IPACHTE# 11-5''XllQ- Harnett County Department of Public Health
Improvement Permit 26853
A building permit cannot be issued with only an Improveme ermit
PROPERTY LOCATION: `y`WC st0 ),3-v a_
ISSUED TO: C U maC(LL-FN IS:2 "o Mac 5 ~NG SUBDIVISION T N s E>J t .Ar-~, LOT #
NEW REPAIR ❑ EXPANON El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'SFQ Proposed Wastewater System Type: C HMO N sxi.-
Projected Daily Flow: o GPD
Number of bedrooms: 2~ Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes -4~Jqo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community .Public El Well Distance from well 16d feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: tae~t3I 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua o ier 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 Improveme ermit 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: C-y L- NQ V\05'"C,S N
Facility Type:
5f Q (~'s ~ Z1
New
PROPERTY LOCATION: ~ ~A ~tG2
SUBDIVISION ) NGIF.N LOT #
❑ Expansion ❑ Repair
Basement? ❑ Yes '19, No Basement Fixtures? ❑ Yes 0010
Type of Wastewater System" C o t4-4 ~ cl rv R~- (Initial) Wastewater Flow: 3JG ® GPD
(See note below, if applicable
C,0 11-4&1J-1 ~ cJ N P' ~ (Repair)
Installation Requirements/Conditions Number of trenches `j~
Septic Tank Size 1 oc5 d gallons Exact length of each trench 'I S feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 5--'~4 inches
Maximum Trench Depth of: - r-r--f 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 17, inches below pipe
Aggregate Depth: t~k, inches above pipe
Conditions: inches total
WATER LINES (INCLUDING 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 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 ation if the site p n, 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,t compliance w'R~ lts~ Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Cons on Authorization Expiration Date: 1
HTE # VR r- Permit # 5
Harnett County Department of I'ablic Health
Site Sketch
PROPERTY LOLATON:~C~L a wC-. l`
ISSUED TO: ~ - GS SUBDIVISION -1 }~~Ga ~-~c E LOT #
Authorized State Agent: - 5~a~-~y ~oL Sao Date:
r, t G
C
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1
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D
IV
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot
File
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 ~1;f71cocr` Design Flow(. 1949):X60 Je
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Metho~k Au er Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
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
_ C_~a
Description
Initia
S st m
Re it System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By: Cam(
System T e(s)
a
p s y
Others Present:
Site LTAR