IPACHTE# 09-S-a3aq-~ Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
25785
PROPERTY LOCATION: B~FPP La "<G ZP
ISSUED TO: ~ENr+Gi~j SUBDIVISION 7yE 'S .r r•~rn X7S LOT # t!53
NEVJX REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0( y3 '7
Proposed Wastewater System Type: C-t-vE r5 Vri p,l
Projected Daily Flow: 3~o GPD
Number of bedrooms: 3 Number of Occupants: C- max
Basement ❑Yes No
Pump Required: ❑Yes .No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well S Od feet Permit valid for: 1X Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: 5 Date: 01 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o rmits. 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 Pe hall 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: N ,E"" tv-C w Cv rncY•~~1 C,5 PROPERTY LOCATION: V F FAt✓ o ~--A`fE ~'D
SFD ('A3' SUBDIVISION LOT #
~
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System" Q o fV -1 ter: ~ y Ni 2!0 (Initial) Wastewater Flow: _ 3r O GPD
(See note below, if applicable
C-.. w"PCL (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size \ o CD co gallons Exact length of each trench 5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. Z.t-'~-30 Inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover. \a'4 NR inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: Aggregate Depth:
WaT~ti L\N~ 1'nvs-~ gf~ ~ ~a.t,r. S~~c S~ssEw.
{o inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type specified it different from the type peci6ed on the app/icatian. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revoca he site p lat 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 subject to complian th th ovisi the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: > 1 Date: t~
Construction uthorization Expiration Date: ~
HTE# Permit #
Harnett ('onnty Depar=tment of v,wic Health
Site Sketch
PROPERTY LOCATON: TSJF,~r P,i-0 LAYS
ISSUED T0: v Mr•» SUBDIVISION \ 1~ E S Jtr M 1~5 LOT # t 53
Authorized State Agent:
>y ~Ot~wE~z TOLi~~opCiy) Date: A
~y
~-pw 1N 6
N~5
C,ZRQ F1-1, Lo o P
Department of Enviromment, Health and Natural Resources Shed:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOILISITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):3 6 6 Property Size:
Location of Site: Property Recorded:
Water Supply: Public ❑ Individual ❑ Well ❑ spring ❑ Other
Evahration Method: Auger Boring ❑ Pit Cut
Type of Wastewater go ❑ Industrial Process Mixed
f f
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
L oWscape
Position/
Slope %
Horizon
Depth
(in.)
.1941
Shuch"
Te dun
.1941
Cooeistanoe
Miners
.1941
soil
Walden/
Color
.1943
soil
Depth (IN.)
.1936
Sol"
Clan
.1944
POW
Horiz
Protlle
Ciao
& LTAR
a-
L%
5
.sFn, ~l
S
Description
Will
System/
Repair System
Other Factors (.1946
Site Classification (.19487
Avad" Space .1943
Evaltmted By:
System
c'
C°'
Others Present: Pb A
SRe LIAR
• 9