IPAC RHTE# 1V -:5 3 2.-s'l� Harnett County Department of Public Health 27875
Improvement Permit
Authorized State AgdE iv I Date: & a � �i SEE ATTACHED SITE SKETCH
The issuance of this permit by t alth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checki g 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 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, .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
ISSUED T 21,y _�i�►�� --' PROPERTY LOCATION: 5'` S�— 'a !zi)
_ SUBDIVISION — LOT # :r'
Facility Type--- 0 New E-.- Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 210
Type of Wastewater System** �w`� fi -..-- -rte (Initial) Wastewater Flow: ` GPD
(See note below, if applicable ❑)
(Repair)
Installation Requirements /Conditions Number of tr ches C
Septic Tank Size 1606 gallons Exact length of each trench '300 feet Trench Spacing: � Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. 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 LOFT. 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 speciled is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site olan, 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
w
Authorized State Agent :__ __ Date: (0 C
Construction Authorization Expiration Date:
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOTION: /' ` ��
f2s�
ISSUED TO:
SUBDIVISION i.. n
LOT # 'a �
NEW
REPAIR ❑
EXPANSION ❑ Site Improvements required pri
to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow:
1
GPD
Number of bedrooms:
3,
Number of Occupants: (0 max
Basement ❑Yes
010
Pump Required: ❑Yes
Type of Water Supply:
❑ No
❑ Community
❑ May be required based on final location and elevations of facilities
Z Public ❑ Well Distance from well feet
Permit valid for: 2-Five years
Permit conditions:
❑ No expiration
Authorized State AgdE iv I Date: & a � �i SEE ATTACHED SITE SKETCH
The issuance of this permit by t alth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checki g 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 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, .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
ISSUED T 21,y _�i�►�� --' PROPERTY LOCATION: 5'` S�— 'a !zi)
_ SUBDIVISION — LOT # :r'
Facility Type--- 0 New E-.- Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 210
Type of Wastewater System** �w`� fi -..-- -rte (Initial) Wastewater Flow: ` GPD
(See note below, if applicable ❑)
(Repair)
Installation Requirements /Conditions Number of tr ches C
Septic Tank Size 1606 gallons Exact length of each trench '300 feet Trench Spacing: � Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. 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 LOFT. 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 speciled is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site olan, 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
w
Authorized State Agent :__ __ Date: (0 C
Construction Authorization Expiration Date:
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON;jjA/f-5—
ISSUED TO: SUBDIVISION LOT
Authorized State Agent Date:
.�
�
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:c>'�
Address: Date Evaluated:
Proposed Facility: ,n✓10 Design Flow (I
Location of Site: Property Recorded:
Water Supply: 1,, ` Public❑ Individual ❑ Well
Evaluation Method: ❑ Adger B g ❑ 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
G -13 �
C' < < s
r
> ".19
° 3 2 - -`
(—h.. (3 -n r1 �J Y' ►�
q
Description
Initial
System
Repair Sym
Other Factors (.1946):
Site Classification (.19480:
Evaluated Bt7.
Others Present:
Available Space(. 1945)
System Type(s)
Site LTAR