IPACHTE#Harnett County Department of Public Health 2 5 3 6 0
Improvement Permit
A building permit cannot be issued with only an, Improvement Permit
PROPERTY LOCATION: Z
ISSUED T0:Ctt~)t C C t,~1tYI,'fy -5 SUBDIVISION r LOT #
NEW,. REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
~r R
Type of Structure: `0 - -01C 71
Proposed Wastewater System Type: tti(r 2i l c s . J~.1
Projected Daily Flow: 0 GPD
Number of bedrooms: c'-: Number of Occupants: oK max
Basement ❑Yes ❑ No
Pump Required'?OYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water SuppI : ❑~`Community Pudic ❑ Well Distance from well ) o 3 feet Permit valid for. Five years
Permit conditions-7k1Q On_1; ?z r ftZ - _r, 1~1,11 n-'A t.nt A 1~ S~ f ON/- t ❑ No expiration
Authorized State Agent:: L.✓L~ _ Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the H th 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 th rte 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.
ISSUED TO: k"rt n c 7L~ C'41 t, tityI/ r/ PROPERTY LOCATION:
SUBDIVISION u~ f~ LOT #
facility Type: ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 4;2~ No Basement Fixtures? ❑ Yes Z,-I-No
Type of Wastewater System* ts,''v9 t~ j (Initial) Wastewater Flow: k/ GPD
(See note below, if applicable
~l,clfr c7Z S - J S. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size J O D3 gallons Exact length of each trench 0-73 feet Trench Spacing: ~ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (P 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
Conditions:
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/ication. / accept the specifIcationr of this permit.
Owner/Legal Representative Signature: Date:
ims construrnon nutnonzanon is sunfect to revocation it me 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 comomy 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 L.6S Date:
Construction Authorization Expiration Date: Of
HTE# J Permit # 3
Harnett County Depa nient of Public Health
Site Sketch
PROPERTY LOCATON: Z
ISSUED T0: n,. n SUBDIVISION I-J-> ~l J z_ LOT #
Authorized State Agent Date: OC
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Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: 31
Address:
Proposed Facility: S+ Design Flow (.1949):
Location of Site: f I
Water Supply: J[Auger ublic Individual
Evaluation Method: Boring
Type of Wastewater: ewage
Property ID:
Lot
File
Code:
Applicant:
Well
Pit
[ ] Industrial Process
e
Date Evaluated:
Property Size:
Property Recorded:
Spring [ j Other
[ ) Cut
[ ] Mixed
P
R
o
F<
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
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
Hodz
Profile: -
Class::, T
LTAR
12
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Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
ISite LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: 1.
Others Present: