IPACHTE Harnett County Department of Public Health
Improvement Permit 27294
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 1 R.e-
ISSUED TO: SP%1g1 1y LL C,. SUBDIVISION \-'I LOT #
NEWWX REPAIR ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'S VO ( 5 ®" 6'
Proposed Wastewater System Type: Pv r-(J aS o* 42 o ; t a,rf (,-C- rase -"t.N�
Projected Daily Flow: Li%O GPD
Number of bedrooms: 4 Number of Occupants: max
Basement ❑Yes XNo
Pump Required:ves ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Su p�,, mmuni ty � Public ❑ Well Distance from well 1 � ® feet Permit valid for: Five years
Permit condition ❑ No expiration
Authorized State Agent::.
The issuance of this permit by the Health Department in no way guarantee ante
site is subject to revocation if the site plan, plat, or the intended use changes. The
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
7 Date: 3 1 1al L3 SEE ATTACHED SITE SKETCH
of other permits. The permit holdh is resbonsible for checking with appropriate governing bodies in meeting their requirements. This
Yemeni Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: _`�F',-V �"� n clas I._LC. PROPERTY LOCATION:
SUBDIVISION kEN1- LOT # _
Facility Type: S` 'o ��0 "r 6� LX New ❑ Expansion ❑ Repair
Basement? ❑ Yes '5�- No Basement Fixtures? ❑ Yes -KNo
Type of Wastewater System ** 9v r,e i o 3-677- f't C. ,��, ,c rr (Initial) Wastewater Flow: 4% 0 GPD
(See note below, if applicable ❑)
Qv +e a�°lo CEt� t N) (Repair)
Installation Requirements /Conditions Number of trenches .-
Septic Tank Size l WD o gallons
Pump Tank Size L ® 1b O gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench a4O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. -11-a14 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: S v 99 Ly �% LR- &1>o*1d �tS; a% LSD CLavN Lo- s 1 o Q �)s� S;', f t� inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: /under fond the system type specified is different from the type specified on the application, l accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject cation if the 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 subje " complianke with o ions the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 31 Na ,13
Authorization Expiration Date: 3
HTE# I —3 — S— �l S3, Permit # Q,-Iag-q
Authorized State Agent:
OR-k) 0 V) El—C)
F-- P6 5— f \ F— IT—,
Date: '3 1 ) mil I
1.9
I
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: % $®Q K,j Design Flow(. 1949): L%Q
Location of Site: Property Recorded:
Water Supply: �ublic❑ Individual ❑ Well
Evaluation Method- Auger Bortng ❑ Pit ❑ Cut
Type of Wastewater: 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
(In.)
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
l
0-L4�)_
G -s
V�1. ivSiNP
a
a
L
vim, tisl�tP
3g,
see sc.r,.
F�1 1,p
Description
Initial
S yste3p
Repair System
Other Factors (.1946):
Site Classification (.1948): QS
Evaluated By: <Z5�
Others Present:
Available Space (.1945)
System Type(s)
P>)rP 1 is
U sri4 o
Site LTAR
5