IPACH T E # N a- 5 -24 t "'fi`b Harnett County Department of Public Health
Improvement Permit 2 6 8 8 3
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Q cc. Y'D
ISSUED T0: n C-Q tv5.5CLUcr%<s 5 SUBDIVISION ®P,xr,or~ LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SCO
Proposed Wastewater System Type: 25°Ao RCoUC~lc~t~ y5;~cn
Projected Daily Flow: Q00 GPD
Number of bedrooms: -5 Number of Occupants: 10 max
Basement ❑Yes No
Pump Required: ❑Yes e~KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community A Public ❑ Well Distance from well IpO feet Permit valid for: )<Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: S IZ71)a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i q 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 Impr tent 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:
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Cc,tv5r5
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~S PROPERTY LOCATION: C) Cd~ib ~ D
Facility Type:
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SUBDIVISION Q-P, v-Z4N LOT #
New ❑ Expansion ❑ Repair
Basement? E-] Yes ~ No Basement Fixtures? ❑ Yes ~ No
Type of Wastewater System** RC')\J , I c)N y5s -t,n (Initial) Wastewater Flow: Ck)3 GPD
(See note below, if applicable
S01 o Q.L.DUCfs\,QA S /5'S*lr-- n (Repair)
Installation Requirements/Conditions Number of trenches Lh
Septic Tank Size I&S-O gallons Exact length of each trench S'C3 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: r6- l2- inches
Maximum Trench Depth of. 1il°aLi 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 speciFcations of this permit.
Owner/Legal Representati Lure: Date:
This Construction Authorization is subject to revoc o e site lat, 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 su o fiance wit prov ' of Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 'Z4 Date:
Con tion Authorization Expiration Date:
HTE# Permit # 2C~T:!~,
Harnett County Department of 'Vblic Health
Site Sketch
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r- 4 aCU,, i v 6 a"-
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: g[,~~cn Design Flow (.1949): o t1
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: `R Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I 1940
SOIL MORPHOLOGY
OTHER
L Landscape
Horizon .1941
PROFILE FACTORS
E Position/
# Slope %
Depth .1941 .1941
(In.) Structure/ Consistence
.1942
Soil 1943 1956
Wetnes
/
1944 Profile
Texture Mineralogy
s
Color Soil Sapro
D th (IN. Class
Restr Class
Horiz & LTAR
1 L5
LK7
4K
L* C' DEL 4"(2
Description
Initial Repair System
Other Factors (.1946):
S st m Site Classification (.1948): X57
Available Space .1945)
b
`
Evaluated B
System T e(s)
~s
r~ cz as l<.
Others Present:
:
Site LTAR
y 5
13 A