IPAC RHTE# t>~-~ at ~~~.e Harnett County Department of Public Health 2 5 2 6 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
O PROPERTY LOCATIO~r SAe f 17"k-j-'e t
ISSUED TO J 3 -.mod Zn~~s S c SUBDIVISION Hr c ,14 LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S i-_ 4/Zl(5 1
Proposed Wastewater System TT pe: _ 31~ X5-7' '6e,
Projected Daily Flow: 0 r-GPD
Number of bedrooms: 3_ Number of Occupants: max
Basement ❑Yes 19-IN'o
Pump Required: 63Yes ❑ No ❑~Mape required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. [ive years
Permit conditions: ❑ No expiration
Authorized State Agent.: -~~1 . Date: yA712(x 7 SEE ATTACHED SITE SKETCH
The issuance of this permit by th th 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. Lo ISSUED TO: ~3 cQ L~fdcJ / LL-C PROPERTY LOCATIO : s~ II /
SUBDIVISION v~ LOT # 137
Facility Type: J U t" New ❑ Expansion ❑ Repair
Basement? ❑ Yes PINo asement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** o lec u J cJJ- (Initial) Wastewater Flow: GPD
(See note below, if applicable
r-Z s 7 ~C _,4-,j
r.~ Jc~,~c- {Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size C~ gallons Exact length of each trench feet
Pump Tank Size D0~ gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 20 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
itio s:~
Trench Spacing: Feet on Center
Soil (over: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
inches total
**If applicable: / understand the system type rpeci6ed it different from the type rpeci6ed on the application. l accept the speci~cationr of this permit
Owner/Legal Representative Signature: Date:
TAil r,..........:.._ A...L_..:._.:..-___ _ .r ,
• ° I° L. 1=,,,1o1-1 11 p a a p-, m me mcnueu me uianges. me sonstrucaon numonzation snan not oe transferred when there is a change in ownership of the site. This
LoMUKUbn numonzauon 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: oo
Construction Authorization Expiration Date: v %7
HTE# Permit # 01s-aZ (-3
naxnett County Depa lment of Public Health
Site Sketch
PROPERTY LOCATON: x4
ISSUED TO: L &C SUBDIVISION LOT #
Authorized State Agent: Date: /
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Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[.Oubiic Individual
( r'rAu er Boring
[ Sewage
JI IC171.
Property 10:
Lot
File
Code:
Applicant:
[ ] Well
[ ] Pit
[ ] Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
Spring Other
( ] Cut
[ ] Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
0
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Son
Wetness/'
Color
.1943
SON
Depth (IN.)
.1956
Sapra
Class
.1944`
i Restr
Horiz
Profile ,
Class
& LTAR
f
G - Z
G- if
L
2* 1';7
5-/ J_C I
q
Z
9 -
e)f
l
Description
Initial System
Repair System
Available Space (.1945)
✓
System Type(s)
i
4
f✓ Q
Site LTAR
q
Other Factors (.1946):
Site Classification (.1948): $11f
Evaluated By:1 1__
Others Present: