IPACHTE# i3 -5`30% Harnett County Department of Public Health
Improvement Permit 27365
A building permit cannot be issued with only an Improvement Permit
,r� /� PROPERTY LOCATIO : 1/�/'i 5 el0(3 ) 0
ISSUED TO: 55�! � 21 &L SUBDIVISION LOT # Z/
NEW C' REPAIR ❑ EXPANSION ❑ Site Im rovements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: 25-91 (Zr-- 474,)
Projected Daily Flow: 366 GPD
Number of bedrooms: '3 Number of Occupants: k2 max
Basement ❑Yes No
Pump Required: es ❑ No ❑ May ybbe-required based on final location and elevations of facilities
Type of Water Supply: El Community E7 Public ❑ Well Distance from well feet Permit valid for: 0 Five years
Permit conditions: ❑ No expiration
Authorized State tint:: Date: q ° 1 �_ SEE ATTACHED SITE SKETCH
The issuance of this permit b e ealth 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 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: 3 L A Z C_ ( C.— PROPERTY LOCATION: Alliq 2 /s 6103 /Zb
SUBDIVISION Ina-,-,&)6i;,-1 �' t` LOT #
Facility Type: Ft 0"'New Expansion Repair
Basement? ❑ Yes Cf No Basement Fixtures? ❑ Yes EN o
Type of Wastewater System ** � fjn,4r) 2� F- LA 2,C (Initial) Wastewater Flow: :� GPD
(See note below, if applicable ❑
U- (Repair)
Installation Requirements /Conditions Number of trenches 3 _
Septic Tank Size % gallons Exact length of each trench feet Trench Spacing: Feet on Center
Pump Tank Size / cz), C-> gallons Trenches shall be installed on contour at a Soil Cover: 4� inches
Maximum Trench Depth of- i It 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
Aggregate Depth:
Conditions:
WATER LINES (INtLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
2., inches above pipe
12— inches total
* *If applicable: /understand the system type speciTed is different from the type specified on the application. l accept the specircations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site Dlan, slat, or the intended use chanties. The Construction Authorization shall not be transferred when there is a chance 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
r
Authorized State A Date: 14 —3-1—
Construction Authorization Expiration Date: -11-3-116
Authorized State
,411 Z
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: t -, —3
Proposed Facility: C � Design Flow (.1949): 9G2c
Location of Site: Property Recorded:
Water Supply: Individual ❑ Well
Evaluation Method: 0"' Anger Boring ❑ 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
% J
F . C«
j
Z_
g
l
. v
t
L
�1
3&
L" ., jz
X' 1J_
Initial
S stem
Repair System
Other Factors ( 1946):
Site Classification (.1948):
Evaluated By: v,
Others Present:
Available Space (.1945)
System Type(s)
U
Z
Site LTAR
7