IPACHTE# - MIN Harnett County Department of Public Health
Imarovement Permit 2 6 8 4 3
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION?lf
ISSUED T0: Z SUBDIVISION dam, LOT #
NEW REPAIR ❑ EX ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
j'.Ct} lZ~5`"
Projected Daily Flow: C GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 0 No
Pump Required: ❑Yes ❑ No L!f Ma & required based on final location and elevations of facilities
Type of Water Supply: ❑ Community LJ Public ❑ Well Distance from well feet Permit valid for: ZFive years
Permit conditions: ❑ No expiration
Authorized State Age / Date: SEE ATTACHED SITE SKETCH
- -le
The issuance of this permit by 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 revocation if the site plan, pla4 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 payout. }UleA-j j
ISSUED TO: T PROPERTY LOCATION: 6
SUBDIVISION 6 ~ LOT #
Facility Type: /New ❑/Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes la'No
Type of Wastewater System** 291~ /zeby (Initial) Wastewater Flow: ``tr66 GPD
(See note below, if applicable
2,S- (Repair)
Installation Requirements/Conditions Number of trenches Z- Septic Tank Size / ZOO gallons Exact length of each trench 19-b 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: ~ 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:
inches below pipe
Aggregate Depth: Z-- inches above pipe
/Z. 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 it dif/erent from the type specified on the application. l accept the soecificatioar of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject 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 A t: G Date:
Construction Authorization Expiration Date:
HTE# iZ- 5 - Z07&V
Permit # 2 & cf3
G11
0 oe-A~
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow(. 1949): Property Size:
Location of Site: Property Recorded:
Water Supply: is Individual ❑ Well ❑ Spring El Other
Evaluation Method: 2 A uger Boring ❑ Pit ❑ Cut
Type of Wastewater: 9''S age ❑ Industrial Process ❑ Mixed
P
R
O
F
SOIL MORPHOLOGY
OTHER
I
.1940
.1941
PROFILE FACTORS
L
Landscape
Horizon
.1942
E
#
Position/
Depth
.1941
.1941
Soil
.1943
.1956
.1944
Profile
Slope %
(In.)
Structure/
Consistence
Wetness/
Soil
Sapro
Restr
Class
Texture
Mineralogy
Color
D th (IN.)
Class
Horiz
& LTAR
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948):
Available Space(. 1945)
Evaluated By:
System T e(s)
Others Present:
Site LIAR
6.