IPACHTE# 13- 5'3153 j
Harnett County Department of Public Health
Improvement Permit 27532
I1 eo Ott S &CSutul p ermit cannot be issued with only an Improvement Permit
J l� PROPERTY LOCATION: G R,\ � rt RU
ISSUED TO Q E O«i®s.a SUBDIVISION LOT # -
NEW'X REPAIR ENSION 11 Type of Structure: 5� - �'�o61
Proposed Wastewater System ,TYpe: �5 ®t`r .� vN 'S7S -��
Projected Daily Flow: 3ert7 GPD
Number of bedrooms: 3 Number of Occupants: Cc max
Basement ❑Yes ef �,No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 ®b feet Permit valid for: Five years Ix
Permit conditions: ❑ No expiration
Authorized State Agent:: ~\ �1-% Date: -) I zZLr A 3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan other permits. The permit holdeil is responsible for checking with appropriate governing bodies in meeting their requirements. This
h
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvem ermit 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, .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: --, of zJ
PROPERTY LOCATION: N'FF -N N
f SUBDIVISION `®
Facility Type: 5�� `�� +��3� X New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes 111 o
Type of Wastewater System* �e �v�0 f1 u t S Err` (Initial) Wastewater Flow:
(See note below, if applicable ❑)
C;*SIQ ,f --'-JS; Repair)
Installation Requirements /Conditions Number of trenches S
Septic Tank Size l 0 gallons Exact length of each trench `� S feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 1'�% inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
LOT # -s-
Trench Spacing: f Feet on Center
Soil Cover: 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: l understand the system type rpeciped it different from the type rpeciFed on the app /ication, l accept the fpecircations of this permit.
Owner /Legal Represent Si nature: Date:
This Construction Authorization is subject to rev if the site p at 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 compliance wi p and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: :Ns I ��� 1�5 Date: -7
Expiration Date:
HTE# 13 75 3)X3)
Permit # 3Z-1531
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant: +
Address: Date Evaluated: -)1 113
Proposed Facility: •S �aOZQ— 5 Design Flow(. 1949): 36a �e
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation MethA Au er B Ping ❑ Pit ❑ Cut
Type of Wastewater: � Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
1��, 3�
S cR
5515
PO -I ,r
S
5
S.'LA
L\04
sgx. C-
Description
Initial
S ste
Rep 'r System
Other Factors (.1946):
Site Classification (.1948): f
Evaluated By:
Others Present:
Available Space (.1945)
Id
System T e(s)
!
Site LTAR