IPACHarnett County Department of Public Health
Improvement Permit 27198
A building permit cannot be issued with only an I rovement Permit
PROPERTY LOCATION:
ISSUED T0: �yN� t7n15 j�U�.�\ 9tt IN G SUBDIVISION' o iS' ��a�E LOT # '1:1_
NEW REPAIR ❑ _ -- gPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: a �° o S4JJG � 0 l� �ls Ecr.
Projected Daily Flow: GPD
Number of bedrooms: _ �' Number of Occupants: 10 max
Basement ❑Yes No
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 140 feet Permit valid for: X Five years
Permit conditions— ❑ No expiration
Authorized State Agent:: �� v W-f--)`,5 Date: 4I I :AO ,,Z— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the u nce of other permits. The permit holder is res nsible 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 li r meet 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: 0 Coot `czv CIS) O-N 1 M [_. PROPERTY LOCATION:
SUBDIVISION—�—Q -16 1�z-5 'RN0 LOT # 11
Facility Type: S- 'C) C2,5`1 New ❑ Expansion ❑ Repair
Basement? ❑ Yes �K No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System ** �S�l® �FSJUCs��d,t ( )
J-xS�E: m Initial Wastewater Flow: C40 GPD
(See note below, if applicable ❑)
`5 —) -,'5 ') E� (Repair)
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size gallons Exact length of each trench QZ0
Pump Tank Size t a 5 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: \`$3(�)
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
feet Trench Spacing: 01 Feet on Center
Soil Cover: ro -- inches
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 1OFT. 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 specifications of this permit.
Owner /Legal Representative Si nature: Date:
This Construction Authorization is subject to revocatio ' site pl n, 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 subjgct to compliance V4� the kkisiol aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: �`�5 Date:
Construct) Authorization Expiration Date: 1'
HTE# i2= 5- 3O ®"3'7 Permit # a-7 M
Harnett County Department of lNiblic Health
Site Sketch
PROPERTY LOCATON: V >) �►A�a�� ��
ISSUED TO: \4 SUBDIVISION --7;.,zM F W el O 6£. LOT # 1
Authorized State Agent: � "S o�-s� Date:
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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: S 20Csut� rn Design Flow (.1949): �9�7
Location of Site: Property Recorded: % Water Supply: Public❑ Individual El Well
Evaluation Method: Auger Boding ❑ Pit ❑ Cut
Type of Wastewater: —91 Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
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
1
�G
L-->
V- <-,--
1 G L -'tom
,f 54*
G 1--5
scL<
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948)
Evaluated By: Cif
Others Present: �—
Available Space (.1945)
14
System Type(s)
'—'AS
Site LTAR
s