IPACHTE# °� -'5 °i Harnett County Department of Public Health 27724
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION::, ® — n-
ISSUED TO: U AM Sr--'-W44 77 SUBDIVISION LOT #
NEW REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 W
M If
Proposed Wastewater System Type: Z'J
[7a V(eR ,)\)
Projected Daily Flow:
GPD
Number of bedrooms:
Number of Occupants: i max
Basement []Yes No
Pump Required: ❑Yes ❑ No
Type of Water Supply: El Community
Cf�Mae required bWd on final location and elevations of facilities
Public 17 f Well Distance from well 160 ? feet Permit valid for: 12"Five years
Permit conditions:
❑ No expiration
Authorized State Age ::
Date: 2.— 77-1 `"i SEE ATTACHED SITE SKETCH
The issuance of this permit by;t a 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 i e 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 TO: f drl��" ` d !' PROPERTY LOCATION: 301
SUBDIVISION LOT #
Facility Type: (14 f IJ New ❑ Expansion ❑ Repair
Basement? ❑ Yes Zr�No Basement Fixtures? ❑ Yes L3`No
Type of Wastewater System" 2w i t {,t (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
'15% (Repair)
Installation Requirements /Conditions Number of trench s Z
Septic Tank Size gallons Exact length of each trench 10 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: Z 61 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: °2 inches above pipe
12- 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: /understand the system type specified is different tram the type specified on the application. /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 ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Di al and to the conditions of this permit. )tt AI IALtItV MIt SKETCH
Authorized State RCnt., , Date: Z 7 --r Lf
Construction Authorization Expiration Date: -..-
HTE# 5TI 9 Permit # Harnett County Department of 11tiblic Health
Site s etch
PWRUTY LOCATON:� 301
ISSUED TO: SUBDIVISION LOT #
Authorized State ent: Date: r P
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:
Proposed Facility: 5tofAA Design Flow (.1949):
Location of Site: �� Property Recorded:
,
Water Supply: DT-' Individual ❑ Well
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: [�'3ewage ❑ 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
L3
b -ZZ
c
AA P
2Z `foo
561
1
�C �L
L
4
4-
•,rte
k
SAC.
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
a�
L.
Site LTAR