IPACHarnett County Department of Public Health 27915
Improvement Permit
A building permit cannot be issued with onl�an Improvement Permit
PROPERTY LOCATION: ► f AwQ6 `a IDQL.
ISSUED TO: VVya1G -� 1--- SUBDIVISION �Ac� \� �-z ���6G LOT #�
NEWA REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S �`"� � �
Proposed Wastewater System Type, ate% - DvC55�ON
Projected Daily Flow: GPD
Number of bedrooms: �_ Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes o!<,N o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well C C)® feet Permit valid for: the years
Permit conditions: ` �'No expiration
Authorized State Agent:: � ;� Date: _ 3 � ate) ��} SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i her permits. The permit holder is respon le 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 Improvemen rmit 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: 5�y�� 1A PROPERTY LOCATION: t--O \ Aom\ IoN a-
1 SUBDIVISION P) An\R,. �t -z-a roc . LOT #
Facility Type: 5 'F9 (, � �J � New ❑ Expansion ❑ Repair
Basement? ❑ Yes IN' No Base of 't Fixt es? ❑ Yes N
Type of Wastewater System ** L e b vc,� e N `)5 , t^ rr\ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
�)'b '/ 0 <C.0 y c t 0 Y) (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size 10 Off} gallons Exact length of each trench )t 0 0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1`1 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: (11 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 ]OFT. 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. / accept the specipcations of this permit.
Owner /Legal Represe j nature: Date:
This Construction Authorization is subject to r-e;btak4 if the'%%Llan, 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 subjrcompliancevsL h the p s ' ns a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
'R—G�S Date:
Authorization Expiration Date: 3
HTE # 1-i — 5 — -�®`-7 4 Q� '1 '6
Permit #
Harnett County Department of lAiblic Health
Site Sketch
PROPERTY LOCATON:71 C--M � Q-
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: o IL-IN 62 i oucSD 0 Date:
too /
=NM
WIN
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M-0
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: Lt C'� Design Flow (.1949):4;
Location of Site: Property Recorded:
Water Supply: .Public❑ Individual ❑ Well
Evaluation Method: Au er Boring ❑ Pit ❑ Cut
Type of Wastewat Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
SOIL MORPHOLOGY
.1940 .1941
Landscape Horizon
Position/ Depth .1941 .1941
Slope % (In.) Structure/ Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
l�
Q"
C'
�5
D
Initial
S ste
Re air System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
(.1945)
l�