IPACHTE#10°1-~~4o Harnett County Department of Public Health 2 5 5 9 4
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ISSUED T0: Cv MP l2.t~Pnct~ t~pc•ti S SUBDIVISION _CNinL~ttp, SEoson,>
LOT # ro
NEW'K REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Sc~0 Q~5-AL't\ '
Proposed Wastewater System Type: Q~ n+e 1 o Co, ,rst T sorro,L
Projected Daily Flow: 3C O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well tC) O feet Permit valid for. ~ive years
Permit conditions: El No expiration
Authorized State Agent.: n Date: 8 11, 2z 4 O SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department it no way guarani 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. 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 TO: Cvm2Fiu-v,"y \A0cfN PROPERTY LOCATION: ?oc-O ~A5A V-is,
SUBDIVISION CAnot_.,r p, Stnso cu 5 LOT # Co
Facility Type: OLD^x New E] Expansion El Repair
Basement? El Yes No Basement Fixtures? E] Yes ~ No
Type of Wastewater System" ~oM-!70 Cor►4~tvs\ orJ o,i, (Initial) Wastewater Flow: 3~b GPD
(See note below, if applicable
vc~sC7 ►J (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size tvoo gallons Exact length of each trench O feet Trench Spacing: Feet on Center
Pump Tank Size ~o gallons Trenches shall be installed on contour at a Soil Cover. 1d-a~ inches
Maximum Trench Depth of. ' -3~ 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
Aggregate Depth: inches above pipe
Conditions: Pa4zRQ2 Fv.Li- ~ Q ~'„fN~ C 'J $E 0,)s NI l~ inches total
C`1 A~ Nc7s 6 ~ E.F~~
**If applicable: / understand the fvstem type specified it different from the type fpecided on the app/ication. / accept the speciflCd#onr of thif permit.
Owner/Legal Representative Signature: Date:
This Construction Aurhntintinn it mhiarf Hr--ti- if the
w, -51' -1 111- -full -1-11 auuoi snail not oe transterrea when there is a change in ownership of the site. This
Construction Authorization is abject to complian ith ,,ionhe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: PoN
Authorized State Agent: - QS Date: % a* o4
ruction Authorization Expiration Date: L-VLZ
HTE# 0:A -5--X~4-4 C) Permit # a55ct4
Harnett Count`T I)epartment of P blic nealth.
Site Sketch
PROPERTY LOCATON: Po N pC,rufy~
ISSUED T0: ~v rh .v a o M SUBDIVISION GAS OL1 N A SF_o>o,~ s LOT # ~o
Authorized State Agent: qsUILV4 E.~~Ta Lvts3o Date:
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUA'T'ION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: - ~ Design Flow (.1949): c
Location of Site: Property Recorded:
Sheet:
Property ID:
Lot
File
Code:
Property Size:
Water Supply: Public ❑ Individual ❑ Well ❑ Spring
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
❑ Other
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Minenlo
kv
.1942
Soil
wetness/
Color
.1943
Soil
Depffi (IN.)
.1936
Sapro
Class
.1944
Restr
Horiz
Profile
Chun
do LTAR
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se-i_.
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P5 , ~5
Description
Initial
S st
Repair System
Other Factors (.1946):
d
Site Classificati
1948
t
ce ,1943
on
E
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Sys
em Ty a
System
PU MP CCc.
va
uate
: O
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h
Site LTAR
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t
ers Present:
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