IPACHTEHarnett County Department of Public Health
Improvement Permit 2 7 0 9 0
A building permit cannot be issued with only an Improvement Perm't
PROPERTY LOCATION: ~4 R O%4z
ISSUED TO: SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: nht N-N U ME. ~ : `
Proposed Wastewater System Type: ~--5 °~or,~:~tlGi d +J 7S s f~cr
Projected Daily Flow: 0 GPD
Number of bedrooms: 21.1 Number of Occupants: max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ITS No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community El Public 'Nr Well Distance from well ! Q ® feet Permit valid for: Five years
Permit conditions: - ❑ o expiration
Authorized State Agent:: 'a \ tzvr ~ Date: 'N SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o ,permits, The permit holders 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 Pere 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.
ISSUED TO: '~~O`f O Y- Oul'"ESL PROPERTY LOCATION:
SUBDIVISION
Facility Type: M 0 mC-- `a~x6 New ❑ Expansion ❑ Repair
Basement? ❑ Yes _>\No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Z)-~dfo~Ov~-S}CSs~t S-y5'~EN\ (Initial) Wastewater Flow:
(See note below, if applicable
2..5OL Q v4~\ 144 `J -TS ; C M (Repair)
Installation Requirements/Conditions Number of trenches 1
a)A 0 GPD
Septic Tank Size 10<D U gallons Exact length of each trench ',.0 0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G inches
Maximum Trench Depth of. S 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: /understand the system type specified if different /rom the type specified on the app/ication. / accept the speciTcationr of this permit.
Owner/Legal Represtntative Si nature: Date:
This Construction Authorization is subject t oca a site p lot or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorizatib~a ~ts~su o compliance he f the and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
LOT #
Authorized State Agent: vv -N- _ ¢G~W Date: Q
Construction Authorization Expiration Date: -
HTE# c5 f~,ti 54, Permit # a:-) 4~
arnett County Department of Public He(alth
Site sketch
PROPERTY LOMON: ~y(z~ QO,s Q V~D
ISSUED TO: d` N ca., SUBDIVISION LOT #
Authorized State Agent:~S 70l-s~~G ~ Date: 15
w OOQG
i 1
1
t-)onC-
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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:
Proposed Facility: Design Flow ( 1949): ~LaCj
Location of Site: Property Recorded:
Water Supply: Public❑ Individual Well
Evaluation Method Auger Boring -1 Pit ❑ Cut
Type of Wastewater: 'Sewage r_1 Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
l>-mil
~x~
~2 Ss7~P
~0~12-~ a~,~
S
11--1
G S
"ry ,.13 ~'~f('
C L ~
v -)Q
ly
V - ff~5~ l`~
Sgt
a~-rz. ss) ~
►CS)(2.,°~~~,,3~i
fz
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By:
System T e(s)
°
Others Present:
Site LTAR
Ls