IPAC RHTE# )i o--~-a sp Harnett County Department of Public Health 2 f 01 0
Improvement Permit
A building permit cannot be issued with only an Improvement P rmit
PROPERTY LOCATION: QC✓ a,-1
ISSUED T0: GvM~En , p.ND nUrh N L SUBDIVISION MN2E- P.s~\ LOT # _
NEW
X VV REPAIR E NSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~5~ <54"
Proposed Wastewater System T}ype: Q vrr~d ~ a EZ
Projected Daily Flow: 3I O GPD
Number of bedrooms: Number of Occupants: 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 feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: w aS Date: w 7 lb SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu of other permits. The permit holder i 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 .1958, .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 `l
ISSUED T0: CUrY1f'~Cf2 LA..tr~ 1~~, l~C~ PROPERTY LOCATION:
SUBDIVISION S`t1~2L p~tvL~~ LOT # sq_
Facility Type: SSK~5_a-",6- New ❑ Expansion ❑ Repair
Basement? ❑ Yes I, No Basement Fixtures? ❑ Yes _X No
Type of Wastewater System** Pv m~ \ a a~°10 oyUSS4 (Initial) Wastewater Flow: _ GPD
(See note below, if applicable
YU n~7 o r~)So/a UCC 6 W (Repair)
Installation Requirements/Conditions Number of trenches y
Septic Tank Size Lo c-*, C-) gallons Exact length of each trench ~-)bfeet
Pump Tank Size O oD gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: I 'inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: -i-u_1% aF G~ Of coy6'rt• NE6AZS4_-:, 0VG-a O
Z N g 5-; tat: f t1d t~ S ~-c'G 5v5TG, t-N S 1k~ 5
ec3 c_. C41 .4tis fso, L
Trench Spacing: Feet on Center
Soil Cover:nches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
R~E2 L`~tE inches total
**If applicable: / anderstdnd the system type specified is different fiom the type specified on the application. / accept the rpecifcationf of this permit
Owner/Legal Representative Signature:
This Construction Authorization is subjecttoto_rrevocation if the
Construction Authorization is subiect m r_mm~liaTh,,.wiR4
Authorized State Agent:
Date:
plat, or the intended use changes. The Construct on Authorzation shall not be transferred when there is a change in ownership of the site. This
%Lllaws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
t2 Gt ~5 Date:
Authorization Expiration Date: ' 11-71
HTE # LQ W5 Permit #
Harnett County Deparfinent of 1'iiblic Health
k' ite S ketch
PROPERTY LOCATON: ~ ~",Cj
ISSUED T0: Cv< sp MG SUBDIVISION
LOT #
Authorized State Agent: ~~tiv i dL~C Dater ~C
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Department of Environment, Health and Natural Resources
Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
SOIIJSITE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Code:
Owner: Applicant:
Address: Date Evaluated: 31 6) ► 6
Proposed Facility: 3 Design Flow (.1949): 3 ~o Property Size:
Location of Site: Property Recorded: 11 )V1 Water Supply: Public ❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
t
P
R
O
F SOIL MORPHOLOGY
I
1940
OTHER
.
.1941
L Landscape Horizon
PROFILE FACTORS
1942
E Position/ Depth .1941 .1941 Soil
# Slope % ft) Structure/ Consiste
.1943 .1936 .1944
Profile
nce Wetness/
Texture Mineralo Color
45
Soil Sepro ReW
IN. Class Horiz
Class
& LTAR
'
c.-v C6-)6
°~'ia 6' S3Y u4 ~1 S~~ 5Q ►G 1 23~} 4
a d Nf
`53y- scL IF -L 55~ 5P 16y2 ~~71C°i `0
US
3 0-~ G s V~,t
-5 sl~p
Description initial Repair System Other Factors (.1946):
Available S cc .1945 S stem Site Classification (.1948):
S stem s Evaluated By:
Site LTAR Others Present: