IPAC/oZ - .s'= Re, ~ 9 a Gm'
HTE#;,;L-ts^o28Y8c? Harnett County Department of Public Health
Improvement Permit 2 6 91 2
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: d Gro/-
ISSUED T(l; )p mot.1 R
Lq'L 'SUBDIVISION LOT #
NEW 5 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: F D 9 ,S'S'
Proposed Wastewater System Type: oks 7-
Projected Daily Flow: '-180410o~)T0GPD
Number of bedrooms: A/ Number of Occupants: 8 max
Basement ❑Yes Lo
Pump Required: ❑Yes LJ No ❑ May be required bb d on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public 7 well Distance from well /Q0 feet Permit valid for: ' Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 3 Z SEE ATTACHED SITE SKETCH
The issuance of this permit by Health epartment 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 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, .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: ~o,>'~s iTv j y tv Mg~e ~s
Facility Type: .SF Z~
Basement? ❑ Yes ❑ No
Type of Wastewater System** _
(See note below if applicable
d New
Basement Fixtures? ❑ Yes
67,rY~ L-.1-~4 , ,Sy/
PROPERTY LOCATION: a CYn~>r~ "P-cf.
SUBDIVISION LOT # ~2 4
❑ Expansion ❑ Repair
❑ No
r_
P~.y+ , '_J ~ yr. ~ syl (Repair)
Installation Requirements/Conditions Number of trenches ,S'
Septic Tank Size /a,5_0 gallons Exact length of each trench 80 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. /8 - ~L) inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: -sq" d , 4,__ ke- 18 E ~cl1e f
(Initial) Wastewater Flow: 5-80 GPD
Trench Spacing: Feet on Center
Soil Cover: 6-/6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
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 subiect 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
Authorized State Agent: #f Dater /,2 ° _
Construction Authorization Expiration Date: 3 J4
6 r 7
i
I
i
r
t
d
d~
,s-o f p,-+I,
N c+ f- L-o rcam t -
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
:~~r(a
Proposed Facility: y G~6U9_0~ c4N Design Flow (.1949): W~p
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Meth, dr~] ~Au er Bo ng ❑ pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
SOIL MORPHOLOGY
.1940 .1941
OTHER
L
Landscape Horizon
PROFILE FACTORS
E
#
Position/ Depth .1941
Slope% (In.) Structure/
.1941
Consistence
.1942
Soil
.1956
Wetness/ •1941
1944 Profile
Texture
Mineralogy
Soil
Color Sapro
D th IN. Class
Restr Class
Horiz & LTAR
L C
s.'
SC-L,
Fri 3)5P,
'
VF~j
l
a°~, 2 I az 33
~ti <
=iii ~C i
x.y
1 '1
1a t"~_ v "
Description
Initial Repair System
Other Factors (.1946):
A
il
S Ste
Site Classification (
1948): IPf
va
able Space .1945)
System Type(s)
02
.
Evaluated By: (J' v~
Site LIAR
W,
a
Others Present: O-r