IPACH T E # a-5Harnett County Department o Public Health
rove et Permit 26981
A building permit cannot be issued with only an Improvement PeRit
PROPERTY LOCATION: NJR,5CQ_-l (3~
ISSUED TO: SUBDIVISION R A aCC ; LOT # f-j_
NEW-K REPAIR ❑ -EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 C 1 )
Proposed Wastewater System Type: +a1P_,T7~OttSac
Projected Daily Flow: 3 ® GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the issuanZe
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
6?- -'sS Date: t~lt el\\ 1~- SEE ATTACHED SITE SKETCH
her permits. The permit holder is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
wem rout shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: .a,~tS~EsS 1-Pt~ ~ ~t PROPERTY LOCATION: ~vcjse:cuy
SUBDIVISION 9,0s ®N; LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes 9, No Basement Fixtures? ❑ Yes _X No
Type of Wastewater System** NV C-_,~,4 lu N ~t (Initial) Wastewater Flow: 36 GPD
(See note below, if applicable
co sit ~f }~s~t~ lc~ N lo-'L (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 1C0 0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 5d feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1~-a1t inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: Co inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
C inches below pipe
inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) UST RE 1 OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED I INITIAL O REPAIR DRAT FIELD AREA.
**If applicable: / understand the system type specified is different from the type specified on the app/ication. / accept the specipcations of this permit.
Owner/Legal Represent ' e Signature: Date:
This Construction Authorization is subject t cation 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 s4~,o :ompliance'1viE n;,~offaaws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:' Date: H s
r ion Authorization Expiration Date:
®1
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:'] r3 j~~jv rN Design Flow (.1949): 3 0 Property Size:
Location of Site: Property Recorded.
Water Supply: ublic❑ Individual ❑ Well ❑ Spring
Evaluation Metho&n\Au er Boring ❑ Pit ❑ Cut
Type of Wastewater: -n Sewage ❑ Industrial Process ❑ Mixed
P
❑ Other
R
O
I .1940 941
F 4Depth.1941 RPHOLOGY
L Landscape
E Position/ .1941
# Slope %Consistence
Mineralo
OTHER
PROFILE FACTORS
1942
Soil .1943 .1956 .1944 Profile
Wetness/ Soil Sapro Restr Class
Color D th IN. Class Horiz & LTAR
Description Initial Repair System Other Factors (.1946):
System/-
ste Site Classification (.1948):
Available S ace .1945) Evaluated By~~,
S stem T e(s) r , Others Present: c
Site LTAR