IPACHTE# ,-s Harnett County Department of Public Health
Improvement Permit 27051
A building permit cannot be issued with onlan Improvement ermit
PROPERTY LO(ATION: ► E >s S~
ISSUED T0: l I- SUBDIVISION ? ,)ir1 5 ~y y LOT # L
NEW REPAIR ❑ CANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: CL1K
Proposed Wastewater System Type: (Qg %-j-4 6 s t 0 N
Projected Daily Flow: '3C C GPD
Number of bedrooms: 23 Number of Occupants: J~7 max
Basement ❑Yes XNo
Pump Required: ❑Yes ';E<No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community IK' Public ❑ Well Distance from well 10 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: QC-2s'N-5 Date: 1!~A1~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the uan of other permits. The permit holder is esponn le 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 Imps nt 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 he met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: ~ L.i ~.~,~zZ. czs *C PROPERTY LOCATION: 112 G j~
SUBDIVISION PCN-No a LOT # 1-l
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** N-4 t-- =-.r , 0 W Pt L., (Initial) Wastewater Flow: b GIRD
(See note below, if applicable cc~ -~~~4-~;1~ ~ K L_ (Repair)
Installation Requirements/Conditions Number of trenches Li
L Septic Tank Size 1 gallons Exact length of each trench 1~ 0 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. 2 fcy 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
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /under fond the system type specified is different from the type speciled on the application. / accept the speciTcations 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 ownershio of the site. This
Construction Authorization is suct~complialr~with t vi s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Co ction Authorization Expiration Date:
HTE # ;
Permit # ZLn(~) 5 i
Harnett Conty Department of - lUblic e-rdt
Site Sketch
PROPERTY LOCATON: (GG-w
ISSUED T0: SUBDIVISION 0 s 0 -1 LOT #
Authorized State Agent: ` 1> (00V [;e . fi01 0)' Date: 5 1~~ ! 1~-
,gam
1 C0
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:
_
D
Proposed Facility:
a @; G
Gc-z tY Design Flow (.1949): p Property Size:
Location of Site: Property Recorded:
Water Supply: P
bli
u
c❑ Individual ❑ Well ❑ Spring El Other
Eval
ti
M
th
d
ua
on
e
o
. uger)3oring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ 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
# Slope % (In.) Structure/ Consistence Wetne
/
Profile .1944
ss
Soil Sapro
Texture Mi
ner
a
l
o Color D th IN. Class
Restr estr Class
Horiz & LTAR
t
g
,
~
Description Initial Repair System Other Factors (.1946):
S stem / Site Classification (
1948):-5
.
Available Space .1945) Evaluated By:
System T e(s) c cJ rte? Others Present:
Site LTAR