IPACHTE #�t-1-5.-5W'1-0 Harnett County Department of Public Health 27950
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
y�L PROPERTY LOCATI N: gnuL -.o R
ISSUED T0: rJ C L1_,5 e ^I V SUBDIVISION E.5 t L- AwO�n'e p ` \r �� Su rn LOT #
NEWX REPAIR EXP I El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5q 0 � L) '�C 1
Proposed Wastewater System Type: a� I U an f o tJ
Projected Daily Flow: r,, ® d GPD
Number of bedrooms: f�>
Basement ❑Yes e':gNo
Pump Required: ❑Yes "�No
Type of Water Supply: ❑ Community
Permit conditions:
Number of Occupants: 1- b max
❑ May be required based on final location and elevations of facilities
Public ❑ Well Distance from well � 0 0 feet Permit valid for Five years
❑ No expiration
Authorized State Agent:: 101 Date: 6 ��-S �'-�1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit holder is responsible flir 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 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: y"
't-o G2S PROPERTY LOCATION:
Facility Type:
Basement? ❑ Yes
Type of Wastewater System **
(See note below, if applicable
SUBDIVISION -N m- ao»6@ /Vnt~ Sucv yv, • LOT # k!�!J
New ❑ Expansion ❑ Repair
No Basement Fixtures? ❑ Yes XNo
c,' . V sv s y r-- . (Initial) Wastewater Flow: QO ® GPD
(Repair)
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size , a 5 Q: gallons Exact length of each trench :�-O 0 feet Trench Spacing: c'l Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: y a Z,t,� 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
Conditions: E� 61S \ ti -T o �t
%40US'e
inches below pipe
Aggrega Depth: inches above pipe
y ap inches total
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.
* *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 ' ture: Date:
This Construction Authorization is subject 4qrevoc ati the Ian, 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 ist�omplian ith t the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �� �' v v \\ '15 Date: C
Construction Authorization Expiration Date:
HTE# k4-5-3500 Permit # 0
04
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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
Sheet:
Property ID:
Lot #:
File #:
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: '3$0Q,n Design Flow (.1949): G ) i Je� Property Size:
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑Well El Spring
Evaluation Metho(kfNuger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ 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
Description
Initial
S ste
Re it System
Other Factors (.1946):
Site Classification (.1948_ {
Evaluated ByU�
Others Present:
Available Space(. 1945)
System T e(s)
�
Site LTAR
d I,