IPACHTE #t3- 5 -'--'1-7t0 Harnett County Department of Public Health
Imarovement Permit 27166
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Gv9R.Css CAUc2QA 141)
ISSUED TO: D Q.. i1oCL "ON N G SUBDIVISION C, /Pc2-Gs5 90 ) glS LOT #
NEWX REPAIR E NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SQ�0
Proposed Wastewater System T�pe: aS °�o • -� Utr, k0N Sys m
Projected Daily Flow: L,, GPD
Number of bedrooms: Number of Occupants: -?Zl max
Basement ❑Yes 'KN0
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: F-1 Community Public ❑ Well Distance from well 1 VJ feet Permit valid for: Aive years
Permit conditions: g ❑ No expiration
Authorized State Agent:: "-11 V Date: l0'1 i' Y�- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit holder' is r@sponsible 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 Improve 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, .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: D Q-- )- -dasa,,,t Nyi c,, PROPERTY LOCATION: CyS'a- `� G`,A\JQ -C"-\ �D
r SUBDIVISION C-1 vcLG.55 v l4„ E- LOT #
Facility Type: SAO 047�"1� ,� New ❑ Expansion ❑ Repair
Basement? ❑ Yes .5( No Ba emtent Fixtures? ❑ Yes ['�14o
Type of Wastewater System" of 10 �ez y G: � ON Sy � ? G� (Initial) Wastewater Flow: �� � GPD
(See note below, if applicable ❑)
9,s"ir RG�V G��b� �7s G� (Repair)
Installation Requirements /Conditions Number of trenches L
Septic Tank Size 10 O o gallons Exact length of each trench C3 feet
Pump Tank Size o® allons Trenches shall be installed on contour at a
C t F '4 EcESa Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
l W. t.
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
N 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 speciled is different from the type specified on the app /ication. / accept the specifIcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to reve. . n 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 subjec( kcomplianc: th tt� ian�of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: vN`N » Date:
Co uction Authorization Expiration Date:
HTE#
Harnett C'onnty
ISSUED TO: 0
Authorized State Agent:
1a G
Permit #
e artnlent of ib"e llealth
site slketch
PROPERTY LOCATON: LOT # t 1?
_ SUBDIVISION ��� 40
t 0 Date: v �a
OLpC
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: 1-�,\3 Design Flow(. I 949):P 0 �
Location of Site: Property Recorded:
Water Supply: El' Public[] Individual ❑ Well
Evaluation Method -Auger BoAng ❑ Pit ❑ Cut
Type of Wastewater: ,Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
� S c�cl
oar'
G
V _�vP
Lo
'
k
V
�-Z
Description
Initial
S stern
Repair System
Other Factors (.1946): p r
Site Classification (.1948):4 t
Evaluated By:
Others Present:
Available Space (.1945)
System T e(s)
i �'�
Site LTAR
;