IPACHTE# 09-s-~~ Harnett County Department of Public Health 2 51 g 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: Q C, ___5_X2,0 C:~ 10 hl SUBDIVISION T; LOT # S_
NEWX REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: s Vl~) __l -1-J G)
Proposed Wastewater System Type: 00-G--~ s0 N t> l.-
Projected Daily Flow: 36Ca GPD
Number of bedrooms: Number of Occupants:? max
Basement ❑Yes j~ No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees a issu 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 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
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, 1957, .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: Nl--5)A Ca c ,c, ~Ct PROPERTY LOCATION:
SUBDIVISION 7_,-~cE-~, LOT # S3
Facility Type: '_-,,V_S) ~tA New ❑ Expansion ❑ Repair
Basement? ❑ Yes _'K No Basement fixtures? ❑ Yes )~f No
Type of Wastewater System** Co svvLr-0: t s--J (Initial) Wastewater Flow: 3~0 GPD
(See note below, if applicable
~i,4AErr ~ 0 " p" L (Repair)
Installation Requirements/Conditions Number of trenches 2
Septic Tank Size to O b gallons Exact length of each trench _-1-5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1'2 - 3 D inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on (enter
Soil Cover: G - s inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
a inches above pipe
1 inches total
**If applicable: /under understand the r,r stem type rpecifled is different from the type specified on the application. /accept the rpeci6cationr 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 k a rhanae in nwnnrthin of rho dto Thit
Construction Authorization is±bJLF'C't to compliance eft' pvisio f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Z s Date: 3
n Co cion Authorization Expiration Date: 3
HTE# C `1 -~1~11~1 Permit # "~V° -
Harnett C'onnty Department of Public Health
Site Sv ketch
PROPERTY LOCATON: V-o
ISSUED T0: ~r vc , ~e r~ SUBDIVISION 1; r,~E ~~s c~ LOT #
Authorized State Agent:_ F 2s~, ~~~~io~s,o Date: C)
2Epfl,12 1~ 2~.A
D
2
v
»S
V) 1 cla o c-cl U U:7°
r w... .
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):
[ J Public [ J Individual
[ J Auger Boring
[ J Sewage
vncci.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ J Well [ j Spring [ J Other
[ J Pit [ j Cut
[ j Industrial Process [ J 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
Soii .
Wetness/
Color
1943
Soil:
Depth (IN.)
1956
Sapru
Class
1944
Restr
Horiz
Profile`
Class-
& LTAR
r
t_S
tip
S
day -51 -49
S i
0
.
3C7{}8~
s ,Q
Description
Initial System
Repair System
Available Space (.1945)
y
I/
System Type(s)
? rf
c-I #4
Site LTAR
.`6
V.
Other Factors (.1946): -
Site Classification (.1948):
Evaluated By:
Others Present: