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IPACHTE# %S-5- �D Q Harnett County Department of Public Health 28316 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION:-tC qQ �c�C' _ ISSUED TO. X 25 1'� SUBDIVISION Q-0 Na6 k)�»rC- i—, LOT # 15-6 NEW REPAIR EXP, SION Site Improvements required prior to Construction Authorization Issuance: Type of Structure:` El _ Proposed Wastewater System Type: Projected Daily Flow: �—' 1�—) 0 GPD Number of bedrooms: (�;7 Number of Occupants: 10 max Basement ❑Yes No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community :l< Public ❑ Well Distance from well � d 0 feet Permit valid for: Five years Permit conditions: „� ❑ No expiration Authorized State Agent:: Date: 1 )$#1 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issula other permits. The permit holder is respot Bible 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 Improvem t. 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 TO: 1 PROPERTY LOCATION: C:,O(�-z Lo 0 C r SUBDIVISION SO(W N -VS LOT # Facility Type: �� ` �� � New ❑ Expansion ❑ Repair Basement? I]Yes No Basement lxture ? ❑ Yes ` No Type of Wastewater System** � o D -J Q� NC --r\ (Initial) Wastewater Flow: 0 GPD (See note below, if applicable ❑) ti f0 Installation Requirements/Conditions Septic Tank Size gallons Pump Tank Size gallons Pump Requirements: ft. TDH vs. Conditions: VK— G�)�JCN 10 ,,J (Repair) Number of trenches Exact length of each trench 1 �i feet Trenches shall be installed on contour at a Maximum Trench Depth of. A "3(o inches (Trench bottoms shall be level to +/-1/4" in all directions) _ GPM Trench Spacing: I Feet on Center Soil Cover: (;~QLz) inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (INCLUDING IRRIGATION) MUST BE 1OFT. 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: !under fond the system type specired is different from the type speciTed on the application. / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocatio ' e s e 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 sghLeeq to complia the provis� f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: 9 Date: n Authorization Expiration Date: HTE # Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON:C0qqC—j-Z, Lo oe ISSUED TO: L-v� SUBDIVISION Qo,)Mc; �umrrN LOT Authorized State Agent:ate: (L 1-16 U s c 'It ID 3�; 01 M 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(2 9) Design Flow (.1949):!;®� �\ Location of Site: Property Recorded: Water Supply: Public❑ Individual ❑ Well Evaluation MethodAuger 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 # SOIL MORPHOLOGY .1940 .1941 Landscape Horizon Position/ Depth .1941 .1941 Slope % (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 ra- �4, Description Initial Repair System Other Factors (.1946): S ste Site Classification (.1948):5 Available Space(. 1945) Evaluated By: System Type(s) Others Present: Site LTAR :�?