IPAC.. Harnett County Department ' Public Health . ..
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ISSUED TO: TO: ----- '�- SUBDIVISION d LOT # ft—
NEW PAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: ?4- n t v �---
Projected Daily Flow: _ Z ig,& GPD ff
Number of bedrooms: Number of Occupants: l max
Basement ❑Yes o
Pump Required: es ❑ No ❑ May bg.xequired based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: years
Permit conditions: _ ❑ No expiration
Authorized State Age Date: SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health Department in no way guarantees 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 the 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 taws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permitl
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 110: PROPERTY LOCATION: 1--r7f'/vLcct�
t
SUBDIVISION LOT #!��
Facility Type: New �❑ . Expansion ❑ Repair
Basement? El Yes No Basement Fixtures? El Yes 2_
Type of Wastewater System" 4-6, Z- No (Initial) Wastewater Flow: 3 -73 GPD
(See note below, if applicable E)��
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size / Vo D gallons Exact length of each trench 7C feet Trench Spacing: Feet on Center
Pump Tank Size e,6 a gallons Trenches shall be installed on contour at a Soil Cover: ii!5�— inches
Maximum Trench Depth of: " - 115 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
_ inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 specified is different from the type specified on the application. l accept the specifications o f 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 JCC AttwtnCV 311 31%L 1%,"
Authorized State A Date:
Construction Authorization Expiration Date: �-' °�
HTE# %Y-- -33(�2Z
Permit # Z 79 79-
Department of Public Health
Site Sketch
IL 1
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: p- -
Address: _ Date Evaluated:
Proposed Facility: i- Design Flow (.1949):(
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method: uger Borin ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
D th (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
= 4_
A3 j�
a
�
`�
Description
Initial
System
Repair System
Other Factors (.1946): ,
Site Classification (.1948):f S
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
7 5-c<
Site LTAR
= 4_