IPACHTE# 09-s-;Ur7s°J Harnett County Department of Public Health 2 5 2 5 5
Improvement Permit
A building permit cannot be issued with only an Improvement Per t
PROPERTY LO(ATI N: 5'~ //`t/ , 1 c~ - ~~1~
ISSUED TO SUBDIVISION _ c~~ { o r/ a~ ti~ 1[ LOT # i 7g
NEW (Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: C) (,C yo,
Proposed Wastewater System Type: o~.-S' < U • cam.
Projected Daily Flow: - GPD
Number of bedrooms: Number of Occupants: _G _max
Basement ❑Yes No
Pump Required: ❑Yes 12/No ❑ MMaa e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~f Public ❑ Well Distance from well feet Permit valid for: [R-rive years
Permit conditions: ❑ No expiration
Authorized State Agent: G Date: 2 9 SEE ATTACHED SITE SKETCH
The issuance of this permit b 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 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, .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:'-S~Iflr. , I 'S.41cli- I I,- PROPERTY LOCATION: SlL 1/y/
SUBDIVISION ~-,t f ti LOT # / -7 q
Facility Type:
2 "1 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No
Basemen
t
Fixtures? ❑ Yes ❑ No
Type of Wastewater System"
ar 7,
p
o~,T~
(Initial) Wastewater Flow: J'~ 0 GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions
Number of trenches C2
Septic Tank Size 000
gallons
Exact length of each trench '7 S- feet
Trench Spacing: 9 Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: G - /e inches
Maximum Trench Depth of. /to
5-30 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
inches below pipe
M
Conditions:
i
;
,t
Lr
Aggregate Depth: inches above pipe
_
o.
-
inches total
"'If applicable: / understand the system type specified is different from the type specified on the app/icwon. / accept the speciAcwons 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 is a change in ownershin of the site. This
Construction Authorization 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
L
Authorized State Agent:_ . Date:
Construction Authorization Expiration Date: a C/c
HTE# 0 9-J - 2 l O Permit # C2 ~oZ
Harnett ("Minty Department of Y' iblic Health.
Site Sketch
PROPERTY LOCATON: J~- Myt j
ISSUED TO:, a► ~c• ~ld,f j ~t SUBDIVISION 44, r c;; f ~fL LOT # l7F
Authorized State Agent: W/,", . f Date:
00
T W
ff
I I
rs~
T~
40, I
1cr,
uepartrnentol MfIvuulunant, nedrtu, wlu owtuldl rl'CSuuIGCJ
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):
f Public [ ] Individual
( j Auger Boring
[ wage
01 "Cull
Property ID:
Lot
File
Code:
Applicant:
Well
[ ] Pit
Industrial Process
Date Evaluated:
T/~~(~
Property Size:
Property Recorded:
Spring [ J Other
[ J Cut
( ] Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941`
OTHER
PROFILE FACTORS
L
E`
#
.194
Landscape
Position/
Slope%
Horizon
Depth
IN.)'
1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942:
Soil
Wetness/` '
Color
1943.
Soil
Depth (IN.)
1956
Sapra
Class
,1944'
f - Restr
Horiz
Profile 1 : .
Class..;
& LIAR '
G-1/&-ly
C'
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948): ~5
Evaluated By:~{ N
Others Present: