IPAC RHTE# `- 7-5Z VU Harnett County Department of Public Health 27715
hDrovement Permit
Authorized State Agj4t'--A�� Z �i Date: 3 -- U — / ' SEE ATTACHED SITE SKETCH
The issuance of this permit by WHealth 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 T0: PROPERTY LOCATION: ��6 eft✓ / -
SUBDIVISION �r� � LOT # �
Facility Type: ��
Z � ❑ Expansion ❑ Repair
Basement? Yes ❑ No Basement Fixtures? &es ❑ No
Type of Wastewater System ** %5 16 C ;� -5 ` (Initial) Wastewater Flow: -7 Z O GPD
(See note below, if applicable ❑)
5°
A building permit cannot be issued with only an Improvement Permit
Installation Requirements /Conditions
PROPERTY LOCATIONe �
ISSUED TO:
SUBDIVISION LOT #
NEW REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
4—"
Proposed Wastewater System Type:�i�
(Trench bottoms shall be level to +/ -1/4"
Projected Daily Flow: qA 9D
Number of bedrooms:
Number of Occupants: max
Basement LfYes ❑ No
Pump Required: ❑Yes ❑ No
❑ May be required ba n final location and elevations of facilities
�� I
Type of Water Supply: ❑ Community
❑ Public Well Distance from well feet Permit valid for: ZVive years
Permit conditions: 4
q ❑ No expiration
cm— 5t.,
Authorized State Agj4t'--A�� Z �i Date: 3 -- U — / ' SEE ATTACHED SITE SKETCH
The issuance of this permit by WHealth 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 T0: PROPERTY LOCATION: ��6 eft✓ / -
SUBDIVISION �r� � LOT # �
Facility Type: ��
Z � ❑ Expansion ❑ Repair
Basement? Yes ❑ No Basement Fixtures? &es ❑ No
Type of Wastewater System ** %5 16 C ;� -5 ` (Initial) Wastewater Flow: -7 Z O GPD
(See note below, if applicable ❑)
5°
epair)
Installation Requirements /Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: ' c ' iI 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: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
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: / understand the system type specified is different from the type specified on the application. I accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site plan, 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 Ag • .fir Date:
Construction Authorization Expiration Date: f
HTE # Permit #
Harnett County Department of 1�iblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: LOT #
Authorized State Age o: Date: 3-1,-JY
M
y
14&,�
Pc
. C_ /kaf5
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On -Site Wastewater Section Lot #:
File #:
SOIL /SITE EVALUATION Code:
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant`] %
Address: Date Evaluated:
Proposed Facility: Design Flow(. 1949): Property Size:
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual Well ❑ Spring ❑ Other
Evaluation Method: El Auger Bo Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
P
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:,
Others Present:
Available Space (. 1945)
R
System Type(s)
Site LTAR
0
F
SOIL MORPHOLOGY
OTHER
I
.1940
.1941
PROFILE FACTORS
L
Landscape
Horizon
.1942
E
Position/
Depth
.1941
.1941
Soil
.1943
.1956
.1944
Profile
#
Slope %
(In.)
Structure/
Consistence
Wetness/
Soil
Sapro
Restr
Class
Texture
Mineralogy
Color
Depth (IN.)
Class
Horiz
& LTAR
_ I . IV
, 3 - CIO,
�- i�-q �
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:,
Others Present:
Available Space (. 1945)
System Type(s)
Site LTAR