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IPACHTE#oa -5=--145 )1 ) Harnett County Department of Public Health 2 5 6 6 4 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: IINg6.N ~A ISSUED TO: c'`NES SUBDIVISION PMnv~,4 ~2 PLOT # ~`I NEWX REPAIR _ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: _5 V L) CFG '31 Proposed Wastewater System Type: '?Q-4?-No \v sYCavAR V Projected Daily Flow: GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes >E No Pump Required:,]RYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the cc site is subject to revocation if the site plan, plat, or the intended use changes. The Impr the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. Date: '-A \ N-1 ~ © e SEE ATTACHED SITE SKETCH of other permits. The permit holder 17S sponsible for checking with appropriate governing bodies in meeting their requirements. This vement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1952, 1 954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references i nto this permit and shall be met Systems shall be installed in accordance with the attached system layout ISSUED TO: \Kjr VF- PROPERTY LOCATION: 76'`sy(--*s S~ ~b5 ~ SUBDIVISION 90x~o LOT # `T) Facility Type: X New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fix tures? ❑ Yes No Type of Wastewater System** P U ccQ o `~.-s /o AE-DUC7,~ ~J jiJ Sy SsEM (Initial) Wastewater flow: 3(.0 GPD (See note below, if applicable Qu Me \ o 3-B 7. Q.E:Duc,S Repair) Installation Requirements/Conditions Number of trenches 5 - Septic Tank Size tC?J© gallons Exact length of each trench feet Trench Spacing: Feet on Center Pump Tank Size O gallons Trenches shall be installed on contour at a Soil Cover: S inches Maximum Trench Depth of. ~q 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: W~~6a,~~~ hvx 10~oyyoF Ni.i._ Qpcms OG 5~-s•c~S r5~ ~7_~10 ~t}~csL,ss. inches total P. 1 c cLC~A c 0 J 1 M s SSat, M- ZeMw- ~'j,G4.5 , ~ F tRP. pct C? C`~ ►•y ~ 5. ,r ~ c G~ ~ *'If applicable /understand the system type specified is different from the type specifed on the application. l accept the specifications of this permit. Owner/Legal Representative Signature: Date: conditons of his transferred when there is a change SEE ownership ATTACHED heSIsiw This Construction Authorization ~ is ~ t compIf t' pns of the o Laws e and inrefluea for Sewage sTreatment t and Disposal o and tto the shall TE SKETCH Authorized State Agent: y 4-S Date: q t1 nstruction Authorization Expiration Date: G HTE# Permit # `~"t-} Harnett Connty Department of ll itblic Health Site Sketch PROPERTY LOCATON: 6 E~ ISSUED TO: 0 S SUBDIVISION p~55oaS o~~i LOT # CA Authorized State Agent: Loy-~~---t0L-y'.s 0 0Ct~ Date: ~j 1 ~`1 1©9 5'-1 77 05 N) A A6z Lc~S E__ I t o" SETeAciL ► fQur,e S° l ~,5~1O C~ X3 362 i ST2~\~c. ~6~ E OIL d.3'7 ~ Jepartmidin ul CllV ll VIlllltllil, rilddlU1, d11U 14dW1dl nt'DUUI I.tlb JI 11d"I. )ivision of Environmental Health Property ID: Lot Dn-site Wastewater Section File SOMSITE EVALUATION Code: for OBI-SITE WASTEWATER SYSTEM Applicant: Owner: Address: Proposed Facility: 3 y, lw~ F Design Flaw (.1949): LOc~ Location of Site: Water Supply: (~J Public [ 1 Individual I) Well Evaluation Method: uger Boring Pit Type of Wastewater. JS_ ewage [ j Industrial Process R SOIL MORPHOLOGY O .1941 F 1 L .1940 Lam Mormon .1941 1941 E Position( Depth Structure( Conslabum 0 S"% IN. Texture L5 S y 6 L-5 > / } p o~-,~M <R lZ SLl S5 ~ ~ I I - via. 1651 Description Initial System Repair System Available Space (.1945) ,System Type(s) Date Evaluated: Property Size: Property Recorded: [ j Spring [ j Other ( j Cut [ j Mixed OTHER PROFILE FAC .1942 Sod .1943 Web"Wr Solt' Other Factors (.1946): Site Classification (.1948): Evaluated By: Others Present: AN N .194 ' PmfNs , Sapra Re* Clime Class Voris & LTAR . i1 P~