IPACHTE# ti~ Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N u2sFA ~J 14
ISSUED T0: C 41,A \ rA 5 )---PNs"P V6-) c-~4 . SUBDIVISION C)U~ LOT # 5
NEW REPAIR ❑ EXPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: U \ ® Go~s.sG~;~os~PL
Projected Daily Flow: L'N GPD
Number of bedrooms: LA Number of Occupants: \c~b max
Basement ❑Yes >~,No
Pump Required-"es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well !®o feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 'AYANgSEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er 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 Improvemen unit 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:
Uqs 0
Facility TYDe:
l
New
SUBDIVISION
❑ EXDansion ❑
Mo1;3' LOT #
ReDair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** +o NPR CgvmP (Initial) Wastewater Flow: LWO GPD
(See note below, if applicable ❑)cc"
IF.-N i 1 o rt s>',,L (Reoair)
Installation Requirements/Conditions
Septic Tank Size t c ® ® gallons
Pump Tank Size \ 00 0 gallons
Pump Requirements: ft. TDH vs.
Number of trenches LA
Exact length of each trench 5 O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1~-~-~ inches
(Trench bottoms shall be level to +/-I/4"
in all directions)
GPM
Trench Spacing: c)I Feet on Center
Soil Cover: C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions:
Authorized State Agent: Date: '0
Can on Authorization Expiration Date:
~O inches below pipe
a inches above pipe
inches total
HTE # Permit # ~ M )
Harnett Comity Department of Miblic Health
Site Slketch
PROPERTY LO(ATON: N U%5 m,-)
ISSUED TO: SUBDIVISION 1!2- o r4-, LOT
Authorized State Agent: - oLiv Date:
,
l~
7
Rp,2x\4 \ "
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: 1~ Q,~C Qfl Design Flow (.1949): 3 F,
Location of Site: Property Recorded:
Water Supply: toZg blic❑ Individual ❑ Well
Evaluation MethoAuge❑ Pit ❑ Cut
Type of Wastewater: -Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
F
R
O
F
I
L
1940
d
L
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
E
#
an
scape
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
V s
Description Initial Repair System Other Factors (.1946):
S ste - Site Classification (.1948):5
System T S as a .1945) Evaluated By:
Others Present:
Site LTAR f`>