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IPACHTE#"S 353a"b� Harnett County Department of Public Health 28194 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: C c3 PCS E.2 I— 00 f ISSUED T0: SUBDIVISIONSVc4>MT� LOT # NEW REPAIR ❑ fPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Proposed Wastewater System Type: 0r, —Jyg —Em Projected Daily Flow: ®© GPD Number of bedrooms: 5 Number of Occupants: max Basement ❑Yes ;K No Pump Required: ❑Yes �K No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community X Public ❑ Well Distance from well � Q0 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 guaran r issuance site is subject to revocation if the site plan, plat, or the intended use changes. Tt pr the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. Date: �� I " 1 15 SEE ATTACHED SITE SKETCH of other permits. The permit holder is responsible 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, .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: flGa"', PROPERTY LOCATION: C -099C>2 _� c�(\3 SUBDIVISION �� � 1-�Ns,,:�C �., ���G S �t�� � i LOT # CS Facility Type: Sfir� ��� .� New ❑ Expansion ❑ Repair Basement? ❑ Yes -�Ek No Basement Fixtures? ❑ Yes ;5� No Type of Wastewater System** a Seo Eswc ; 0 N / Em (Initial) Wastewater Flow: (�C)C) GPD (See note below, if applicable ❑) 2.5°10 kZ-G� Installation Requirements/Conditions Number of trenches 1 Septic Tank Size gallons Exact length of each trench '105 feet Trench Spacing: c) Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (� -_&-A inches Maximum Trench Depth of:iV( 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: /understand the system type specified is dif/erent from the type specified on the app/ication. / accept the .specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorizatio*4s ubject 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 subject to co," ' celg the provisions 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: 3 Construction Authorization Expiration Date: 5 HTE# 1 S - S- Permit # a1Q0)1)H Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: ISSUED TO: Q>,J\L(DCi� L—C)0,� SUBDIVISION lvks;� 1� 1,,,D ; 1N�c� S,) -,—\ LOT # Authorized State Agent:- Date: '5 1 6v� - "s C-- paw 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: 5Q7 Design Flow (.1949): Location of Site: Property Recorded: Water Supply: ublic❑ Individual ❑ Well Evaluation Method�Auger Bor' g ❑ Pit ❑ Cut Type of Wastewater: 17y4ewage ❑ 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 �s Description Initial Repair System Other Factors (.1946): S stem Site Classification (.1948) Available S ace (.1945) Evaluated By: System Type(s) 2lc Others Present: ~ Site LTAR .Z�