IPACHTE# Wig- r- a Harnett County Department of Public Health 2 4 5 9 2
Improvement Permit
A building permit cannot be issued with only an Im,,Provement Permit
PROPERTY LOCATION: ...~lC / ~~'►e c
ISSUED TO:~ Cc //,u rf- SUBDIVISION LOT #
NEW f;/ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M a 67~-
Proposed Wastewater System Type: Cc VZ✓4 ; ot1
Projected Daily flow: -7(90 GPD
Number of bedrooms:3 Number of Occupants: G max
Basement ❑Yes Ei No
Pump Required: ❑Yes W'No ❑ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ! Public ❑ Well Distance from well feet Permit valid for. El-Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: - /`k~~!~- r/ Date: -.I 111X5200 9 SEE ATTACHED SITE SKETCH
The issuance of this permit tif-the Health 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 9 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.
Construction Authorization
Reouired for Buildine 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: S~ ~l c C PROPERTY LOCATION: SA / I q
SUBDIVISION LOT #
facility Type: M L1 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? Yes ❑ No
Type of Wastewater System" Cc re tlC14 nG1 I (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable
lo~~~%.h- -4`+ (Repair)
WWLition Requimimpts/Condidons
Septic Tank Size GEC) gallons Exact length of each trench q j(7 o feet Trench Spacing. Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. %Q inches
Maximum Trench Depth of: c2;~ 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:
inches below pipe
Aggregate Depth: a inches above pipe
inches total
**If applicable: / understand the system ty pe specified it different from the type specified on the application. / accept the specilcationc of this permit
Owner/Legal Representative Signature: Date:
ims construawn Aumonzauon is subect to revocation u the site plan, plat, or me intended use changes. Me Lonstrucuon Authorization shall not be transferred when there is a change in ownership
of the site. This Construction Authorizatio 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 Agent Date: Construction Authorization Expiration D
HTE# O 1- S' a t 3S~ Permit # a V S-~,
narnett Connty I)epartment of 11ablic nealth
Site sketch
PROPERTY LOCATON: Sk /,7/ y ~~ue~ ~oc k
ISSUED TO: Sc y c c- %")oQ rL SUBDIVISION LOT #
Authorized State Agent: 4L~,~
c3 . E~. f Date: ~/l~d
,9 75
/7f
9,-k- Ad-
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
( ~,Ablic [ J Individual
[ Au r Boring
[ ewage
v. icca.
Property ID: a
Lot
File
Code:
Applicant: /
Date Evaluated:3)E/ 2"`t
Property Size:
Property Recorded:
[ ]Well (j Spring [ J Other
[ J Pit [ ] Cut
[ j Industrial Process [ j Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
1940
Landscape
Position! .
Slope%
Horizon
Depth
(IN.)
.1941.
Structure!
Texture
.1941
Consistence
Mineralogy '
.1942.
Soil
Wetness!'
Color
1943
Soil :
Depth (IN.)
1956
Sapra
Class
1944
Restr
S Horiz
Profile`
Class.
& LTAR
`J
5~- I/L
s 1 -c
is h
O ` ~ l~j
o
G d t-
li-V
Ou /IC t
Jl J_//1
~J.J_
'
CS` /
/
S~ iz`I 'mo
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
f°s~✓
C
ISite LTAR
Other Factors (.1946):
Site Classification (.1948)/
Evaluated Byll
Others Present: