IPACHTE# 14 " 3 Harnett County Department of Public Health 28005
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
\ \ —\ PROPERTY LOCATION: C-Q — -4 CDGl,
ISSUED T0: C 1�c E }�O t� E S LL SUBDIVISION LOT # Y�
NEWX REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System zTT pe: 2—s" o p U eic NQ �J S yss E�
Projected Daily Flow: - (�0 GPD
Number of bedrooms: c7-) Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes ?< No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet Permit valid for: X Five years
Permit conditions: \ ❑ No expiration
Authorized State Agent:: ��\ `�� \� Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other ts. 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 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 TO: Y`� G�C=�- `� U MC S LC PROPERTY LOCATION: L c— L-\, Oa-
SUBDIVISION x �� -1 SUBDIVISION (''�ca �-c�® S� LOT # 1'4_
Facility Type: C) J New ❑ Expansion ❑ Repair
Basement? ❑ Yes : No Basement Fixtures? ❑ Yes �No
Type of Wastewater System ** �s of o �40 v c.,) d � S y 2) i (Initial) Wastewater Flow: Co O � GPD
(See note below, if applicable ❑) b
�e.o v c,sscr >s ��l��Grc\(Repair)
Installation Requirements /Conditions Number of trenches 4
Septic Tank Size gallons Exact length of each trench '2S feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G 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: ! un—derstafld the system type specified is dif /erent from the type specified on the application. / accept the specilcationr of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is su ect to revoca' if the si an, 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 subliance with t rovisions o nd Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Construe ' uthorization Expiration Date:
HTE# Permit # �n 5
Harnett County ]Department of Public Health
Site Sketch
ISSUED TO:
Authorized !
PROPERTY LOCATON: ���lv �a-
SUBDIVISION LOT #
01-1-4 fCL— —TO .Date: (Z
13C�/
. ,oN QCL
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 FacilityfJ� Design Flow (.1949): � Property Size:
Location of Site: Property Recorded: �.
Water Supply: 'S Public❑ Individual ❑ Well ❑ Spring
P g
Evaluation Method:❑ Auger Boring
F1 Pit F1 cut
Type of Wastewater: ❑ Sewage El Industrial Process El 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
L5
—� —�
16
sz
v"s
�Z sslsp
10 ftz
5
r
X16
Description
Initial
System
Repair System
,
Other Factors(. 1946): i
Site Classification (.19481
Evaluated By: J -'
Others Present: __
Available Space (.1945)
System Type(s)
SO
Site LTAR