IPACHTE# 12= 5- Z5V-) Harnett County Department of Public Health
Irovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: )) h,
ISSUED TO: C-4- SUBDIVISION Po LOT # &S
NEW 15< REPAIR ❑ EXP-A1rS10N ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: VG 0 L46 3` I--1G
Proposed Wastewater System Type: Z.%0/0 e-.EOuc.5lctN,t
Projected Daily Flow: ':S(—<D GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes >f�No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ,< Public ❑ Well Distance from well 10(:' feet Permit valid for: X five years
Permit con itio El No expiration
Authorized State Agent:: y� �� -G:�1S Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarante h issuance of other permits. The permit hokler 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.
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: �rz*� �-��� ��mcS PROPERTY LOCATION:" 1 N6�n�cQ.S�
SUBDIVISION PQ"i>a r, LOT # a5
facility Type: SF� 6 x�t6� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes �No
Type of Wastewater System ** 44 5'010
0 y C5 'N I Q N (Initial)
Wastewater Flow: 3(Q GPD
(See note below, if applicable ❑)
aC /6
94 flUc;�)c1 isS-5�,K,_(Repair)
Installation uinements/Conditions
EP °'nQ)
Septic Tank Size 10 n gallons
Exact length of each trench
feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil (over. S" inches
Maximum Trench Depth of.
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
Aggregate Depth:
Conditions:
inches below pipe
inches above pipe
inches total
* *If applicable: understand the system type speciTed is different from the type speciCed on the application. /accept the pecifications of this permit.
Owner /Legal
re:
Date:
This Construction Authorization is subject to r ion if 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 Constructio rization is a 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: N vs Date:
1" I o ction Authorization Expiration Date: 11 1 1 _
11, x'
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)-
Location of Site: Property Recorded:
Water Supply: IaPublicEl Individual ❑ Well
Evaluation Methodu er Borhig ❑ Pit ❑ Cut
Type of Wastewater: Wewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
L5
Ls�'
% )rl�
L -4
S
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By: (T
Others Present:
Available Space (.1945)
V,
System Type(s)
S
(;LGO
Site LTAR