IPACHTE# Q9-5 Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: "~,-ty
ISSUED T0: "t~-L_o L C~ ~ 1 SUBDIVISION
LOT #
NEW A REPAIR ❑ KPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S`c n - S0
Proposed Wastewater System Type: (Lo v-,i v°~~ t) r-4 t>,G_
Projected Daily Flow: (~2 (~_)o GPO
Number of bedrooms: 5 Number of Occupants: 10 max
Basement ❑Yes X No
Pump Required: ❑Yes '1< No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community *X Public ❑ Well Distance from well NM feet
Permit conditions:
Permit valid for. A Five years
❑ No expiration
Authorized State Agent: 2 Date; SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance 4! rr permits. The permit holder is responsib a 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 taws 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: \ IA20'w C t` sZc~c l PROPERTY LOCATION: tw~t ~
SUBDIVISION LOT #
Facility Type: ~40~xOZ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System**
"'J -r_; \ r-t
(See note below, if applicable
~ v E-" "a N (Repair)
Installation Requirements/Conditions Number of trenches 5
Septic Tank Size %`~6C~5
gallons Exact length of each trench 5d feet
Pump Tank Size
gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z-A--3b inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements:
ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow: (~,C5 O GPD
Trench Spacing: Feet on Center
Soil Cover: ! inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
C inches below pipe
inches above pipe
f inches total
**If applicable: / understand the system type Specified is different from the type specified on the app/ication. / accept the specifmmionr of this permit
Owner/legal Representative Signature: Date:
This Construction Authorization is subiert r&dBYnr]tinn if rho j, ~1- I,i~r hc +e~ave n e A-- Tk. r . ...II
i ~ -~~-~~p--~ n... u~ uuna~~,~cu nncn Vlclc a c,l c 111 UnIICI )111 UI 111C )IIC. 1111)
Construction Authorization is t~compliance si~t ions a laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
25566
Authorized State Agent: Date: '7 MW I
Cons tion Authorization Expiration Date: 1
HTE# Permit #
Harnett County Department of l_l~tblic Health
Site Sketch
PROPERTY LOCATON: ~)wy `aj
ISSUED TO: %-Ag>&n, G ~F2~~N SUBDIVISION LOT #
Authorized State Agent
7
Dater C3~1
0(1 P~wDs
~ C Q rrv ~.t~' 3 U rr A L
2C.PMZCa..
3a ~ a~~A
5}~
33
rw~.
-y n'l~ o~ 3
ueparul etit ul CIIV❑VIII IItlIII, ritidltll, dllu IVdtuldi r\eluut l."
Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: - ..~_o,4Design Flow (.1949): 030cp~
Location of Site:
of met.
Property ID:
Lot
File
Code:
Applicant:
Water Supply: Public (j Individual ( I Well
Evaluation Method: Auger Boring ( ] Pit
Type of Wastewater: Sewage ( ] industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ j Spring
[ ) Cut
[ ) Mixed
[ j Other
P
R
U
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN-JA
.1941
Structure/
_ Texture
.1941
Consistence
Mineralogy
.1942 ,
Sol
Wetness/'
Color
.1943
Solt
Depth IN.)
.19813
Saps
Class
.1944
~ Re*
Horiz
Profile ;
Class
3 LTAR
(3
C, 5
v_~ j fag
S
Description
Initial System
52pair System
Available Space (.1945)
System Type(s)
C,0,
Co S)
ISite LTAR
Other Factors (.1946): _
Site Classification (.1948): j
Evaluated By:('~\
Others Present: -