IPACHTE# I'- '"5-33LU3 Harr,dt County Department of Public ..ealth 27931
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
1 PROPERTY LOCATION: C)V62;�-ti', —5, V.D
ISSUED TO: 0 14 SUBDIVISION LOT #
NEW' REPAIR ❑ (PANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5� c Q3' (
Proposed Wastewater System Type: `---5110 VSay(7NVUN ��75'NE-yl�
Projected Daily Flow: --V" ® GPD
Number of bedrooms: 3, Number of Occupants: C, max
Basement ❑Yes XNo
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well l 0 Q3 feet Permit valid for: X Five years
Permit conditions: 5'�- E -v-ac -N ®�a��ht �4 \J \Q4j i�' VCL6`"� ®y" � o 0 S G ❑ o expiration
Authorized State Agent:: `�� 7! � `R-6cNA5 Date: 51-) i\4 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i �f 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 Improvem t 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 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 T0: Oct' T o, �AnLoev--
Facility Type: 51;-O (C-3 nG ')5d New
Basement? ❑ Yes �S\ No
Type of Wastewater System ** _
(See note below, jf applicable ❑)
Z)�/o Q- .r,-o yc N S �5:G�1 (Repair)
Basement Fixtures? ❑ Yes
�Sls 2CrovUSl6N
PROPERTY LOCATION:
SUBDIVISION
❑ Expansion ❑
No
5--� lb� Eiv"
0 v C- f1\K1-1-_s '�'p
Repair
Installation Requirements /Conditions Number of trenches
Septic Tank Size t ® O G gallons Exact length of each trench ��5- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: \ j �n d^' (0 �x" "0UsL — ► Qp` 1" N C'
LOT #
(Initial) Wastewater Flow: 3'® GPD
Trench Spacing: Feet on Center
Soil Cover: G "'� 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: l understand the system type pecified is different from the type .specified on the application. I accept the specifications of this permit.
Owner /Legal Representati nature: Date:
This Construction Authorization is subject to revocaton ' si an, 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 subjectjkl pptpliance wit provisio _ Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: �L�o Date: 51-7
Constru 'on Authorization Expiration Date:
HTE# Permit # a 13
Harnett County Department of Riblic Health
Site Sketch
"s.Q
L®
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: 3 Qom)' yn Design Flow (.1949):
Location of Site: Property Recorded: l
Water Supply: %Bo' blic❑ Individual - El
Evaluation Metho j Auger g ❑ Pi t ❑ Cut
Type of Wastewater: � Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
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
% Li
3
p•ao�
C5 5
�,
o -�a
� S
v� ►�s�
Description
Initial
S ste
Repair System
Other Factors (.1946): �f
Site Classification(. 1948):
Evaluated By: Cf
Others Present:
Available S ace (.1945)
System T e(s)
Q
D
Site LTAR
„ vt
% Li
U—, D-Das 121 r V VXU>% „v (Z64 V 1Q419