IPACHTE#oc) -S--3-)5y Harnett County Department of Public Health 25180
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Y \ LLB a na Ca + p p~ c C~A yli cx R-D
ISSUED TO: MQl cCLX l SUBDIVISION U2 ~t~ C'lct~r~N LOT
NEW'X REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: (I ?-s . lac) t",E.
Proposed Wastewater System Type: a5~~°c~~ c o
Projected Daily Flow: Lf-~ C) GPD
Number of bedrooms: 4 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ~K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well i c-- feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent.:
The issuance of this permit by the Health Department in no way guarantees the issu i
site is subject to revocation if the site plan, plat, or the intended use changes. The Imprm
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: a 1 SEE ATTACHED SITE SKETCH
other permits. The permit holder is res onsible for checking with appropriate governing bodies in meeting their requirements. This
nent 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:PROPERTY LOCATION:
SUBDIVISION Q (ZsC--i- , X-") c -N LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System" c`~S°lo (Initial) Wastewater Flow: 4%-Q GPD
(See note below, if applicable
~~~I~ ~GO~c t,c3TV ys<~ (Repair)
Installation Requirements/Conditions Number of trenches 5
Septic Tank Size SC~d gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of., 1 inches
(Trench bottoms shall be level to +/-1/4"
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)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / anderftand the tyJtem type rpeciled it different from the type rpeciled on the application. / accept the ,rpecilcations of thin permit
f Owner/Legal Representative Signature: Date:
This Construction Authorization is subje to_r if the ky aan, 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'lp6)et` oo compliance~e~ ~ \ns-oflhe laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 13~ Date:
Cons tion Authorization Expiration Date: a T
HTE# Permit # "a ID-) ~C)
Harnett County Department of Mibl is Health
Site Sketch
ISSUED TO: ! J-r,o
Authorized State Agent:
2~P~~ ~z Q~-F\
Date:
Shy ~
S5 ~
5c?, D
L
N1~,L~yt~ GaRGGt_ `-~UrcC~, ~C,
PROPERTY LOCATON:
_ SUBDIVISION LOT # C>
ueparunent ui cnvnUnniem, r,cauu, ally
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: t-Nvt" Design Flow (.1949): Ly20
Location of Site:
Property ID:
Lot
File
Code:
Applicant:
Water Supply: Public [ ] Individual [ ] Well
Evaluation Method: Auger Boring Pit
Type of Wastewater: f~Sewage [ ] Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
Spring (j Other
[ ] Cut
[ ] Mixed
P
R
O
F
SOIL MORPHOLOGY
1941
OTHER ; :
PROFILE FACTORS
Y.
Y {
L
E
#
1940
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
Claw.,;,
& 4TAR
LS
Description
Initial System
epair System
Available Space (.1945)
System Type(s)
.
~s~/
Site LTAR
't''~
Other Factors (.1946): _
Site Classification (.1948): Q~
Evaluated By:(,'~j"ti
Others Present:
~ x601 C~.- X73 ~