IPACHTE# �� -�i Harnett County Department of Public Health 27739
Imurovement Permit
Authorized State nt::' Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Department in no way gua antees 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 a 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, .1957, .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.
f (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size ID&O gallons Exact length of each trench SO feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. a 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: Z, 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 app lication. / accept the specipcations 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 Disposal and to the conditions of this permit SEE AI IACHED SIIE SKETCH
Authorized State Ag Date: 3 — -Z (, -4 \I
Construction Authorization Expiration Date:
A building permit cannot be issued with only an Improvement P mjt
PROPERTY LOCATION: ' r as
ISSUED TO' 0
/U
y
SUBDIVISION v11
LOT #
NEW
REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization
Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow:
3(--,0
GPD
Number of bedrooms:
,.
Number of Occupants: max
Basement ❑Yes
210
,f
Pump Required: ❑Yes
Type of Water Supply:
❑ No
❑ Community
G3'yMae required based on final location and elevations of facilities
L✓� Public ❑ Well Distance from well feet Permit valid for:
ive years
Permit conditions:
❑ No expiration
Authorized State nt::' Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Department in no way gua antees 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 a 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, .1957, .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.
f (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size ID&O gallons Exact length of each trench SO feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. a 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: Z, 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 app lication. / accept the specipcations 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 Disposal and to the conditions of this permit SEE AI IACHED SIIE SKETCH
Authorized State Ag Date: 3 — -Z (, -4 \I
Construction Authorization Expiration Date:
HTE # 3 15 Permit # Z-7 --7 -3
Harnett County ]Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: SUBDIVISION rle,� LOT #
Authorized State A Date:
lwy-
0
-y-
- I
vo
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: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well
Evaluation Method: Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑"Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
i
5L
s" 3�
iz
_15
.vii
0 - �
%-31
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948): ,j In
Evaluated By:
Others Present:
Available S ace (.1945)
System Type(s)
Site LTAR