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IPACHTE# V%— L44321& Harnett County Department of Public Health 30138 Improvement Permit A building permit cannot be issued with only an Improvement Permit —T PROPERTY LOCATION: 1T-SostiR5 1< -LL -Y Rz ISSUED T0: _H Old tNl9 t t n k I q�„p, SUBDIVISION LOT # NEW X REPAIR ❑ 1SION ❑ Type of Structure: SFO W742-%ra Proposed Wastewater System Type: C.0..46r A10ND.t- Projected Daily Flow: 36© GPD Number of `bed� oms: 3 Number of Occupants: )P. ax Basement XYes ❑ No Site Improvements required prior to Construction Authorization Issuance: Pump Required: Oyes XNO ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ❑ Public �X Well Distance from well IC C) feet Permit conditions: Permit valid for. Five years ❑ No expiration Authorized State Agent: Y 5 Date: 7 11I 3q SEE ATTACHED SITE SKETCH The issuance of this permit by she Health Department in no way guarantees t e of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirement. This site is subject to revocation if the site On, plat, or the intended use changes. The Improv lent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with she pmvisions of the laws and Rules for Sewage Treatment and Disposal and to mndmons of this permit. Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1958..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: PQ -QT s^ ? l A4 a PROPERTY LOCATION: —114 o C, P0 Yom[ LLy Ra SUBDIVISION LOT # Facility Type: 5�0�8�SeLi 0 �' New ❑ Expansion ❑ Repair Basement? 1:5( Yes ❑ No Basement Fixtures? ,.Yes ElNo Type of Wastewater System`* C.,cs r.rC it) N cx.L (Initial) Wastewater flow: 36 0 GPD (See note below, if applicable ❑) N &t A t V a AI., (Repair) Installation Requirements/Conditions Number of trenches Li Septic Tank Size 50o Ci gallons Exact length of each trench S IAC feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches Maximum Trench Depth of: 1 inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/-1/4" '-)_ 36" above the trench bottom) in all directions) L+J' R� Pump Requirements: ft. TDM vs. GPM sg. Aggregate Depth: Conditions: WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. inches below pipe a inches above pipe inches total "'Ifapplicable, / understand the r}rtem type rpedhed it different from the type specified on the appficadon. / accept the specXca6onr of this permit Owner/Legal Representative Signature: Date This tons "zation is subject to revocotion if the sire plan, plat, or the intended use changes. The comment Authormation shall not be transferred when there is a change in ownership of the site. This construction Authorizatio subject ian the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: St15 Date: 7 14 Lonstruction Authorization Expiration Date: a 1 23 H T E # M "S-L1'I3-.) Permit # 3013% Harnett Counter Department of Public Health Site Sketch _ PROPERTY LOCATON: +-1-y ISSUED TO: �4o a,q S Ipac-, SUBDIVISION LOT # Authorized State Agent:T� `qi w `iota 5ao{(� Date: -7,- 114 W O C7^(J^G/�^ f \"A �1j'r\•+J 6sa o _ TJ -a 6MA3 V,L ZDV R,J Sss � 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: 3 FS DCI Design Flow (.1949): _ t66 Location of Site: Property Recorded: Water Supply: ❑Public[] Individual Well Evaluation Method: Auer Boring El Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F 1 L E # .1940 Landscape Position/ Slope% Horizon Depth (In.) SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS Profile Class & LTAR .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz L. wSl c C G U \PR) w +( G lata 58x, G F R d P 2 a- 51 C L Fa N rip C-� Sgt c Fn L Description Initial Repair System Other Factors (.1946): S ste Site Classification (.1948)'" Available Space(. 1945) . Evaluated By: S stem Type(s) Others Present: Site LTAR Z ; 1 I I?