IPAC RRHTE# OJ- - J~~16Xk Harnett County Department of Public Health
Improvement Permit
25965
A building permit cannot be issued with only an Impil" 297~ ij PROPERTY LOCATION: ~ ( ~ t "(d.
ISSUED T0: k~~ S } Q. P~ fit` Cl SUBDIVISION C{r~~ LOT #
NEW
REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5-~y( =3 cr `
Proposed Wastewater System Type: o~Q~+ . k I'~~
Projected Daily Flow: _GPD
Number of bedrooms: Number of Occupants: IL max
Basement ❑Yes [moo
Pump Required: ❑Yes 12 o ❑ Ma be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well /CFd feet Permit valid for. P'Iive years
Permit conditions: ❑ No expiration
Authorized State Agent: c,. Date: SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health Department 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 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, .19S4, .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: C~t`~~5, p~/PROPERTY LOCATION: L-I~-ew
SUBDIVISION fl ` C all LOT #
Facility Type: -5- It- New ❑ Expansion ❑ Repair
Basement? ❑ Yes Fe~No Basement fixtures? Yes ❑ No
Type of Wastewater System * `yd cr~i~ :ate e~.. (Initial) Wastewater Flow:-36CJ GPD
(See note below, if applicable
'4, ct-.', f~vlt~r.. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /Q0_ gallons Exact length of each trench 000 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: /6 inches
(Trench bottoms shall be level to +/-1/4"
Pump Requirements: ft. TDH vs.
in all directions)
GPM
Conditions: A(,, &-k,.-A /=.titf c. - Q
1 ~lI a. 4- '~'r 17-9 D , s- c,.f K
d f;~.
-VV--
av % '->J CIA
Trench Spacing: Feet on Center
Soil Cover: - /Z inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
anderumd the system type specified is different from the type specified on the application. / accept the specifications of thu 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
Construction Authonzation 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
-14
Authorized State Agent-
Date:
~~l Q
Construction Authorization Expiration Date: G mad S'
NTE# 9- r- P2) 7l (k Permit # 12 5- 1~ r. 15-
Harnett County Department of Public Health
site sketch
PROPERTY LOCATON: t-la cI Id-
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent• .mac Date: Z°C
E
r~--l
Jul
J(2 /4y
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOI JSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: ❑ J tic ❑ Individual ❑ Well ❑ ❑ Spring ❑ Other
Evaluation Method: uger Boring ❑ pit cut
Type of Wastewater. Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
SOIL. MORPHOLOGY
OTHER
I
I
.1940
.1941
PROFILE FACTORS
.
Landacaps
Horizon
E
#
Position/
Slope %
Depth
(la)
.1941
Struct
/
.1941
C
.1942
Soil
.1943
.1936
.1944
Profile
ure
Texture
onsistence
Minerab
wetnaw
C
l
soil
Sspro
Restr
Clan
o
or
Dqft IN.
Clan
Horiz
dt LTAR
a
c
t
sr
rp
f7tPit, J /
G -a~ S 0y-
2-7-*k ~~t I ~~fq
1~ c,-I-r uly-Af~l
LG A r, k &-c illpP 3
~-w 6-CX-9X-/
-5-f J-/-/-,
„a..:lpuN, tmtw Repair System Other Factors (.1946):
s stem site Classification (.1948r
Available -Space .1943 Evaluated By:
stem s
Rife t.TAR Others present: