IPACHTE# 1 -s - 33T6 0 Harnett County Department of Public Health 27869
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: PQ
ISSUED T0 ,SUBDIVISION I!w VI LOT #
NEW G REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ?J":>
Proposed Wastewater System Type: 2. i"
Projected Daily Flow: (.0-1 GPD
Number of bedrooms: — Number of Occupants: Amax
Basement ❑Yes 12r No �/'
Pump Required: ❑Yes ❑ No 1�9'�Ma,y,. a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L' Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
Rr-Five years
❑ No expiration
Authorized State A :: 'O Date: `!7 �", / �/ SEE ATTACHED SITE SKETCH
The issuance of this per by th Ith Department in no way guarantees the issuance of other permits. The permit holder is responsible for the cing with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if th 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
Reauired 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. i"J -d-d dCic4,n—
PROPERTY LOCATION:
fi--Z"'V f --Z"'
VO 0�
,� SUBDIVISION _j' -fit
�c:.. LOT # 3
Facility Type: t
� New Expansion El
Repair
�❑,,�
Basement? El Yes No Basement Fixtures? El Yes I�'No
Type of Wastewater System ** b-% iz fsr"i
� 7- ._.. 'S �
(Initial) Wastewater Flow: -X� GPD
(See note below, if applicable ❑)
Z-1-5-'XI air)
Installation Requirements /Conditions
Number of trenc es
Septic Tank Size /60 gallons
Exact length of each trench
feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover: 47 inches
Maximum Trench Depth of:
inches
(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4"
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Aggregate Depth:
Conditions:
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.
inches below pipe
inches above pipe
inches total
* *If applicable: / understand the system type specified is different from the type specified on the app /ication. / accept the specifications 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 ATTACHED SITE SKETCH
[Authorized State Ag nt: Date: d �_
Construction Authorization Expiration Date: 9-- C6'11
HTE# P -i --S�- 33 5" DO Permit # ? 8 �- 5
Harnett County Department of 11�-tblic Health
Site Sketch
1t, &
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: '5 Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: DlullicFl Individual ❑ Well
Evaluation Method: E1__A69er Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ fewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
Ie
�p'G
-
Lps_Q
-i
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By-
Others Presentr-
Available Space(. 1945)
System T e(s)
Site LTAR
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