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IPACHTE# Harnett County Department of Public Health 28312 Improvement Permit A building permit cannot be issued with only an Improvement Permi PROPERTY LOCATION: M frz ISSUED TO: 50 N) c -A S C.1---, y rump,SUBDIVISION _N )n NJ t ti tp �, L LOT # y NEVI REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: "I Proposed Wastewater System Type: QJS3' / o — \J0 -'t Q a yss�,� Projected Daily Flow: GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes >< No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well L0 feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: Date:y► 1 115 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuanc father permits. The permit holder is responsible 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.. 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 T0: �olfinr `jcH v mcg, t.t sJ PROPERTY LOCATION: -I-) Q_ -Z C"1.1 C) SUBDIVISION `i2`�A�� �L to sG LOT # Facility Type: SSG �)S "6]0 -�K New ❑ Expansion ❑ Repair Basement? ❑ Yes IM No Basement Fixtures? ❑ Yes �WNo Type of Wastewater System** va\G"J (:; -�5>�—M (Initial) Wastewater Flow: X60 GPD (See note below, if applicable ❑) d C' Q-r--z\Jc:5+\ (Repair) Installation Requirements/Conditions Number of trenches 3 Septic Tank Size is ) gallons Exact length of each trench 5 e Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench DeP th of.• N 3b Pump Requirements: ft. TDH vs. Conditions: (Trench bottoms shall be level to +/-1/4" in all directions) GPM feet Trench Spacing: Feet on Center Soil Cover: C inches inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. 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: l understand the ystem type tpeciled it different from the type specified on the application, l accept the speci6cationr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to�h�pro at, 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 subj�ct�compLaws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: L) 1 /15 Construe Authorization Expiration Date: 't 1 aG HTE# Permit # `�� i ---)- Harnett Connty Department of 1--'ablic Health Site Sketch PROPERTY LOCATON� ISSUED T0: ��Y' K N SUBDIVISION 1122 Pj}A o LLP,GC^ LOT # Authorized State Agent: Pki��S CGz�v `� �i bGS� Date: L ��_ 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, d?Q i-.\ Design Flow (.1949): 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 ❑ Mixed ❑ Other P R O F I L E # .1940 Landscape Position/ Slope % SOIL MORPHOLOGY .1941 Horizon Depth .1941 .1941 (In.) Structure/ Consistence Texture Mineralogy} OTHER PROFILE FACTORS — Profile Class & LTAR .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) — .1956 Sapro Class .1944 Restr Horiz FY -6 l Description Initial Repair System Other Factors (.1946): Systers, i Site Classification (.1948): Available Space (.1945) V Evaluated By: System Type(s) 5 % Others Present: Site LTAR