IPACHarnett County Department of Public Health
Improvement Permit 2 71 9 7
A building permit cannot be issued with only an Improvement Per
/- PROPERTY LOCATION: 1;Q- WC.-ll
ISSUED TO: ® SA-k t-k N'-5 ��) `_., p�L '•111 SUBDIVISION LOT #
NEW' REPAIR ❑ EXPANSION
Type of Structure: M f t-4 v1 " f�,
Proposed Wastewater System Type: 21-S °/a ON
Projected Daily Flow: 3L-® GPD
Number of bedrooms: 3 Number of Occupants: r- max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes XNo ❑ May be requi ed based on final location and elevations of facilities
Type of Water Supply: El Community El Public Well Distance from well 1®® feet Permit valid for: No ive years
Permit conditions: �_ c� expiration
Authorized State Agent:: :n NAS Date: 11 1-1 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ' ce of other permits. The permit hol r is r sponsible 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 Imp vement 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. c�
ISSUED T0: a zS i YQ� �P,1, �1">� PROPERTY LOCATION: '�D
l SUBDIVISION LOT #
Facility Type: MPA ` 1 Cam �LJ New ❑ Expansion ❑ Repair
Basement? ❑ Yes "�k No Basement Fixtures? ❑ Yes 'tOo
Type of Wastewater System" 2-5"1a '0�ou c; s o,, S,ys-s E -'q (Initial) Wastewater Flow: -'&60 GPD
(See note below, if applicable ❑)
34� ya �Gay SK 10 N 5 )ff7 F-- sr (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size 1 b (!�d gallons Exact length of each trench 2i2l-5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. )S inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: SU09" 1 —)-IF- (Avg ` �� � �C24m 16L.)-
Trench Spacing: S Feet on Center
Soil Cover: 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: !understand the system type specified is different from the type specified on the app lication. / accept the specifbtions of this permit.
Owner /Legal Represen atjve Signature: Date:
This Construction Authorization is subject to 'on if the site plan, t, 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 suto compliancth of�and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: r>5 Date: \l ) A
Construct) horization Expiration Date: \
HTE# Permit # �),l A-1
Authorized State Agent:
r — - - I
( Q-Lfl-pol, s
"-4GCL Toi� -) Date: \N ) 5_ y)•
T
V66
qS
•
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949)-�� o
Location of Site: Property Recorded:
Water Supply: Public❑ Individual El Well
Evaluation Method ugR ing ❑ Pit ❑ Cut
Type of Wastewater: __-®Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
G
QyX3
C'
rr�� .e
x
1
SCE,
' �
}O� o G � � )C4
'W' t
tic
e ,j, C-L
c
Description
Initial
System
Repair System
Z
Other Factors (.1946):
Site Classification (.1948): r»�,
Evaluated By:
Others Present:
Available Space (.1945)
/
System Type(s)
Site LTAR
'u