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IPACHTE# Z737 ,Z~ Harnett County Department of Public Health Improvement Permit 2 6 5 2 8 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATIO ZQ) ISSUED T0: SUBDIVISION LOT # NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: l~ - " Proposed Wastewater System Type: ZZ, ts' Projected Daily Flow: 3 GPD Number of bedrooms: Number of Occupants: max Basement ❑Yes No Pump Required: ❑Yes ❑ No ld' a ee required based on final location and elevations of facilities Type of Water Supply: El Community IJ Public El Well Distance from well feet Permit valid for: Z Five years Permit conditions: ❑ No expiration Authorized State A f Date: SEE ATTACHED SITE SKETCH The issuance of this permit by a ealth 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 i e 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. ISSUED TO: • e' ,d~ C} PROPERTY LOCATION: /02 C / SUBDIVISION LOT # Facility Type: 1111,41LI111 5A) /New ~E Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ L1Yes No Type of Wastewater System' Z~ (Initial) Wastewater Flow: Z _ GPD (See note below, if applicable ~ A a (Repair) Installation Requirements/Conditions Number o trenches Z- Septic Tank Size Woo t7 gallons Exact length of each trench /,-0 feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches Maximum Trench Depth of: Z4''' 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: /L inches total WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. 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 it different from the type specified an the app/ication. /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 5 [Authorized State A Date: Construction ~xpiration Date: - - fd HTE# Z73Z,-Z- Permit # 2&5 0 T Harnett County Department of Public Health Site Sketch ;,f 1 J /-ZC Z et' Department of Environment, Health and Natural Resources Division of Environmental Health On-Site Wastewater Section SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM ~ jj I ~ - Sheet: Property ID: Lot File Code: Owner: Applicant: ))Lt' Address: Date Evaluated: f'J' JY9d I / Proposed Facility: Design Flow (.1949): 3p&,t Property Size: 5 Location of Site: ropjP7 Property Recorded: Water Supply: Pu ~blic❑ Individual El Well El Spring El Other Evaluation Method: Auger Bop' g ❑ Pit ❑ Cut Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed P R O F I L E # 1940 Landscape Position/ Slope % orizon Depth (In.) OIL MORPHOLOGY .1941 .1941 .1941 Structure/ Consistence Texture Mineralogy THER PROFILE FACTORS .1942 Soil .1943 .1956 .1944 Profile Wetness/ Soil Sapro Restr Class Color Depth (IN.) Class Horiz & LTAR 5L ~su~s 3v' .51 La .K ~t1 St11 °3 5L ~sN f Y Initial S ste 11 Repair System Other Factors (.1946): Site Classification ( 1948): EAvailable (.1945) . Evaluated B : 26 y Others Pres t en :