IPACHTE# /,3-Sr�o2z`lZ Harnett County Department of Public Health
Improvement Permit 27631
A building permit cannot be issued with only an Improvement Permit
*;� PROPERTY LOCATION: d —y x-
ISSUED T0: Ita�Jer�U�' r� SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: M p} Z es K"7 6
Proposed Wastewater System Type: -Z5—% 'R-CJ i =amt SJ w-
Projected Daily Flow: Va n GPD
Number of bedrooms: q Number of Occupants: max
Basement ❑Yes 0No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes i�IIN o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
Five years
❑ No expiration
Authorized State Agent:: 1 e�� ,��' `�� Date: / /.I/ e) (2-01-7 SEE ATTACHED SITE SKETCH
The issuance of this permit byblreHealth Department in no 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 Permio
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: 6- S " PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: 1414 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System ** 'irx, J, J, -/ (Initial) Wastewater Flow: Vec) GPD
(See note below, if applicable ❑)
CzrS . ��� -'°� =-t ,J- � (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size /00 0 gallons Exact length of each trench €0 feet Trench Spacing: `� feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: /6 -ZQ 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
Conditions:
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 specified is different from the type specified on the application. l accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
Thk rnnstrnrrinn AurhnriMtion is subject to revocation if the site o1an. plat. or the intended use chanties. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization 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
Authorized State Agent 'wf Date:
Construction Authorization Expiration Date: 1111,64 o/6
HTE# / 7 -J- 3,Z2V 2- Permit # a-7 (-,3/
0
County Harnett Depaii-Cment of '.
Site Sketch
PROPERTY LOCATON: ?-7
ISSUED TO: G,, e, S-- y SUBDIVISION LOT #
c
Authorized State Agent: w -. '/f Date: id //6 "7
0
ate"
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: /v +,3/ /(?
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: �lic❑ Individual ❑ Well
Evaluation Method: Auger B tng ❑ 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
yy
:76,77
eb
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By.0 —
Others Present:
Available Space(. 1945)
7
System Type(s)
f� .
Site LTAR