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IPACHTE# I 3o(;~7 Harnett County Department of Public Health Improvement Permit 27291 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 0-1 p GaS C.t -, L) (Z,(; 1 'CZ, ISSUED TO: d V ®0(L : 1 SUBDIVISION C—)eQF5s f'b, j 7-C LOT # NEW'WJ REPAIR ❑ r J ENSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: � (3-�' x ® Proposed Wastewater System Type: a-S'7(!, E.tv-, Projected Daily Flow: Qn© GPD Number of bedrooms: 5 Number of Occupants: l ® max Basement []Yes '><No Pump Required: ❑Yes 1No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1-b C) feet Permit valid for: Five years Permit conditions: -- .4- ❑ No expiration Authorized State Agent:: � \V` N - 'iiiL—)- \55 Date: 3 I r. ) ,3 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees th", i ce o(Ti other permits. The permit hold r is fesponsible 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 Im Went 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.. struction 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: �L )gym �'\ G sD PROPERTY LOCATION:�Ps -� SUBDIVISION 1V"-5,5 {�o, � r- LOT # Facility Type: �� x� n� 14 New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System ** Q..Slo 9<- 11)y X5 °6-11\ Lq (Initial) Wastewater Flow: CEO GPD (See note below, if applicable ❑) 25�'l,`UG �os� �1ac taASe��,1�(Repair) Installation Requirements /Conditions Number of trenches Septic Tank Size gallons Exact length of each trench 8-15 feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 1cs inches Maximum Trench Depth of: is 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: M IN) my n?, C3� o V C.ov e'z, N C�c -Dtp �y D- -- G0 p' NN !LD inches total do �') cY-,- oyt4 C, '�'v! So,1- 'D yCL'A, Q CL co<`'nu, n WATER LINES (IN(LUDING 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: I understand the system type specified is different from the type specifled on the app /icatiom / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This Construction Authorization is subjti '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 subjko complian ith the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 31 Constr 'on Authorization Expiration Date: QA ) H T E # Permit # —a:l —c, M OL-OF 5 / 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:���3 Proposed Facility:. C,,6 Design Flow (.1949): f ` Location of Site: Property Recorded: Water Supply: ❑ Public❑ Individual ❑ Well Evaluation Method:[] Auger Boring ❑ Pit ❑ Cut Type of Wastewater: ❑ Sewage ❑ Industrial Process Sheet: Property ID: Lot #: File #: Code: Property Size: ❑ Spring ❑ Other ❑ Mixed 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 3, --� y C� cox �-r� 35) y1 30 \ yC ` / \\ Description Initial S ste epair System Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: �- Available Space(. 1945) System Type(s) Type(s)2L 2��/i Site LTAR �—