IPACHTE# t4— ���I Harnett County Department of Public Health 28009
Improvement Permit
A building permit cannot be issued with only an Improvement Permit (�
PROPERTY LOCATION:
ISSUED TO: CL-:-� (DE �� � SUBDIVISION '°" LOT # ci
NEW)< REPAIR ❑ FF EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Y) P, o MC
Proposed Wastewater System T pe: ''S°/ a'
Projected Daily Flow: ��� GPD
Number of bedrooms: 3 Number of Occupants: max
Basement []Yes �KNo
Pump Required: ❑Yes :�KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l CQ feet
Permit conditinn3•
Permit valid for: Five years
❑ No expiration
Authorized State Agent:: Date: —7 13 1 )'1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of of rmits. The permit holder is bsponsible 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 Permi all 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: CL- - -10C- �S i t�,so t'► PROPERTY LOCATION: C--J QQ -5s C� CGe\ 91)
SUBDIVISION — ^ LOT #
Facility Type: i�o ME �`�� G� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement FiA res? ❑ Yes o
Type of Wastewater System ** `��"lo \ Ovcn 1C) N �5 E /''� (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) /
C;'� 0i tai (Repair)
Installation Requirements /Conditions Number of trenches 'D
Septic Tank Size gallons Exact length of each trench 56 feet Trench Spacin : ` 1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: \5 —30 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. TDN vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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: /understand the system type speciled is different from the type speciled on the application. / accept the specipcatiom of this permit.
Owner /Legal Represents ' ' nature: Date:
This construction Authorization is subject to revoi i f the site plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This
construction Authorization is sukk14Lcompliance the ns o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ���, �\���� X15 Date:
Authorization Expiration Date:
HTE# t -S-3L 00 Permit # a��)6�
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: C-" (L(f'55 �tivR.G»
ISSUED T0: Cl—� ��� SUBDIVISION LOT #
Authorized State Agent: i\S 0 L-IN Date: —7 3 �'
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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
Owner: Applicant:
Address: Date Evaluated: \
Proposed Facility:% -M) 57K-" Design Flow (.1949): —'Y -- 4
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑Well
Evaluation Metho.Auger Bor' g ❑ Pit ❑ Cut
Type of Wastewater: ''E]~ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
SOIL MORPHOLOGY
.1940 .1941
Landscape Horizon
Position/ Depth .1941 .1941
Slope % (In.) Structure/ Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
(
1-5
c,5
1
Description Initial , Repair System Other Factors (.1946):
Syst9K Site Classification (.1948):5
Available Space (.1945) 14 Evaluated By:
System Type(s) Others Present: --
Site LTAR ,