IPACHTE# - s-3:�o3 Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: it
ISSUED TO: � ��vf:tZ, a r��s SUBDIVISION �ia��N ic)°r l-- LOT # V45
NEW 1k�,( REPAIR ❑ EXP ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:�9
Proposed Wastewater System Type: °io Uc;—,
Projected Daily Flow: o GPD
Number of bedrooms: 3 Number of Occupants: �O 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 feet
Permit conditions: _
Permit valid for:
Five years
❑ No expiration
Authorized State Agent: ��- Z&O,5 Date: !i '�)a— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issr cf 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 Improve ent 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: \A° rs
PROPERTY LOCATION:
SUBDIVISION :vc.0, N 11 N I LOT # 1S
Facility Type: �' a' � -K New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes _X No
Type of Wastewater System" a's ®zd U GC �G A 'S S-Y 51 -�—in (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
2.,'5' °1cs ��- UC�.tc1,r•1 �Y.s�G� (Repair)
Installation Requirements /Conditions Number of trenches 2�.
Septic Tank Size t 4 O ® gallons Exact length of each trench '?,)d feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: _V inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover: G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
* *If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is suble ocation if the site Ian, plat, or the intended use changes. the Construction Authorization shall not be transferred when there is a change in ownership of the site. Ihts
Construction Authorization is subject- ycompliance hry�he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: N % 9—c--)A5 Date: 1) )a
ction Authorization Expiration Date: IN ar.
HTE #
Harnett County
Permit #
Department of "tiblic Health
Site S hetc
PROPERTY LOLATON:
ISSUED T0: Est SUBDIVISION Ci0 N LOT # 1
Authorized State Agent: Q(--06 (tLW & i Date: 1A-;L6I �—
)01
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: ti Property Recorded:
Water Supply: ❑'Public❑ Individual ❑ Well
Evaluation Method Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑. 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
S
t"J
c
1
\
t
i
j q
.v
"�
�_' S
• ' tl
�)7 `
5 1 1
'Fn `' >) )lP
S,S
Description
Initial
SysteAl
Repair System
Other Factors (.1946):
Site Classification (.1948):5
Evaluated By: C",
Others Present: —
Available Space(. 1945)
System Type(s)
5'" +i 5`
=
Site LTAR
a
S