IPAC RHTE #.12 ' — Harnett County Department of Public Health
ImDrovement Permit 27214
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: g °®3
ISSUED TO "� '" /re ° "� SUBDIVISION ivfP' LOT # /Y
NEW 5e RfPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: */, iZ,6WQW
Projected Daily Flow: 66 GPD
Number of bedrooms: 5 Number of Occupants: max
Basement ❑Yes No ,.
Pump Required: ❑Yes ❑ No 516ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Le? Public ❑ Well Distance from well feet Permit valid for: alive years
Permit conditions: ❑ No expiration
Authorized State Agen° , _�° % Date: / rl Z SEE ATTACHED SITE SKETCH
The issuance of this permit by �kt� ealth 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 t e 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.
(See note below, if applicable ❑) °
Z AW JIJ i (Repair)
Installation Requirements /Conditions Number of tren es
Septic Tank Size JD0 6 gallons Exact length of each trench / feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: ' ,A inches
(Trench bottoms shall be level to +/ -114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
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
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 ofl the app /icatiom / accept the specipcations 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 Ag Date: iC ° _ r 7—
Construction Authorization Expiration Date: . 1,-7
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Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On -Site Wastewater Section Lot #:
File #:
SOIL /SITE EVALUATION Code:
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant: 10 7- w
Address: Date Evaluated: do t S –36 �(Z
Proposed Facility: 7S-f °- Design Flow (.1949): .51.6 Property Size:
Location of Site: Property Recorded:
Water Supply: ❑`Public❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: E:r Auger Boring El Pit ❑ Cut
Type of Wastewater: [k-S wage ❑ Industrial Process ❑ Mixed
P
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): y'
Evaluated By:
Others Present:
Available Space(. 1945)
R
System Type(s)
i
Site LTAR
O
F
SOIL MORPHOLOGY
OTHER
I
.1940
.1941
PROFILE FACTORS
L
Landscape
Horizon
.1942
E
Position/
Depth
.1941
.1941
Soil
.1943
.1956
.1944
Profile
#
Slope %
(In.)
Structure/
Consistence
Wetness/
Soil
Sapro
Restr
Class
Texture
Mineralogy
Color
Depth (IN.)
Class
Horiz
& LTAR
Z
S( -e-t
111
s .
q
L
-1I-
SL
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): y'
Evaluated By:
Others Present:
Available Space(. 1945)
System Type(s)
i
Site LTAR