IPACHTE# t 3 S° 3 M4 Q1 r etc County Department of Public Health
Improvement et er it
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: O a L1 '�'}
ISSUED TO: �0MQ5 SUBDIVISION S�F;)LAJ��S _oz.L_ LOT #
NEW'- REPAI ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 LiS '-6
Proposed Wastewater System Type: r°Y o c>UC71� 1 U *1
Projected Daily Flow: 36® GPD
Number of bedrooms: Number of Occupants: max
Basement [--]Yes )< No
Pump Required: ❑Yes ANo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent: _ ' Date: t 13 13 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guara ees issuance of other permits. The permi 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 in nded 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.
Reouired 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 s em layout.
ISSUED TO: \A';_�IXA - t�ot�,t � PROPERTY LOCATION:
SUBDIVISION - Z)V,Mqt,.t> _e, `-Note- LOT # �-
Facility Type: ' RD (245 '`6 / New ❑ Expansion ❑ Repair
Basement? ❑ Yes 14\ No Basement Fixtures? ❑ Yes ,VNo
Type of Wastewater System" a Q�l0 QZ!Dttc.,1 O A (Initial) Wastewater Flow: b GPD
(See note below, if applicable ❑) 0
10 - Uyi 1 d (Repair)
Septic Tank Size
gallons
Exact length of each trench W 'Q
feet Trench Spacing: 9 Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover aLN--6 inches
Maximum Trench Depth of: 3�"'�$
inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4"
36" above the trench bottom)
in all directions)
Pump Requirements:
ft. TDH vs.
GPM
inches below pipe
Conditions: I�6 � GP
�) 0-,t -S
� a
* �t-c( iD R.c�c L,114
Aggregate Depth: inches above pipe
inches total
* *If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative T
This Construction Authorization is subject ter
of the site. This Construction k" arization is
Authorized State Agent:
Date:
plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
k��'SEE ATTACHED SITE SKETCH
QG—�S Date: 8 l3 )3
Authorization Expiration Date: U' ,
HTE#
IM, W.
Harnett County Department of Miblic Hetalth
Site hetch
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: 4 j
Proposed Facility: g�,� Design Flow (.1949) O J,
Location of Site: Property Recorded:
Water Supply: .. Zublic❑ Individual ❑ Well
Evaluation Method:] AugQr Boring ❑ Pit ❑ Cut
Type of Wastewater: ewage ❑ 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
E
U"^,
Q ;Q
C) -all
X.
C
Description
Initial
S stem .
Repair System
Other Factors (.1946):
Site Classification (.1948): 5
Evaluated By: C�7
Others Present:
Available S ace (.1945)
System Type(s)
°1050
Site LTAR
ca
E