IPACHTE 31 cl 1-+Ll Harnett County Department of Public Health 27658
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C'i, fl )SL41i
ISSUED TO: C(-,F'a SUBDIVISION Stap,`)L —vt-�5 `� -was..L~ LOT #
NEWX REPAIR ❑ E3ERANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ��O (Sa:- SSZ ",J
Proposed Wastewater System Type: VU ry l o jo (_;) o g\}
Projected Daily Flow: `<DZD GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes �No
Pump RequirePMes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply__0 Community Public ❑ Well Distance from well 10S) feet Permit valid for Five years
Permit conditions: '�— ❑ No expiration
Authorized State Agent:: 2
The issuance of this permit by the Health Department in no way guarantees the issua
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: '3 'S'3 SEE ATTACHED SITE SKETCH
permits. The permit holder is resporlible for checking with appropriate governing bodies in meeting their requirements. This
Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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 T0:
Facility Type: �`'� New
Basement? ❑ Yes No Basement Fixtures? ❑ Yes
Type of Wastewater System" Q u m \ o Q-6 1
(See note below, if applicable ❑)
PROPERTY LOCATION: Qc-o �IA2-A
SUBDIVISION t--vK. t..- .i>A -15 `�- o u LOT #
❑ Expansion ❑ Repair
Vo
-,J C,� ` (Initial) Wastewater Flow: ® GPD
U 4 6 �� . (Repair)
Installation Requirements /Conditions Number of trenches 1�>
Septic Tank Size i (t) COQ) gallons Exact length of each trench C—C) feet
Pump Tank Size i ® d ® gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. \-9- , inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: C—® 1 Q) inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
* *If applicable: /understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject ation if the ' Ian, 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 Authorization is subjelis,�ompliance ' s o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: '`'` � ��?»�® F 1� l Date: '8 1 QPA 1
Constructlo thorization Expiration Date: g Z?
HTE # \3 — S--� l Permit #
Harnett County Department 04'Public Health
Site Sketch
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: )3
Proposed Facility-.3 (3 01\ Design Flow (.1949): `16 C �
Location of Site: Property Recorded:
Water Supply: blic ❑ Individual ❑ Well
Evaluation Method: uger Boring El Pit ❑
Type of Wastewater: Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Clans
dt LTAR
.1941
Structure/
Texture
.1941
Consistence
minereloxy
.1942
Soil
Wetness/
Color
.1943
Soil
IN.
.1956
Sapro
Class
.1944
Restr
Horiz
5c,t'
I`f1
1..�
" J6 w
s`
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): Pj
Available Space .1943 Evaluated Hy: K
system s P Others Present: �'A
Site LTAR