IPACHTE# !)'~-~5--23HV Harnett County Department of Public Health 2 5 7 0 5
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
j~ { PROPERTY LOCATION: /5~3 f.3~-((
ISSUED Tf) (11~►IVYt SUBDIVISION LOT #
NEW ~j REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S15b
Proposed Wastewater System Type:
Projected Daily Flow: 3t,,D_ GPD
Number of bedrooms: -3- Number of Occupants: max
Basement ❑Yes IQ'No
Pump Required: ❑Yes ❑ No Cy be required b on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public 14 Well Distance from well feet Permit valid for. f4 Five years
Permit conditions: ❑ No expiration
Authorized State Age ~/~~(R Date: Z 3 oc) SEE ATTACHED SITE SKETCH
The issuance of this permit by th Ith 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 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 taws 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 It ISSUED TO: Kew /It- 14 1 rye e s PROPERTY LOCATION: JY -5763 l3 -:A ~.c., IZ6
SUBDIVISION LOT #
Facility Type: 5 New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes [K NO
Type of Wastewater System' ZS'~/b =--bur QyJ ;511-5 4.0-- (Initial) Wastewater Flow: 4.0 GPD
(See note below, if applicable
?S °6A (Repair)
Installation Requirements/Conditions Number of trench (s Z-
Septic Tank Size /DbO gallons Exact length of each trench / rl? feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. Z" inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: / Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
Z inches above pipe
12- inches total
**If applicable: / understand the system type specired is different from the type specified on the application. / accept the speciecations of this permit.
Owner/Legal Representative Signature: Date:
um Lumirucuun eumonzanon is suDfect to revocation if me site plan, plat, or the intended use changes. the Lonstruction Authorization shall not be transferred when there is a change 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
Authorized State
Date: P-23 -,D`3
Construction Authorization Expiration Date: //-23-1V
HTE # C6-'5-- Z3 i -7Lt Permit # Z 5'7 0
Harnett County- Depa;rtlnent of niwic nealth
Site Sketch
PROPERTY LOCATON: ;~Vt 15-73 41 / !!t°.tw
ISSUED TO: _ ~.3h3 :~F-(~. ~r /t7j!nlp_:5 SUBDIVISION LOT #
Authorized State Age zznx--Onl Date: Ll-.27 3 y0
&57A-ca/-- 2k%-
:6 -W 10C) `0W- 0,C
Well
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WAS'T'EWATER SYSTEM
Owner: Applicant: T-5 I" ~ I 1-17-0'7 - 1 /-9-0 )
Address: Date Evaluated.
Proposed Facility: Design Flow ( 1949): NO
Location of Site: Property Recorded:
Water Supply ❑ Individual Well
Evaluation Method: 9111-wage uger Boring ❑ Pit ❑
Type of Wastewater ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
cut
Mixed
P
R
O
F
1
940
OIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
M
.
l.oAmps
Position/
slope %
Horizon
Depth
(hr.)
.1941
Sbuch"
Tubse
.1941
Consistence
Mineralogy
.1941
soil
Wetaassl
Color
.1943
Soil
.1936
Sal"
Class
.1941
Ream
Horiz
Profile
Clan
LTAR
/
L
a - z rf
5~
&41L~
Ly o
s=L
W
2
Lr
a-Z~
SL
~L
Description
Wial
s em
Repair System
Other Factors (.1946k
Site Classification (.1948y:
Available Spy* C 1945)
V
Evaluated By: T1- ° 0r r DN
Type(a)
'°L.
Odm Present:
Site LTAR