q gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: Exact length of each trench -1 S feet Trenches shall be installed on contour at a Maximum Trench Depth of. )q ' 30 inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM Trench Spacin : Feet on (enter Soil Cover: 7" 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 LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: l understand the system type speciped is different from the type speciped on the application. l accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation . site pla lat, 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 s 'ect to compliance withkie p<visio~iws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: ~ 1'l Constru'akn Authorization Expiration Date: 1-111L HTE# 10 °S 2S -7$-d Permit # 'D-(c, . Harnett Connty Department of 1~-tblic Health Site Sketch ISSUED TO: N--') o Authorized State Agent: PROPERTY LOCATON: ~►NG&N Ra-~ - SUBDIVISION i'a~-, o n s d~ r-~ LOT # N ,~6 LN I `N 01 Date: 1 1`21 SC) V r N CP r Z cA 11~- 7 / Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIIJSITZ EVALUATION for OPT-SITE WASTEWATER SYSTEM Sheet: Property ID: Lot File !1: Code: Owner. Applicant: Address: Date Evaluated: fl/.))) Proposed Facility: 3 Bevrzo o r,. Design Flow (.1949):3 r.0 Property Size: Location o(Site: Froperhr Recorded: Watet Siupp I >ic ❑ Individual ❑ Well ❑ Spring ❑ Other Evaluation Method: LT<Auger Boring ❑ Pit Cut Type of Wastm ater 11~ewage ❑ Industrial Process C] INixed. P it O F SOU. MORPHOLOOY OTHER 1 L .1940 .1941 PROFRS FAOTORR Laws"" Horizon .1941 E Poeidad Slops % Depth (Ia) 1941 .1941 Str t w soil .1049 .1956 .1941 PMM* uc u Comidme Welled soil S■pro Re* CIA" ~ Taxwm Minenlc C Color IN. Clw Hons. ALTAR i a o s VRtiI-A) 'G S 55 $~S Site ClAWCadou (.194ik ?6 EVahzted ~ =l 9 V ~~Cl~ - - Others Present: