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IPACHTE# 11-s--QA5 Harnett County Department of Public Health Improvement Permit 26854 A building permit cannot be issued with only an ImprovempOermit PROPERTY LOCATION: M 1 rna62- ISSUED T0: 1Ne. SUBDIVISION 1 sc~GE_ev LFl~ LOT # 3 NEW ' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: '5 S~ 4 Proposed Wastewater System Type: 4s(D/o U-'Dvc,) aN y5S';-z1f` Projected Daily Flow: 2~ GPD Number of bedrooms: 3 Number of Occupants: L, max Basement ❑Yes No Pump Required: ❑Yes No,j1ay be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well ! C DO feet Permit valid for: Five years Permit conditions: _ ❑ No expiration Authorized State Agent:: ZfJ1S Date: 1~T 111 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the ce of other permits. The permit holder is responsible 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 It ement 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, .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 T0: ~~m L1.SaNfl Ocn ~ N G PROPERTY LOCATION: M -1C-C D 0-V4 6 SUBDIVISION 'Tir j GG-N) Pz taCC LOT # `5 l Facility Type: ~~flSS'~J New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System** 2) RCCOvL,\Or1 S 5,7 C-- (Initial) Wastewater Flow: GPD (See note below, if applicable) aS~'/~ ON (Repair) Installation Requirements/Conditions ( Number of trenches k cl Septic Tank Size 1~Q gallons Exact length of each trench 1 'd Q) feet Trench Spacing: 1 Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: }a inches Maximum Trench Depth of: al--3® inches (Maximum soil cover shall not exceed (Trench bottoms shall be level to +/-1/4" 36" above the trench bottom) in all directions) Pump Requirements: ft. TDH vs. GPM inches below pipe Aggregate Depth: inches above pipe Conditions: inches total WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. **If applicable: /under understand the system type specified /s different from the type specifed on the application. / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation site p 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 suboo ttdCkprnpliance i the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: ^~G ~S Date: onstr 'on Authorization Expiration Date: HTE# Permit Authorized State Agent: t`1Si ~Gtel vE/L--TOu YS!p OT Date: t~1~111 0 0 c 6'% U 9 N 1~11-1, Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOILISITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility: 35 C-4>pzo r~~ Design Flow (.1949): 36 a ~e Location of Site: Property Recorded: Water Supply: J'~Sew% blic ❑ Individual ❑ Well Evaluation Method: uger Boring F1 Pit ❑ Type of Wastewater: age❑ Industrial Process ❑ Sheet: Property ID: Lot File Code: Property Size: ❑ Spring ❑ Other Cut Mixed P R O F I 1940 OIL MORPHOLOGY .1941 THER PROFILE FACTORS L E # Landscape Position/ Slope % Horizon Depth (In.) .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Colo .1943 Soil IN. .1956 Sapro Class .1944 Re& Horiz Profile Class & LTAR o s~ t v Upa~` c ~ L- ~a '~tt5 ~3~ GL g 5 S Description Initial s stem Repair System Other Factors (.1946): ? . < Site Classification ( 1948): ° Available Space .1943 . Evaluated B " System Ty~s) Y-, Oth P t Site LTAR ers resen :