IPACHTE# `57- Z_ X17 Harnett County Department of Public Health
Improvement Permit 2 6 8 4 0
A building permit cannot be issued with only an Improvement Permit
_ PROPERTY LOCATION:52 / r
ISSUED TO- / v i2 ~ SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 15 f:Z 6
f fe°eJ iS'
Proposed Wastewater System Type: d' 1r,
Projected Daily Flow: 3(o GPD
Number of bedrooms: Number of Occupants: (.1 max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No 12V6 required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: I3` Five years
Permit conditions: ❑ No expiration
Authorized State Age " Date: y - /_0 - ✓ 'Z SEE ATTACHED SITE SKETCH
The issuance of this perm!i1by Health Department 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 revocatii 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
Reauired 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: 51 L16cl6 rT Pi' S PROPERTY LOCATION:
_ SUBDIVISION LOT # f
Facility Type: ZNew Expansion ❑ Repair
Basement? El Yes 1' No Basement Fixtures? El Yes No
Type of Wastewater System** ZsDk a (Initial) Wastewater Flow: (c t GPD
(See note below, if applicable
Z,75%/ lz'f-- )o cn (Repair)
Installation Requirements/Conditions Number of trenches 5
Septic Tank Size /OO gallons Exact length of each trench C) feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 21 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 inches below pipe
Aggregate Depth: Z- Inches above pipe
Conditions: 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 app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation it 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
FAuthorized State Date: f 2--
Construction Authorization Expiration Date: - L=
HTE# f ~r Z& l 7 Permit # 2.6 D
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: J;U5`- l~)
ISSUED TO: SUBDIVISION LOT #
r
Authorized State Ag Date: f Z..
f
1
3
.F
7%
i
Iq C
rig ,7`>
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: ZN Design Flow (.1949):~~ Property Size:
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well ❑ Spring
Evaluation Method:[] Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: a Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F SOIL MORPHOLOGY
I .1940 .1941
L Landscape Horizon
E Position/ Depth .1941 .1941
# Slope % (In.) Structure/ Consistence
Texture Mineralogy
i Z L 3 L` _ z SL.
OTHER
PROFILE FACTORS
1942
Soil .1943 .1956 .1944 Profile
Wetness/ Soil Sapro Restr Class
Color Depth IN. Class Horiz & LTAR
L' o L
caL
f
s~
Z>
I
yip ~L-~/ ~5
u 1
Description Initial Repair System Other Factors ( 1946):
S stem Site Classification (.1948): C~
Available S ace .1945) Evaluated By: i
S stem T e(s) z r z-& Others Present:
Site LTAR 3
Sheet:
Property ID:
Lot
File
Code:
❑ Other