IPACHTE# Q J-= -Z :311 ~ Harnett County Department of Public Health 25802
Improvement Permit
A building permit cannot be issued with only an fI ~provement Permit
PROPERTY LOCATION: f c std10-r0SC, Zci
ISSUED TO: _~sr a.c.~ wCC,t- SUBDIVISION
~-C I'azr LOT # (Y~
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S~
Proposed Wastewater System Type: ),S" e-1y-_+S;, Av'1 _
Projected Daily Flow: ,36 L GPD
Number of bedrooms: J Number of Occupants: max
Basement ❑Yes iAo
Pump Required: ❑Yes [;'lo ❑ Maybe required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Ind' Public ❑ Well Distance from well feet Permit valid for. L'7 Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: in5yy s c.~ / Date: !~,7Q/Z_c0 SEE ATTACHED SITE SKETCH
The issuance of this permit by ealth Depatmnt 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 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, .1959, .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. f~
ISSUED TO: __7 ' s, Z-J cc-,f PROPERTY LOCATION: y can Je .~~i.
SUBDIVISION Cc ra / f a /-a, r LOT # ~l
Facility Type: J~ mew ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑~'No Basement fixtures? ❑ Yes 0 No
Type of Wastewater System** ,Z S'y Zed v J, J lj4c,.. (Initial) Wastewater Flow: GPD
(See note below, if applicable
p 6 PJ_ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /000 gallons Exact length of each trench VO feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 2 Yinches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Pump Requirements: ft. TDH vs. GPM
Conditions: !Ic
/6
Q, F Ne1,14-ri'hVA-z c.
-fl-,
inches below pipe
Aggregate Depth: inches above pipe
inches total
rc~c , ec Grtr, f`~ ✓ `~ts r•c! l ~C>_ o Q
If applicable: / underrtand the ryftem type specified is diNerent from the type rpecided on the app/ication. / accept the peciflcationr of thin permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject 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
unruruuwn aumonzauon 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 Agen Date:
Construction Authorization Expiration Date: J °Za/
HTE# o ~I-S--~~~ cl Permit # ~S-TC 2
Harnett County Depaz1ment of ll~ blic Health
Site Sketch
PROPERTY LOCATON: &lLc- --j-eTe,. .
ISSUED T0: rQ.~ C aJ c J SUBDIVISION LOT # t
Fir
Authorized State Agent Date: 0 6X0 4
E
t
is
a
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7
uepartmenr ul CtIv11U11111Ci11, 17Cdilt 1, d11U NdWldl r\UbUU1Leb
Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ )d'ubiic (J Individual
[ j AAyger Boring
[J"Sewage
JI ICCI.
Property ID: 1
Lot
File
Code:
Applicant: f
Date Evaluated: !rd
Property Size:
Property Recorded:
[ ] Well (J Spring [ ] Other
(j Pit (J Cut
[ J Industrial Process Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
I
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942 .
So#
Wetness/'
Color
.1943
So#
Depth IN.)
.1956
Sapm
Class
.1944
Restr
Horiz
Profile ,
Class
& LTAR
, f
f
CJ6'~
Description
Initial Sys 'm
Repair System
Available Space (.1945)
/
System Type(s)
a
rv (o
Site LTAR
Other Factors (.1946): _
Site Classification (.1948f,>_
Evaluated By:^
Others Present: