IPACHTE#«g Harnett County Department of Public Health 2 5 2 9 7
Improvement Permit
A building permit cannot be issued with only an Improvement Pe t
rcti ~c(.
i PROPERTY LOCATION: S'9 I Z0 t 7. Jk 4-r0
ISSUED T0: SUBDIVISION C0.,6 G .o. J--o-ft t% .f LOT # 4 q
NEW 2" REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: `f6
Proposed Wastewater System Type: f ,j~'P f o c o.ti~ : ow~Q
Projected Daily Flow: -3 6 GPD
Number of bedrooms: 3 Number of Occupants: G, max
Basement ❑Yes RIO
Pump Required: ED < ❑ No ❑ MMaa be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community l~ Public ❑ Well Distance from well feet Permit valid for. Pliye years
Permit conditions: ❑ No expiration
Authorized State Agent.: c Date: ~ oa SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance 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 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..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .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: C~.M ~OU l or+c~ o.~~ PROPERTY LO ION: S`t /za
SUBDIVISION a.ro (,.,c, ,-~Gc S- t 1,r LOT #
Facility Type: -~FQ Er New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ o
Type of Wastewater System** -Fo /.-p (o (Initial) Wastewater Flow: -T o GPD
(See note below, if applicable
Z° -4~ 4o 92s 1y eel 4.4. - cl-- (Repair)
Installation Requirements/Conditions Number of trenches /
Septic Tank Size ZOO Q gallons Exact length of each trench feet
Pump Tank Size /000 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: .2 el inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
1`
Conditions: c-4 Q /L • S; A f f c3 r_ t I n s L (t ,,..t
Trench Spacing: 9 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
~c inches below pipe
Aggregate Depth: inches above pipe
1 inches total
**If applicable: l 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 revocation if the site 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 subject to compliance with the 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: a--. Date: 2f~ q
Construction Authorization Expiration Date: J` -7 t f Y
HTE# 0 `1-J-- X15-18 Permit # -f'~L g 7
Harnett County Department of F' iblic Health
Site Sketch
PROPERTY LOCATON: l~ IJ° / I AaR-,' Qfo- /Cj-
ISSUED T0: SUBDIVISION ZI; V, All, J~ ZJV, LOT #
Authorized State Agent: U /C J,- Date:
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Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON,-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[--Sewage
[ }-Public ( J Individual
( )'4 er Boring
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated: fs'~~ 9
Property Size:
Property Recorded:
( ) Well (J Spring Other
[ J Pit Cut
(J Industrial Process (J Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
.1940
Landscape
Position/
S"%
Horizon
Depth
IN.)
1941
Stricture/
Texture
.1941
Consistence
Mineralogy
.1942
Sol
Wetness!'
Color
.1943
Son/
Depth IN.)
.11956
Saproi
Cis"
.1944
Restr
Horn
Profile ;
Class
& LTAR
&
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Aj ,o
2.1~ r
Site LTAR
Other Factors (.1946): _
Site Classification (.1948): f
Evaluated By: &,-l
Others Present: or