IPACHTE# Harnett County Department of Public Health 2 6 a 0 9
Improvement Permit
A building permit cannot be issued with only an Im rovementPer(~it
PROPERTY LOCATION: '
N~7.~ 7J
ISSUED T0: -C0 m LPwD c~tr > 1N L SUBDIVISION _ M \2~ bj gttw y\ LOT # _
NEW, REPAI~❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S tt'I Lq -A L4
Proposed Wastewater System Type: `a,5% ~Enc~c.~0 ~.t~y j 5 c•.
Projected Daily Flow: 3Gd GPD
Number of bedrooms: Number of Occupants: !21 max
Basement ❑Yes eKNo
Pump Required: ❑Yes El No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well LOO
feet Permit valid far: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 1 lO SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o e fs. 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 Permi 1 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, .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
ISSUED T0: Cu .,P~~tLC~, ►fl \~dr^LS ~N C- PROPERTY LOCATION:
5~ SUBDIVISION M ~Cz G ~c~.t~G~r\ LOT
Facility Type: j --N New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'K No Basement Fixtures? ❑ Yes No
Type of Wastewater System** a-S% P, EOc-< d S~1S-St✓c~ (Initial) Wastewater Flow: oD GPD
(See note below, it applicable A) "IS
'RF
uD>J S-y
.sC)
5,~ m (Repair)
Installation Requirements/Conditions
Number of trenches 1
Septic Tank Size L 0 ,0 D gallons
Exact length of each trench 2 3` feet
Pump Tank Size 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: \JprTsn- S -x r L
zY,~c It; VQOr, 1ErP'T1~
1\ a
Trench Spacing: 9 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
gate Depth: inches above pipe
es inches total
**If applicable: / mnderstand the system type specified is different from the type specified on the app/ication. / accept the spec1f2m1onr o/ this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocon if th ,site n, t 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 ompliance wit prop s ws Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
'T
Construc ' uthorization Expiration Date: 4 ~
HTE# Permit # '2~6C)C)~
Harnett Cotint}-7 Department of 1' iblic Health.
Site Sketch
PROPERTY LOCATON: C,~l
ISSUED TO: C c~ iJ SUBDIVISION C'1t~2C ~ ~ LOT #
0 r ter
Authorized State Agent: Date: lC
C3 (Lo t~
o fl
R t~~ C, N 0 r,l R
I'}
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOIUSTTE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Date Evaluated: 3f ► c) o
Proposed Facility: 3 Btu: ~~~f, Design Flow (.1949): 3c6
~P
Property Size:
Location of Site:
Property Recorded.
Water Supply:
Public ❑ Individual ❑ Well
❑ Spring ❑ Other
Evaluation Method:
Auger Boring ❑ pit ❑ cut
Type of Wastewater:
Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
I
SOUL MORPHOLOGY
OTHER
L
.1940
L
d
.1941
PROFILE FACTORS
E
#
an
scape
Position/
Slope %
Horizo
Depth
(In.)
n
.1941
SW
n
w
.1941
.1942
Soil
.1943
.1936
.1944
Profile
c
u
Texture
Consistence
Mineralo
Wetness/
C
l
Soil
Sapro
Restr
Class
o
or
IN.
Class
Hortz
& LTAR
5
Cr-6
G 5
v~L ~NQ
S
V-1 5 ) P
M 1~
05
~,x
s
Y
b S
d
r-N
U S
%4 PL iz, INC
i'1_'36
5~ ~ ~ cry- E'rL SS ~ S
P~
3G
P sr\
Description Initial Repair System Other Factors (.1946):
S st
Available S cc .1943
Site Classification (.1948):
S stem a
L o Evaluated By:
Site LTAR
Others Present:
C, _
(7 ~ a ' ~K 5r L Z s~ S IOw ~
L~L