IPAC RHTE# /,Z - r- 7 0f74 Harnett County Department of Public Health
Improvement Permit 2 71 0 3
A building permit cannot be issued with only an Improvement Permi
t 1 PROPERTY LOCATION: /e"t
ISSUED TO: l ~y tintur~e J SUBDIVISION LOT # f
NEW REPAIR ❑ , EXPANSION ❑
Type of Structure: o ,ci c{ 4 y -2 C,+
Proposed Wastewater System Type:P ~J✓~~ ~~c9u c~ JEe..
Projected Daily Flow: 4160 GPD
Number of bedrooms: c,( Number of Occupants: max
Basement ❑Yes RIN-o
Pump Required: Oes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1i Public Well Distance from well /00 feet
Permit conditions:
Permit valid for:
Site Improvements required prior to Construction Authorization Issuance:
P'Fwe years
❑ No expiration
Authorized State Agent:: el, ~
J Date: 7/~f2-~lZ SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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
`~e~, Cafe/ Crl ,ed
ISSUED TO: C PROPERTY LOCATION:
SUBDIVISION LOT # / 2,
facility Type: Z [Er New ❑ Expansion ❑ Repair
Basement? ❑ Yes Q" No /~Basement Fixtures? ❑ Yes ❑ No /
Type of Wastewater System** &jp ?,r,7~ f(eJ . J : fv Ire (Initial) Wastewater Flow: 616 0 GPD
(See note below, if applicable
J - (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size / OCR U
gallons
Exact length of each trench 00 feet
Trench Spacing: ? Feet on Center
Pump Tank Size l0 0a
gallons
Trenches shall be installed on contour at a
Soil Cover: - / Z_ inches
Maximum Trench Depth of. / 8 ' ~L q 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
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Aggregate Depth: inches above pipe
CM-
on
t
ons: S J
L),,u0
o&A_
c
t
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 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 Agent: ~"J.__,_ ew Date: 7 1-5- ,2 y l z,
Construction Authorization Expiration Date: 7,/f` z u/7
HTE# /02. -J=~- 7 caS"?le Permit # 2.? / o
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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: (s16 ,~,,.cz
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public[] Individual L'J ~'vell
Evaluation Method: ❑ Auger Bor g ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
940
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
. /
lb 12 t"
PS 3
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7,1~ ,2 rb
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rte, J
S 3 5
V rc
rr
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By:
System Type(s)
Others Present:
Site LTAR