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IPACHTE#--'Harnett County Department of Public Health Improvement Permit 26521 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: '~~¢!a%y~/r*>, .>t ISSUED T0: gym: SUBDIVISION LOT # NEW REPAIR ❑ EXPAN N ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Proposed Wastewater System Type: Projected Daily Flow: z. f GPD Number of bedrooms: c Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes ❑ No zxpueblic required based on final location and elevations of facilities Type of Water Supply: ❑ Community ❑ Well Distance from well feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State A Date: SEE ATTACHED SITE SKETCH Z -Z The issuance of this permit b Health Department in no 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 i nto this permit and shall be met. Systems shall be installed in accordance with the attached system layout. ISSUED T0:- PROPERTY LOCATION:,Sr- P 'f p/Ji~✓rcl'1',- y SUBDIVISION / LOT # Facility Type: t✓ ` New ❑ Expansion ❑ Repair 2 Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System** (Initial) Wastewater Flow: 41 f) 0 GPD (See note below, if applicable (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size gallons Exact length of each trench 110 feet Trench Spacing: - , - Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a~ Maximum Trench Depth of: tr;"'~"r~inches Soil Cover: 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: /Z- 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 spedfled on the application. / accept the specipcations of this permit. Owner/Legal Representative Signature: Date: This Lonstruction Authorization is subject to revocation it the site plan, plat, or the intended use changes. the Lonstruction Authorization shalt not be translerretf when there is a change in ownership of the site. Ihis 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 gent:, . -s ue = Date: Construction Authorization Expiration Date: - - t.} HTE#f'~i - Permit # Harnett County Department of Riblic Health Site Sketch PROPERTY LOCATON: 3 ISSUED TO: SUBDIVISION LOT # Authorized State A(nt: Date: r l I Q, 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: '7- J', l-111 Proposed Facility: Design Flow (.1949): Y j Location of Site: Property Recorded: Water Supply: [l Public❑ Individual ❑ Well Evaluation Method:E 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 1940 OIL MORPHOLOGY .1941 THER PROFILE FACTORS L E # Landscape Position/ Slope % Horizon Depth (hi.) .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR d q- a c, ors Cs -c,4f ,a _;7- r 0-7 Description Initial S ste Repair System Other Factors (.1946): Site Classification (.1948):0 r Available Space (.1945) Evaluated By: System T e(s) z L: Others Present: Site LTAR