IPACHTE# la- 5-3o_33.6 Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 4a,l
ISSUED TO: �AmF� W RC cam SUBDIVISION —7-1 \J tL,PkC. . LOT # �-
NEW 'ty X ' REPAIR 1 4PANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '10
c
Proposed Wastewater System Type:
Projected Daily Flow:
Number of bedrooms: 3
Basement [--]Yes � No
-
l)XnC
GPD
Number of Occupants: max
Pump Required: ❑Yes -5k No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community , K Public ❑ Well Distance from well litQ feet Permit valid for: Five years
Permit conditions: �_ 11 ❑ No expiration
Authorized State Agent:: \, 4L^'YNS Date: 't I 10 ilk SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan other permits. The permit holder is re onsible 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 Improvern-ANPerunit 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: �P�+h�" P�GC.iFS2 PROPERTY LOCATION: 4al
SUBDIVISION LOT #
Facility Type: 57,11 "x`7 New ❑ Expansion El Repair
Basement? ❑ Yes `U, No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** ��° o �GSJUG,-,Nn I (Initial) Wastewater Flow: 316 Q GPD
(See note below, if applicable ❑)
-'- �-G�UC;`�10w (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size 10 Cc:!) gallons Exact length of each trench 4 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: \1 °a� inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 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 application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to rev_ocfttiiL the to 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 su*�" compliance 'th tPlai tthe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: \ ' a0 Date: 1 $ 13
Con uction Authorization Expiration Date: 7 l5 t�
HTE# 1;-" 5 ° -3033L
ISSUED TO:
Authorized State Agent:
Permit # `�S 5 1� S'
Harnett County department of Miblic Helalth
Site sRetch
PROPERTY LOCATON: `-�-.�, I
-�- SUBDIVISION �� icizA 1:) t Q,- i6 F- LOT #
Date: 1 ) 5��3
rX-.
j I kaA).
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: 3gBoan'� Design Flow (.1949): jbt'j ,1
Location of Site: Property Recorded:
Water Supply: ` Public❑ Individual ❑ Well
Evaluation Method: Auger B ring ❑ Pit ❑ Cut
Type of Wastewater: a 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
>
try
3Ei
::s ? 56-i
��
53K. 0
a
-7 C�
3
0 -30
C 52
,
30-q o
G 2,1(Q
e5,
L10
sB V-1 s&.I—
6e4_,,
�5�P
Description
Initial
Systerfi
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:'j,
Others Present: —
Available Space(. 1945)
System Type(s)
J
Site LTAR
S