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IPACHTE# II - ~o Harnett County Department of Public Health Improvement Permit 2 6 5 6 2 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: fl®t- ISSUED TO: W N N rt ~.~.o s3 S-vQ'Q S) 0 N SUBDIVISION lrt o15 cr .tio~E LOT # 10 ell NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5F0 Proposed Wastewater System Type: 1u 9-EoUC:~Z v10 N Projected Daily Flow: L-"" GPD Number of bedrooms: I-A Number of Occupants: max Basement ❑Yes ~j No Pump Required: ❑Yes ❑ No Type of Water Supply: ❑ Community Permit conditions: I May be required based on final location and elevations of facilities X Public ❑ Well Distance from well 1 feet Permit valid for: '`ti Five years ❑ No expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the is e 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.. N5 Date: tFT)I SEE ATTACHED SITE SKETCH of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This 9ektent 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, .1957, .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: 0 Gi%Av- c~NJ PROPERTY LOCATION: _DoC~E'- SUBDIVISION~ny-,T--ctS 910QF- LOT # 10 Facility Type: S~~x6a~ New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System** aS%EOVC,~~ N (Initial) Wastewater Flow: Q9 Q) GPD (See note below, if applicable 2 d1~ ~~DuGi~ON Sy3 BEM (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size 1-CD(b G gallons Exact length of each trench feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of., inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: c1 Feet on Center Soil Cover: inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total 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. **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 revo '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 ct o compliance wi e p aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: RC--`~S Date: I ~l Construc ' Authorization Expiration Date: ~1 1 HTE# \1,-5-~ (o Permit # Z•-'S(; +7 . Harnett County Department of iblic Health Site Sketch PROPERTY LOCATON: aoC.'s V-D ISSUED T0: ~1 rt N G ~ ~ b SUBDIVISION -7-m ~SZ5 1©'- E LOT # 1d~1 Authorized State Agent: Pt E e ~,Q 150 Depatztment of Environment, Health and Natutal Resources Sheet: Division of Environmental Health On-Site Wastewater Section Property 1D: e Lot SOMSITE EVALUATION File M: Code: for ON-SITE WASTEWATERSYSTEM Owner. Applicant: Address; Date Evaluated: Proposed Facility: a o~Egx2,o o r-, DqdP Flow (.1949): L N 0 6~r property Size: LacadoQ a~ 9ita: Propeity recorded: Watet SuppCy, Pub$C ❑ Wmdual ❑ Well ❑ Spring ❑ Other Evaluaden Method: Auger Boring pit Type of wastewater: S ❑ I d cut. ewage n ustrial Process mixed. P R O F OIL. MORPHOLOGY OTHER I .1940 .1941 L Lu damps IF ; PROFIl.6 FgL*iORR .1941 E Positled 41 .1941 Soil M Slops % ttwf Consistence WefneW `a$4s 1956 1941 Plolll® un Mlnarata Color L s Soil S'P iO Restr IN. Class Hartz. CtaN & LTM L_ eca ar 3y" m Other Factor, (.19461 Site CluMcadoa (,19481 ' lF Zc Evahzted By: c a Others Present: ~ ~