IPACHTE# 1a =3a-°1 arnet County Department of u lit Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: NC%a.'l
ISSUED T0: �P+�IECL �Ot�.F s SUBDIVISION 1 SaGC;r! Sax G LOT # N3 )
NEWW--�< REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: r-� seit 14b V Cri a m S 7 t,-3 ax",
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement [--]Yes -'8� 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 10 D feet Permit valid for: XFive years
Permit conditions: ❑ No expiration
Authorized State Agent: `� '��r+5 Date: i I El' 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee lance of 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 rovement 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..
* *If applicable: /understand the system type speciled is different from the type specified on the applicatiom l accept the specifications of this permit.
Owner /Legal Representative Sjgna Date:
This Construction Authorization is subject to revocation if the s a , t, 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 3s ' t to compliant t r ns fit nd Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: _
Construction orization Expiration Date:
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: 0 71+ 6
PROPERTY LOCATION:
1
SUBDIVISION N
0 ) NNC- LOT # 13 i
Facility Type: SGT CL� "� C-s3J
New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement
Fixtures? El Yes No
Type of Wastewater System ** `a� °I a
� vcs5 h 4N I5 ; ��
(Initial) Wastewater Flow: d GPD
(See note below, if applicable ❑)
Z
Z 5% RC-Z
?v !L O
y (9 (Repair)
Installation Requirements /Conditions
Number of trenches 1
Septic Tank Size 10 O Q gallons
Exact length of each trench la 6 feet
Trench Spacing: C)i Feet on Center
Pump Tank Size Loo0 allons
Trenches shall be installed on contour at a
Soil Cover: ':�A° T- inches
Maximum Trench Depth of: 3 --cN 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
inches below pipe
(onditions: �> uf- FLu±e,ati N Q �.5
_
S? ��LLOW *,Xs (�ass\?ILZ- e 4
Aggregate Depth: inches above pipe
�v 0 inches total
r, % 9 shrog .
).p
* *If applicable: /understand the system type speciled is different from the type specified on the applicatiom l accept the specifications of this permit.
Owner /Legal Representative Sjgna Date:
This Construction Authorization is subject to revocation if the s a , t, 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 3s ' t to compliant t r ns fit nd Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: _
Construction orization Expiration Date:
HTE#
Permit # r --�l —C�,Sl 5-
Harnett Count
y Department of Public Health
Site shetch
PROPERTY LO(ATON: N C�--1
ISSUED TO: SUBDIVISION Gcvj vol,� LOT
Authorized State Agent: ®L-`V-"DC, Date:
i
C cam.
23 1:,,
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:', a t'a�7QF3 Design Flow (.1949):0
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual El Well
Evaluation MethoC or g ❑ Pit ❑ Cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
SOIL MORPHOLOGY
.1941
Horizon
Depth .1941 .1941
(In.) Structure/ Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
e V^V
`,• S
Q
Description
Initial
System/
Rep it System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: —
Available Space (.1945)
V
System Type(s)
Abo
e V^V
Site LTAR
Q