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IPACHTE# Harnett County Department of Public Health Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: Uac:6 ISSUED TO: H Ca ,4 5,,s-cw c o2,s SUBDIVISION -35- LOT # NEWX REPAIR ❑ EX7N ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: �5 70 ( , 6S Proposed Wastewater System Type: Vo �av c-> > off\ Projected Daily Flow: Q) ® GPD Number of bedrooms: 5 Number of Occupants: 1 max Basement ❑Yes >K� No Pump Required: ❑Yes El No May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well V 0 0 feet Permit valid for Five years Permit conditions: -- ❑ No expiration 4i Authorized State Agent: � �-C= r�5 Date: 13 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holder is rest nsible 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.. in all directions) Pump Requirements: ft. TDH vs. GPM Aggregate Depth: Conditions: 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. inches below pipe inches above pipe inches total * *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is su fie cation if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This Construction Authorization is su$f� ccompliance�tl "ons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: aI Z's 113 Authorization Expiration Date: D=10_1 0? 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: H ��� Ca -2 N a U US 0<Z5 PROPERTY LOCATION: SUBDIVISION Q) el ,v. o s 7 LOT # 'A 1 Facility Type: s�fl �65 xU�� New ❑ Expansion ❑ Repair Basement? ❑ Yes _-I�K No Basement Fixtures? ❑ Yes No Type of Wastewater System ** a!�;_© C Q.Cw071_1 ®y., SyS (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) Q-­O U I ctyt (Repair) Installation Requirements /Conditions Number of trenches Septic Tank Size 3 2-S' 0 gallons Exact length of each trench 4ft 340 feet Trench Spacing: 1 Feet on Center Pump Tank Size y 0 o 0 allons Trenches shall be installed on contour at a Soil Cover: Q- la, inches (sue v� DoE a Maximum Trench Depth of. 1 a4 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 Aggregate Depth: Conditions: 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. inches below pipe inches above pipe inches total * *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is su fie cation if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This Construction Authorization is su$f� ccompliance�tl "ons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: aI Z's 113 Authorization Expiration Date: D=10_1 0? HTE# � 3— 5— � Q u a, Permit # Q, —) D:l H(arnett County Department of tblic Health Site Sketch PROPERTY LOCATON: QOG5 9-P ISSUED TO- CZ Z5 CZ/\] C.� 0CGS SUBDIVISION -17 LOT # Authorized State Agent: ON CA— Date: 13 ' L3)" 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: S Zen V k@i Design Flow (.1949): 4� @ U Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation Method2l,_ Auger B ring ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Mixed ❑ Other P R O F I 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 i l S V$( i 's 1 G �jr✓L , � r 1 5,0y -may 2eo .° sg)2-sci2 �51�rP�5 Description Initial System Repair System Other Factors (.1946): Site Classification (.1948) :i' Evaluated By: Others Present: •� ' Available Space (.1945) System Type(s) ';-cle. Site LTAR a_; � i l