IPACHTE# Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
\ PROPERTY LOCATION: ' t
ISSUED T0: SUBDIVISION O'+'TioL45 Y 0\,1`l LOT # �1}
NEWX REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:`��� {✓�'�
Proposed Wastewater System Type: a.S °l® QSIDUcss't4$i Sys —,t�M
Projected Daily Flow: L rte® GPD
Number of bedrooms: 4 Number of Occupants: $ max
Basement []Yes No
Pump Required: ❑Yes o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1100 feet Permit valid for: ,Five years
Permit conditions: ❑ No expiration
Authorized State Agent; \ Q.151—'T'4S Date: Qk 1--I- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees ante of other permits. The ermit older 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 inten ed 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.
1 i t'
Reauired 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: E3 zL CLw �A o "16s PROPERTY LOCATION: l s N sit 910,
SUBDIVISION Al.", 01y5 P o , SS LOT # Ltd
Facility Type: SAO -•'��� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes '�<No
Type of Wastewater System ** 0 �Ebvc�s ► 0 W (Initial) Wastewater Flow: d GPD
(See note below, if applicable ❑)
-6lz010 'Ru3uG' t01� (Repair)
Septic Tank Size L tJ 13 6 gallons Exact length of each trench 1 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. (-- inches
Maximum Trench Depth of: 11':o� —W4 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
* *If applicable: /understand the system type specired is different from the type specified on the app lication. / accept the specipcations of this permit.
Owner /Legal Representative Signature:
This Construction Authorization is subject to
of the site. This Construction�kdt tization is
Authorized State Agent:
Date:
plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
t,wkth the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Date: 1� l3 1
Construe uthorization Expiration Date: �a- ti3 1
H T E # Permit #
)S(3 ,
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: L., � YZ�)",±`\ Design Flow (.1949):L)JQ�r u
Location of Site: �` Property Recorded:
Water Supply: LJ Public❑ Individual ❑ Well
Evaluation Methodu er Bring ❑ Pit ❑ Cut
Type of Wastewater: 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
3pX
P
P5�
Description
Initial
S st m
Re air System
Other Factors (.1946): , ,
Site Classification (1948):
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
Site LTAR