IPACHTE# Harnett County Department of Public Health
Improvement Permit
2 7 0 9 2
A building permi
t cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
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ISSUED T0
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UBDIVISION
SVIIEV
O~ LOT #
NEW.
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171
REP
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E NSION
Site Improvements required prior
to Construction Authorization Issuance:
55 xLA
Type of Structure: _ 15 0
Proposed Wastewater System Type: a-V''1o Rov~s~p,N S
~s:Ea~
Projected Daily Flow: 3(,6
GPD
Number of bedrooms: 3
Number of Occupants: Q1
max
Basement ❑Yes ~N)
Pump Required: ❑Yes "'D No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply: ommunjty
'X Public ❑ Well
Distance from well 100 feet
Permit valid for: Five years
Permit conditions: c
s \ _
❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the is c
site is subject to revocation if the site plan, plat, or the intended use changes. The Imps
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
5 Date: '8I )511"01, SEE ATTACHED SITE SKETCH
other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
&tt Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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 T0: ~M~,ECLtgtvt~ ~~t` -5 ~lyG PROPERTY LOCATION: PIZX-s IZD
SUBDIVISION ANN-Fc)2D LOT # r-Aa
facility Type: 5 TU New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** 2•S~~o QEDUCM) SysSsm (Initial) Wastewater Flow: 3 GIRD
(See note below, if applicable
'.,Ss'/oC,~JJ ` (Repair)
Installation Requirements/Conditions Nnmhpr of trpnrhps
Septic Tank Size 1 MO gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench to 1 d feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: K inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
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 is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Si nature: Date:
This Construction Authorization is subject to revocation ' site plan, 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 witlfkprov ' s L d Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Z4Date: 35
Construction horization Expiration Date: q
HTE# 1 '~--5() \
Permit # ' ~ 4
Marnett County )epartinent of Public eldth
Site Sketch
"as ,
L-0 a v.D p GL--
al~`l '
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:` ,A
Proposed Facility: 3 ~{2 Design Flow(. 194
Location of Site: Property Recorded:
Water Supply: ❑ Public[] Individual ❑ Well
Evaluation Method:[] Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ Sewage ❑ 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
<AR
L5
~rn
C> 44
V
Description
Initial
Systqfn
Repair System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By: 'Z
System T e(s)
Others Present:
Site LTAR