IPAC A - tank 1HTE #14- 5 -3ag lj5 K Harnett County Department of Public Health 27788
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Ust'f�l t�
ISSUED T0: �SAtr�S K-J —0 a _ SUBDIVISION KI L-o Q LOT #
NEW X REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: a U O L_e-
Proposed Wastewater System Type: 94� 'Z o - U
Projected Daily Flow: GPD
Number of bedrooms: a Number of Occupants: 4 max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ',i<, Public ❑ Well Distance from well 4® 0 feet Permit valid for: ❑ Five years
Permit conditions: -`F 15 9 6r2 r N ` , t 5 F<W, �1 �t F p� Q\ t.4 '1 o i,P, t_ � �pq_O Ct s r\ ❑ No expiration
!../ J ? L 6'X _ C—_ P,". 45-.4Z:19_ 41. I-, to ca,r F_ A S (:P sacs \ v- F SP oS , r . .s T,--_ _,�
Authorized State Agent:: S Date: '� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is�Improvemes�hall The permit holder is resp sible 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. Th 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 p..
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: S PROPERTY LOCATION:
SUBDIVISION �ZS,,"If,S 77ML -0fL LOT #
Facility Type: _� V P t_E� New ❑ Expansion ❑ Repair
Basement? ❑ Yes -1>-\No Baseemgnt Fixtures? ❑ Yes
Type of Wastewater System ** ta—S / z) QGi6 uC�' ) 0 u _'y5 EM (Initial) Wastewater Flow: a'�� GPD
(See note below, if applicable ❑)
a '_� nt
y) U L'!'� V3 N (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size aQ gallons Exact length of each trench i ® feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: ate`- 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: i a.,. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
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 l accept the specifications of this permit.
Owner /Legal Representative tg Date:
This Construction Authorization i subject to revo n if t Ian, r 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 slst�t `sq�liance with t ovisit ws a ules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 911)N)
Construction Authorization Expiration Date:
HTE # l L� v 5— 3`�" ?zip
Permit # `1 *�'�
Harnett Connty ]Department of -�iblic Health
Site Sketch
PROPERTY LOCATON: V-�
ISSUED TO: c-n L- CCQ , SUBDIVISION 1 -qgJ , LOT #
Authorized State Agent: Date: `4 "V-1V)
i
a�C)
tiS�a.� 3a,�,rt
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:p; n�
Proposed Facility: � j Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public[ Individual ❑ Well
Evaluation Method: Boring ❑ Pit ❑ Cut
Type of Wastewater: r age ❑ 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
o-"
}
a
m`:
S L
-7
150 -,
Ll
A
�
l
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): 5
Evaluated By:
Others Present:
J
Available Space(. 1945)
System Type(s)
d ; L.
Site LTAR
h5