IPACHTE#I 15 ` Harnett County tent IIc Health
rove et Permit 2 6 9 7 5
Number of bedrooms:
Basement ❑Yes `,?~No
Pump Required,
Mes
El No
Type of Water Supply:
❑ Community
Permit conditions:
Number of Occupants: '2 max
❑ May be required based on final location and elevations of facilities
Public ❑ Well Distance from well X- ®d feet Permit valid for: Five years
~N` ❑ No expiration
Authorized State Agent:: L-_ 5 Date: 3 0 a'~ ~ 0, SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holder is responsibl 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 emit 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: t"N > ~G- S PROPERTY LOCATION: QqZ a-z_-i ?9
SUBDIVISION Vjz sC-mo P4 LOT #
Facility Type: SF{~ -A5 New ❑ Expansion ❑ Repair
Basement? ❑ Yes '>~!k No Basement Fixtures? ❑ Yes "No
Type of Wastewater System** pv -0' o Qtw &N'C) u N NI- (Initial) Wastewater Flow: GPD
(See note below, if applicable
0 mp ® Co N-4 ri N Pt (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size LIC? ®Q gallons Exact length of each trench 50 feet Trench Spacing: Feet on Center
Pump Tank Size ~O®® gallons Trenches shall be installed on contour at a Soil Cover: 6- inches
Maximum Trench Depth of: I~-3 L. 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:
Aggregate Depth:
inches below pipe
inches above pipe
inches total
MATER LINES (INCLUDING IRRIGATION) UST RE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: 1 understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re f the 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 suEcompliance the a and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
W Date: 3
rization Expiration Date: '
HTE# Permit #
`$0 "
1el-),
Pia.-.v 1 F-w L41
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: L~ g"xiC~t Design Flow (.1949): Z 0~
Location of Site: Property Recorded:
Water Supply: ,.ublic❑ Individual ❑ Well
Evaluation Method.-a,AU erBoring ❑ Pit
Type of Wastewater: ❑ Cut
ewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Other
❑ Mixed