IPACHTE# 2 -5--201&82- Harnett County Department of Public Health
Improvement Permit 27012
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO:/ SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improveme required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: H~_, GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 2- No
Pump Required: ❑Yes ❑ No ❑ Maxe required based on final location and elevations of facilities '
Type of Water Supply: ❑ Community L!t Public El Well Distance from well feet Permit valid for: L~1 Five Jyears
Permit conditions: ❑ No expiration
Authorized State Age 1-1 Date: - `,71 M 1 L SEE ATTACHED SITE SKETCH
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, 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
(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.
(See note below, if applicable
/K -14W
Installation Requirements/Conditions
Septic Tank Size / gallons
Pump Tank Size /060 gallons
YZ,a Lf-o
V44""2
Y'7 14M ice' rsepair)
Number of trenches
Exact length of each trench ey feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 24-7/ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 62 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
`f' inches below pipe
Aggregate Depth: 2- inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. 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 specilled on the application. / accept the specifIcations 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 Aged 5 Date: ~2-i -T 7,
Construction Authorization Expiration Date: t'- Z'( ° i Z
HTE# 17,-,5 ' Permit # Z70) Z.•
Harnett County Department of Public Health
Site Sketch
0
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: Design Flow (.1949): t
Location of Site: Property Recorded:
Water Supply: llYublic❑ Individual ❑ Well
Evaluation Method: Auger Bon ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
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
Z
o` Z8
L-
2ND"
2). AS5
,I
y 3`4
1
D -Z'
'S1_
?L 0~
L
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification
Available Space (.1945)
Evaluated By:
System T e(s)
Others Present:
Site LTAR
L