IPACHTE# ,13- - 3ZY* Harnett County Department of Public Health 27705
hDrovement Permit
A building permit cannot be issued with only an Imp r vement Permit
PROPERTY LOCATION•- g L+ojc, tTJ>
ISSUED 110. I � SUBDIVISION 0 A Fc LOT #
NEW LvY REPAIR ❑ %1 EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5J
Proposed Wastewater System Type: i -j3
Projected Daily Flow: Jf<a GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ZNo
Pump Required: ❑Yes ❑ No LI Ma, e required based on final location and elevations of facilities �/'
Type of Water Supply: ❑ Community L�f Public ❑ Well Distance from well feet Permit valid for: L�' Five years
Permit conditions: ❑ No expiration
Authorized State Ag ° . r Date: /Z "& 13 SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health 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 Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .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 TO: � PROPERTY LOCATION: f ®� L itC�
�o
SUBDIVISION LOT #
Facility Type: Z New �❑1 Expansion El Repair
Basement? F-1 Yes No Basement Fixtures? El Yes E? No
Type of Wastewater System ** fir, _ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
(Repair)
Installation Requirements /Conditions Number of tren es
Septic Tank Size r,3 gallons Exact length of each trench )94?� feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. N ZZ Zoe � nches
(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: 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 application. / accept the specifications ofthisperInit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, slat or the intended use chanties. The Construction Authorization shall not be transferred when there is a chance in ownershin of the sire. 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 nt: Date: /Z
Construction Authorization Expiration Date: /Z—& -
HTE# % i `5 , 521
Permit # 2-,7 -7 &°5,
Harnett Coil ty Department of N-tblic Health
Site Sketch
PROPERTY LOCATON: ) 6 ?- c I R16
ISSUED TO: SUBDIVISION v LOT #
Authorized State A t: Date: 1
l!c"
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: rLr 3
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Q Public❑ Individual ❑ Well
Evaluation Method: ❑—Au--ger Bori g ❑Pit r_1 cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
t$L 11
: -
3,
�t —�
; c��
K t
v 3
L
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Ljr
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5-L
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space(. 1945)
System Type(s)
Site LTAR