IPACHTE# 'S C)G� 0, C, Harnett County Department of Public Health
Improvement Permit 27404
A building permit cannot be issued with only an Improvement {Prmit
nn PROPERTY LOCATION: ti"',cr1A*a
ISSUED TO: CZ V \'r "i P��` t-Q N t" �s� y Co SUBDIVISION CKioss,"A G LOT # �
NE"� REPAIR ❑ EX NSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �L; 6-7"'; -
Proposed Wastewater System Type: 2���10 �-� td� t ct.rfy'�-
Projected Daily Flow: L16 (Z) GPD
Number of bedrooms: 4 Number of Occupants: `� max
Basement []Yes XNo
Pump Required: ❑Yes cNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well 1 ®® feet Permit valid for: ,Five years
Permit conditions: El No expiration
Authorized State Agent:: ��. ��`` �=� Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan ier permits. The permit holler 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 rmit 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 Permio
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 T0: Scau; E�,s�� -�N �Q'CQL—SU)CS PROPERTY LOCATION: t��)
C
SUBDIVISION Q t ���r� CsS�,v LOT #
Facility Type: 5 e'Q `°��� >K, New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes �No
Type of Wastewater System ** Q_ j °J'J (DJ c..S-) a N may- >' 5 (Initial) Wastewater Flow: 4Z ® GPD
(See note below, if applicable ❑) f
S o �,, P 0C;'C' � lz5 12 (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size �- O d 0 gallons Exact length of each trench to feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: ':;� inches
Maximum Trench Depth of- `� 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: S Z-C S G 5 �`�G� �d Q_ >, o i Q )Qs 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: l understand the system type speciled is different from the type speciled on the application. / accept the specilcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect_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 s 2i_ compliance w uA�df s and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �\�� �y��\\5 Date: 3_ e) �3
Authorization Expiration Date:
HTE # 13 — 5 N (, Permit # ai LA 0
Authorized State Agent: (.0 L GJ-1 Date:
-* Kl--L S\Jaq-,C.,e-
NC) PC)pj r
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00- S U
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: to gVLV\ Design Flow (.1949):'A�1
Location of Site: Property Recorded:
Water Supply: XPublic❑ Individual ❑ Well
Evaluation Method'( Auge Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
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
1
-
(Or )3
6
'Li`b
-`�
s)�
to�1 / /�(,�
X53
i
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification ( 1948):
Evaluated Bye;
Others Present: 8A
Available Space (.1945)
System T e(s)
� 7 r Qf
D
Site LTAR