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IPAC RHTE# l Harnett County Department of Public Hewth Improvement Permit 26728 A building permit cannot be issued with only an Improvement Permit S~ ISSUED T0: ~ ~oCt-~ U tom( i i C- PROPERTY LOCATION: C-,) PQ-~ss tJCLC,~ `~.D SUBDIVISION C. Q-&'5 _5 Pol . LOT # NEWLY REPAIR ❑ E' NSION 171 Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 6 (1-kO' \f Proposed Wastewater System Type: °Io 0(J 0,S\0 J5-~~: m Projected Daily Flow: ® GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes LX No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well \ d® feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date: VN ll SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance of other pe the permit holder is resp risible 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 shal 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 TO: YN-Q~' N \Y-A G PROPERTY LOCATION: C tonCS5 a ~,.Q SUBDIVISION C!, 1Q( Gs5 LOT # `A Facility Type: 'DR' New ❑ Expansion ❑ Repair Basement? ❑ Yes -1~k No Basement Fixtures? ❑ Yes X No Type of Wastewater System** c~~~t a V-Zov cs N 5 Est (Initial) Wastewater Flow: GPD (See note below, if applicable L -~,r c.: ,c, tv 'z:-,`J'5 CSr (Repair) Q- S" @ Installation Requirements/(onditions Number of trenches Septic Tank Size N CX!) 0 gallons Exact length of each trench feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: i' inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: c) Feet on Center Soil Cover: Co inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe 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: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocation if the site plan, 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 sub' a with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. Stt AIIACHED SIZE SKETCH Authorized State Agent: Date: Y -N Con ction Authorization Expiration Date: HTE# tt 2D-1 IA"9,, Permit # 2~4~1-A Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: C QE s C-,6 G ISSUED TO: loo( S Q14 T SUBDIVISION C-~)P~-ESS o LOT # ~i 7 ~94W (o LINEIL "fOLK5$?O(tF Date: Authorized State Agent: d D G y P C s s P G T \A Cj\r. tL66,J Pn~ra Department of Environment, Health at itural Resources Division of Environmental Health On-Site Wastewater Section SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Applicant: Address: Date Evaluated: Proposed Facility:lj ,p Mct,c, Design Flow (.1949): Q Location of Site: Property Recorded: Water Supply: Public[] Individual ❑ Well Evaluation Method Auger Bori ng E] Pit ❑ Cut Type of Wastewater: ]:Sewage ❑ Industrial Process She Property ID: Lot File Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F I 1940 SOIL MORPHOLOGY .1941 OTHER PROFILE FACTORS L # Landscape %n/ Slope L-5 Horizon Depth (In.) t, .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth IN. .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR 5_ ) ol+ © F, `j Vitt 1VS~h Description Initial R pair System Other Factors (.1946): S ste ' Site Classification ( 1948): } Available Space .1945) Evaluated By: System T e(s) 8-*s * is Others Present: Site LTAR y, V%