IPACHTE# 5-~i3 Harnett County Department of Public Health
Improvement Permit 2 7 0 6 2
A building permit cannot be issued with only an Improvement P mit
PROPERTY LOCATION: MV'.16
ISSUED TO: 9--~012ES;, ~OtY~P~S ~~oc~G SUBDIVISION ~S>'~E~aCZsa LOT #
NEW, REPAIRjANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S~ O ~t-' 0 x LA L J
Proposed Wastewater System Type: a;~° o RGwyCA ~O r4-
-Z-Projected Daily Flow: S-st% GPD
Number of bedrooms: L-) Number of Occupants: max
Basement ❑Yes -XNo
Pump Required: ❑Yes -;iI<No ❑ May be required based on final location and elevations of facilities -Tk Type of Water Supply: ❑ Community Public ❑ Well Distance from well 11Z!)Q feet Permit valid for: Five years
Permit conditions: ~c \ \ ❑ No expiration
Authorized State Agent:: >1S Date: ~ 1. SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of ermits. The permit holde is respo Bible 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 Pe ' 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, .1957, .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: -0 ~,ES2r: ~ t-tiaMps 0 5 PROPERTY LOCATION: R2~c5 9-'D
SUBDIVISION N S» EF WD LOT # 7-
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ~L N0
Type of Wastewater System" Q-sol a ~ -pvC,r~ 11 O"N S 7 S '1Z r_- r+N (Initial) Wastewater Flow: Lt"9 0 GPD
(See note below, if applicable
210 V\GjJv G;1 0,ij Sys TGsr (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size \ 0 0 1::!" gallons Exact length of each trench ) S 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. D,'A---4A4 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: 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 specifed on the application. / accept the specipcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization i j vocation if the site plan, plat,,or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershin of the dtp_ This
Construction Authorization is *'C*Qcomplance r t~. - the La d Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 4,31
Construction uthorization Expiration Date: 6
3HTE# l 6'a91~ Permit
Iss
Ndl
Lo c,,(-,Noc,o W,
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 FacilityL%&&Q( 1 Design Flow 1949):LAO
Location of Site: Property Recorded: ~~11
Water Supply: Public❑ Individual ❑ Well
Evaluation Methodj:RAuger Bing ❑ Pit ❑ Cut
Type of Wastewater: '~Q Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
A
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
r
G
Description
Initial
S ste
Re air System
Other Factors (.1946):
Site Classification (.1948):5
Available Space (.1945)
Evaluated ByQ__
'
System Type(s)
1 o S
\
Others Present:
Site LTAR
}