IPAC RHTE# 1L4 ®5- -3�533�,2, Harnett County Department of Public Health 27929
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
\ - , PROPERTY LOCATION: Mc0 U c--V- C
ISSUED T0: SUBDIVISION �Ae,gPFj,n r LOT #
NEW REPAIR E� NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ® : 1
Proposed Wastewater System Type: 2S° ° Qucfi 0 t� Yg
Projected Daily Flow: L4' C} GPD
Number of bedrooms: H Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ITS No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -j Public ❑ Well Distance from well ICO feet
Permit conditions:
Permit valid for:
Five years
❑ No expiration
Authorized State Agent:: %����` �1y Date: 5 1-'7 1) -1-) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance-. t permits. The permit holders resp Bible 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 it 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. c�
ISSUED TO: PROPERTY LOCATION: c. sa Vr'F> E P
SUBDIVISION 0eP5S2..� LOT #
Facility Type: c�5� C3a'b New ❑ Expansion ❑ Repair
Basement? ❑ Yes , No Base ent Fixtures? ❑ Yes X No
Type of Wastewater System ** �-s�o vc T o sv'� Cv (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
4-S —/" R -E4U(:�T} o (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size S C7 0 0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench `2 ® feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: `ate 3d inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: ! Feet on Center
Soil Cover: t > inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING 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 app lication. / accept the specifications of this permit.
Owner /Legal Representative Date:
This Construction Authorization is subject to revocation if the ' Ian, 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 subj�yo cogliance with the visions_o and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 -7 1 1
Const tl uthorization Expiration Date: 7
HTE# -t &5
Permit # n
Harnett Connty Department of Public Health
Site Sketch
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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 izll Auger Boring El Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
Description
ape
TEPosftion/
%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
.1942
Soil .1943 1956 .1944 Profile
Wetness/ Soil Sapro Restr Class
Color Depth (IN.) Class Horiz & LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
)_4
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ti ,1
5lj1i J-
"
rt 1 P
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: ��
Available Space (.1945)
System T e(s)
Site LTAR