IPACHarnett County Department of ublic Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:'GCZO 1 e�wE2
ISSUED TO: 2�pt2fl�SJ CV rnM�ea6 -s SUBDIVISION ® LOT #
NEW REPAIR ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '57-0
Proposed Wastewater System Type: �:5°jo�l26oyc.-, i sa Syg ;CSr,
Projected Daily Flow: `5r®® GPD
Number of bedrooms: 3— Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes N No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t00 feet
Permit conditions:
Authorized State Agent:: :�! Z&
The issuance of this permit by the Health Department in no way guarantees the issu
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Permit valid for:
Five years
❑ No expiration
1` Date: t1 �a ��V1, SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
vtt Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: C-Umcn IN445 PROPERTY LOCATION:
SUBDIVISION LOT #--3
Facility Type: g� S� X New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** a. "fib ucr� t o� Y�-5�rn (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
a.S'h K -Z9C;;1oss 5-951-'fn (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size t O ®® gallons Exact length of each trench 5®
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: �' 3
(Trench bottoms shall be level to +/ -I/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
feet Trench Spacing: Feet on Center
Soil Cover: S� a� inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
* *If applicable: / understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit
. permit.
Representativ Si nature: Date:
This Construction Authorization is subject to re on if the sit plan, 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 s4i compliances th ion f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: R Date: » 46 1a
ruction Authorization Expiration Date: V\ %—M
HTE# Y�-- 5- 30O (al-4I
Permit #53�.
Harnett County Department of I-�iblic Health
Site Sketch
PROPERTY LOCATON: 0-w62?b
ISSUED TO: M\N4.5 SUBDIVISION LOT # 3
Authorized State Agent Date: t�
M
M
r"` °c 'D `T ow6SL '9�0
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):6 _ `k
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method:' AugeqBring ❑ Pit ❑ 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
j
5`7
"3�
5
,3 Nt
%,.05
L a04
5
3
vY'2
S
Description
Initial
S st
Repair System
C
Other Factors (.1946):
Site Classification (.1948):.-`
Evaluated By:
Others Present: 1
Available Space (.1945)
System Type(s)
d-S' 1
UP
Site LTAR