IPAC RHTE# IJ -,5 - .7Z --79/e Harnett County Department of Public Health 27804
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
,,�J t PROPERTY LOCATION: Jeaf-
ISSUED TO- / "t �J �� y�I�Me�t1 SUBDIVISION LOT #
NEW � REPAIR ❑ • EXPANSION ❑
Type of Structure: 141 /VX Ice
Proposed Wastewater System Type: a5-7- cdjc�
Projected Daily Flow: �'� 0 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 210
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: []Yes ❑ No RIM-ay be required based on final location and elevations of facilities ,�
Type of Water Supply: F-1 Community 12""-Public ❑ Well Distance from well feet Permit valid for: I_� Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Z Z =! , Date: Date: //.Y-11/2-0/ ci SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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, .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: �/ "tali J- iLsIkl"Q t'1 PROPERTY LOCATION: J cy--fe- .J
r SUBDIVISION LOT #
Facility Type: 2 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2" No Basement Fixtures? ❑ Yes^ ❑ No
Type of Wastewater System ** 0 5r 7v ,&J (Initial) Wastewater Flow: —3�- GPD
(See note below, if applicable ❑)
as-7. ,�e�u6� v� �Ytf74- ^ (Repair)
Installation Requirements /Conditions Number of trenches 15"
Septic Tank Size !COO gallons Exact length of each trench G0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: iZ inches
Maximum Trench Depth of: /a- 28 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
�� ���� Aggregate Depth: inches above pipe
Conditions: , /'
t fei S�� -S(�W P� L�:y �I, 4e-e J�J inches total
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.
* *If applicable: l understand the system type specified is different from the type specified on the app /ication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershio of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and
and to the conditions of this permit.
Authorized State hent�'� ��� , � If Date: /b
Construction Authorization Expiration Date:
aG
SEE ATTACHED SITE SKETCH
HTE # /�3 °5 - 3aS 7 8 �' Permit # 027 3 a `�
Harnett County Department of ll�-tblic Healt:M
Site Sketch
PROPERTY LOCATON:
ISSUED T0: ��ll ��� {ltn� -��1 SUBDIVISION LOT #
Authorized State Agent: //. /"� /., ��.,�'t� Date:
l
/Q 12 1
.JGsly Rd.
aY, %r
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:
Proposed Facility:
Location of Site:
Water Supply: [
Evaluation Method: Auger
Type of Wastewater: [
Date Evaluated: /d 1/7 //1
Design Flow (.1949):
Property Recorded:
Pu ic❑ Individual ❑ Well
Bo ng ❑Pit ❑cut
Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
L
E
#
I
.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
l Lr
Af_f
�f
Ar
V;
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space(. 1945)
System Type(s)
Site LTAR