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IPACHTE# //-s)~, ~O IaL Harnett County Department of Public Health Improvement Permit 2 6 3 2 9 A building permit cannot be issued with only an Improvement Permit - r ~J PROPERTY LOCATION: It~ ISSUED T . .J G ~ytyla ~{+t~~ /7o^y SUBDIVISION LOT # NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: J-FO (s3 X, Q! Proposed Wastewater System Type: CQA,0W =cat Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes 2 No Pump Required: ❑Yes ❑ No ® May be required bmd on final location and elevations of facilities Type of Water Supply: El Community El Public 5 Well Distance from well feet Permit valid for I ve years Permit conditions: ❑ No expiration Authorized State Agent:: /2-t~~ &W Date: -7 /fa 42-011 SEE ATTACHED SITE SKETCH -a A The issuance of this permit by th Health h Department in o way guarantees the issuance of other 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. f ISSUED T0: ,C 6+LN5r`e1 e-~i e° /fe~,~l © /arc- PROPERTY LOCATION: SUBDIVISION LOT # Facility Type: VNew ❑ Expansion ❑ Repair Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Xes ❑ No Type of Wastewater System** C":1r8 (Initial) Wastewater Flow: 2 cc GPD (See note below, if applicable 4 C.ean.~~~~. e.t (Repair) Installation Requirements/Conditions Number of trenches .J Septic Tank Size 000 gallons Exact length of each trench 60 feet Trench Spacing: 9 Feet on Center rna•'x Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of: /--9- 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 faaditions: Cam ~~(4-N-49 C j~ inches total WATER LINES (IN(LUDING IRRIGATION) MUST BE 10FT. 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 different from the type specified on the application. / accept the specifications of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject 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 compliance with 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: v' Date: 0 8111 Construction Authorization Expiration Date::. ,,Aof HTE# fl' 5 =r~2 b 19 5 Permit # R'- 3 k 9 Harnett County Department of I-N-tblic Health Site Sketch PROPERTY LOCATON: A ~ k.- W~ ISSUED TO: ~ ° /7G pf G?t C SUBDIVISION LOT # Authorized State Agent: Date: ((a x" t i ~s d p oo wctt ~ i I-D All' Department of Envhonment, Health and Natural Resources Sheet: Division of Environmental Health Property 1D: On-Site Wastewater Section Lot SOuJSITE EVALUATION File : for ON-SITE WASTEWATER STSTEM~ Cody: Owner: Applicant: Address: Date Evaluated:_~~~ 2~~1 Proposed Fxilit)r Desigp Flow (.1949): Property Size: Location of Sits: Property Itecorded: Watet Sup* ❑ Public ❑ Individual 'Well ❑ Spring ❑ Other Evaluation Method: Auger Boring ❑ Pit Cut Type of Wastewater Qf Sewage ❑ Industrial Process Mxed R O F SOIL MORPHOLOGY iZ r .1940 L L a H 1941 PROFILE PAC 1OR9 me pe n 9 Poritlaal 4 Slope % orizon DqA 00 .1941 stucnud .1941 Corwdeaoe .1942 sail wetn"d 149 .1956 Soil .1944 Frot11® a-7 Texdere G ' Mtarnlo Color S®pro QY, Cteae Re* Cleu Hans. ALTA V ~ 4 C C3 C,;V i, I i~y IT 10 KePaw 3yo m Other Factors (.1946) Site M"iBcatlon (,1948x Evahated B): /j.,,.. Others Preme C r