IPACHTE# 12; Harnett tt t art nt of lic Health
Improvement er it
A building permit cannot be issued with only an Improvement Permit
`, PROPERTY LOCATION: B001-10F,C 00,
ISSUED T0: iN4L1 SUBDIVISION 71-16 5 UMm N-5 LOT # 1(n
NEW'X REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S`S0't1a0
Proposed Wastewater System T pe: �-SO1c �- CZuCrc )oN Sy'-
Projected Daily Flow: 1W0 GPD
Number of bedrooms: lA Number of Occupants: g max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community _X Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent.. �:NS D VA 1-7 ��- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees t uance of other permits. The permit lolder 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.
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 T0: 4� c�+?s�L-4- �� Orn�s �s�eC' PROPERTY LOCATION: UL C�C32-
S C--O Cs® x�0 "J SUBDIVISION i r SUnm,� LOT # 10
Facility Type: � New ❑ Expansion ❑ Repair
Basement? ❑ Yes '>V\ No Basement Fixtures? ❑ Yes X No
Type of Wastewater System" ZSY, �6QU vi�(3 aJ (Initial) Wastewater Flow: '-)il GPD
(See note below, if applicable ❑)
®lo 10 Uch> b,a, } (Repair)
Septic Tank Size C) Q gallons Exact length of each trench � x) 50 feet Trench Spacin Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. t -,Q inches
Maximum Trench Depth of: 1o'�Q 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
Aggregate Depth:
Conditions:
inches below pipe
inches above pipe
inches total
* *If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Date:
This Construction Authorization is subject1sreyocati Ian, 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 n is s ' to i he 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: 1l ai S.�
Construct Authorization Expiration Date: _ ) a J`1 is?
HTE# Permit #
ffiti-nett County Department of Public Health
Site Sketch
PROPERTY LOCATON: e>-*vi-ofirL i ,
ISSUED TO: %nMF- INC— SUBDIVISION ') FiG (Y\ LOT # 10'-)
Authorized State Agent: o Date:
I-
I
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: Vt 6 t jiXk51 Design Flow(. 1 1949): t'A 4 SO
Location of Site: Property Recorded:
Water Supply: >ublic❑ Individual ❑ Well
Evaluation Metho&:IkAuger Boring ❑ 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
i
ys
� ,
r
G'
�
r
y
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948)cr
Evaluated By:�
Others Present:
Available Space(. 1945)
1
System Type(s)
Site LTAR
rr