IPAC- 1. -5- 2t)C) Q, Harnett County Department of Public Health 25526
Improvement Permit
A building permit cannot be issued with only an Im movement Permit
PROPERTY LOCATION: S0<-6 ez
ISSUED TO: Yc -ant C4) Ay" c G 0 N SUBDIVISION7T e.2.5 Q —,vGe- LOT # 1'4:?,
NEW )!� REPAIR ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SQ--Q `'53 AU.
Proposed Wastewater System Type: 2.5`10 G�c5Gldst o :Esc
Projected Daily Flow: 4-:" , b GPD
Number of bedrooms: L4 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community , Public ❑ Well Distance from well too feet Permit valid for: Five years
Permit conditions: _ \_ ��,c ❑ No expiration
Authorized State Agent:: �*������������ \\�'� Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o g� 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 N t 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)
ermit)
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: >'rcq co vcs-:Q,vcz:�16 N PROPERTY LOCATION:
SUBDIVISION —Y ,7& 06S- LOT #
Facility Type: S�� �53� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes o
Type of Wastewater System" c) �/o M Eta (Initial) Wastewater Flow: ��8 4 GPD
(See note below, if applicable ❑)
Q..s' lr 9--C-o V c,':�t d (Repair)
Installation Requirements /Conditions Nnnnhor of tronrhoc
Septic Tank Size 1.03 0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench O
Trenches shall be installed on contour at a
Maximum Trench Depth of.
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
feet Trench Spacing: Feet on Center
Soil Cover: 1%-G inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
* *If applicable: /understand the system type specified is different from the type specired on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to re he site plart. plat, 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 subjeot�kcd%hance wit pr i t ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: \� \\` Date:
Construct) uthorization Expiration Date:
HTE#
ISSUED TO:
Authorized State Agent:
Permit #'`�
Harnett County Department of Niblic Health
Site Sketch
PROPERTY LOCATON: flocs
_ SUBDIVISION LOT #_
Date:
±�3C3
�.G NS V () Y
M
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):
Location of Site: Property Recorded: s
Water Supply: 'Public❑ Individual ❑ Well
Evaluation Method: [Au r B ring r_1 Pit El cut
Type of Wastewater: q,)Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
L ST
V /�
�f J
�5
V M, ;,5)41
hNIS2 Qoc
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By: :;v,
Others Present:
Available Space (.1945}
System Type(s)
� Y o
Site LTAR
6
`x