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IPACHTE# do X-21 A' Harnett County Department of Public Health Improvement Permit 2 6 6 3 2 A building permit cannot be issued with only an mpro ent Permit PROPERTY LOCATION: ~ ISSUED TO- gzt- G ti/d r w SUBDIVISION LOT # _ NEW ~ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: Q Vt-. Proposed Wastewater System Type: C c~ 1 V'4'~- - c it --Q Projected Daily Flow:.-? (t:, ® GPD Number of bedrooms: J Number of Occupants: max Basement ❑Yes R'*-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 /00 feet Permit conditions: Permit valid for: P ive years ❑ No expiration Authorized State Agent:: Date: IAA E` f ~ et SEE ATTACHED SITE SKETCH The issuance of this permit by ealth Department in no way guarantees th 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, .1957, .1958, and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordauce with the attached system layout. ii ISSUED TO: Co CL - Facility Type: L~ ` / New Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Y Type of Wastewater System** ' e.A ~ " - PROPERTY LOCATION: ~c s ~.J 4 ,1d. SUBDIVISION LOT # ❑ Expansion ❑ Repair ❑ No (See note below, if applicable 2 r (Repair) Installation Requirements/Conditions Number of trenches -,~7 Septic Tank Size 1010+ gallons Exact length of each trench feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. / (S inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: _ (Initial) Wastewater Flow: -7(- Q GPD Trench Spacing: feet on Center Soil Cover: ( inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: C inches below pipe ~Z 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 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 per'it. )tt AI IALHU) 311t MILH Authorized State Agent: Date: _ 1.2S- X-7 Construction Authorization Expiration Date: 2- /Z-vG HTE# Permit # 2 3-. arnett County Department of Public Health Site Sketch PROPERTY LOCATON: ISSUED TO: j"~ cist ~c r c:, SUBDIVISION LOT # Z Authorized State Agent• Date: _7 Zc<f ~o -71 A-,l- i-- 4-~, J-c,tP- /11'h0-5Cja 1-4. 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: A ~t"y Proposed Facility: Design Flow (.1949): Location of Site: Property Recorded: Water Supply: L!J Public❑ Individual ❑ Well Evaluation Method: Q Auger Bo g ❑ 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 (In.) .1941 Structure/ Texture .1941 Consistence Mineralogy .1942 Soil Wetness/ Color .1943 Soil Depth IN.) .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR Z A 'r Q~-g &1~r 11' /Vflvf 3~ ~r/sue rr~~ 16#711 _76 Description Initial System,.,' Repair System Other Factors (.1946): Site Classification (.1948)~f Available Space (.1945) Evaluated B System T e(s) Others Present: C c Site LTAR