IPACHTE# 13.5- 303 Harnett County Department of Public Health
hDrovement Permit 27270
A building permit cannot be issued with only an Improveme t Permit
PROPERTY LOCATION: ®off
ISSUED TO: rVc e 40 SUBDIVISION 0 K Mcn 14—T LOT #
NEW)< REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 56"O (LA
Proposed Wastewater System Type: ° o DW-1oucv l0QN
Projected Daily Flow: Li l 0 GPD
Number of bedrooms: 4 Number of Occupants: � max
Basement []Yes 'K 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 L00 feet Permit valid for: XFiye years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: ?a J N91 ) � SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit holder is rnsible 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, .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: m,�YzE 1i c rre-,-) PROPERTY LOCATION: ®mss go
�y �,n5 SUBDIVISION Q)�A xrwd ri• LOT # 12S
Facility Type: Q i, New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes � No
Type of Wastewater System ** QL5 cZcr 9--C-0 Q VC 0 t t (Initial) Wastewater Flow: 480 GPD
(See note below, if applicable ❑)
c� ®�o
Installation Requirements /Conditions
Septic Tank Size 10 Q GG gallons
Pump Tank Size 1000 gallons
Pump Requirements: ft. TDH vs. _
'RI'DV C<, \o rJ (Repair)
Number of trenches 1
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1$ ' 30 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
_ GPM
Trench Spacing: � Feet on Center
Soil Cover: (�' inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: �--'! o\i"1 �d ��% G �FS?'la EO H�tJ Lvi 1s inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: /understand the system type pacified is different from the type speciled on the app lication. / accept the specifications of this permit.
Owner /Legal Representative fS gtfatux - _ Date:
This Construction Authorization is subject to vocation Z,3 s Ian, plat or the intended use changes. The [ onstruction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is compliance he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
[[Authorized State Agent: QL; Date:
on ction Authorization Expiration Date: 1�
HTE # Vl— Permit # XYZO 0
H(arnett County I)epailment of Miblic He(alth
Site Sketch
PROPERTY LO(ATON: 0006 QD
ISSUED TO: M -Wo T'C'&_5 SUBDIVISION C>vvr sog—1 LOT # V3,
Authorized State Agent: o Date:
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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: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: .Public❑ Individual ❑ Well
Evaluation Method Auger Boring ❑Pit [7 cut
Type of Wastewater:t 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
(1n.)
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
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C
os
Z)S-
Description
Initial
S ste
Repair System
Other Factors ( 1946):
Site Classification (.1948): i°j
Evaluated By:
Others Present:
Available Space( 1945)
System Type(s)
as--)a iZ
-.9
Site LTAR
_] 1
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