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IPACHTE# ~~-5•~~tbCO Harnett County Department of Public Health Improvement Permit 2 6 71 5 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: 1~ Ne6 sv I.D ISSUED TO:. vL C1.Pry C, OcnnES SUBDIVISION ~o N5 Q®~ 4' LOT # l NEWX REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S TSD ( Proposed Wastewater System Type: Pv M970 : Solo'REZ vG'C\ ON Projected Daily Flow: 3 o GPD Number of bedrooms: 3 Number of Occupants: irc, max Basement ❑Yes X No Pump RequiredlYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ~ Public ❑ Well Distance from well 1 C'1~ feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: HS Date: SAN30e 1 ~ SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way g arantee uance of other permits. The permit holder Is is respotsible 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. Ti ovement 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 T0: PROPERTY LOCATION: tv Q E" QZ 1 SUBDIVISION PM0 N5 P o 1>\t'i LOT # a 1 Facility Type: JFQ (1a~~'~s3~ ~ New ❑ Expansion ❑ Repair Basement? ❑ Yes X No Basement Fixtures? ❑ Yes "'VNo Type of Wastewater System** Pv MP 'Vo ~S®~ aEpyCsS~ otyySSri~► (Initial) Wastewater Flow: 3c® GPD (See note below, if applicable 9vnio77' o Qa. /o EDuys\O^J (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size 1 o gallons Exact length of each trench ) SO feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: _1 a- S~3 inches Maximum Trench Depth of: a•u°3b 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: 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 Lion if the sit 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 sub) t complia with visio f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: °1'30 ~ M ction Authorization Expiration Date: HTE# tl - S Harnett County ISSUED TO: Authorized State Agent: Permit # "~G -i 1S' epartme t of Aiblic Health Site Sketch PROPERTY LOCATON: ►w GVcw ~-o - SUBDIVISION Pc~~© m5 'Q oN n LOT # Date: cc~3®111 9G, 7 S) M G N 7) ~=-s ,1 Cp, L-, a 6 2- 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: Proposed Facility: 3 e 65OQ,Cn, n 7 Design Flow (.1949):360 Location of Site: Property Recorded: Water Supply: Public❑ Individual El Well Evaluation Method Au er 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 % S- UDC C Horizon Depth (In.) ° .1941 Structure/ Texture G l .1941 Consistence Mineralogy \V -'T L .1942 Soil Wetness/ Color .1943 Soil Depth (IN.) .1956 Sapro Class .1944 Restr Horiz Profile Class & LTAR G iption Initial S st Repair System Other Factors (.1946): Site Classification (.1948): j ble S ace (.1945) -j Evaluated By: T e(s) P ! C, Others Present: AR << C