IPACHTE#-11-1 70'-1)5% Harnett County Department of Public Health 28012
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L—ae Cd u ,!; % L, ,I e (zo
ISSUED TO: E.L G. ® NZ"0'S'Q'. SUBDIVISION '° LOT # _
NEW )q REPAIR ❑ EXPANSION ❑
Type of Structure: rl 63 �A \A OmC G L '` 0 --
Proposed Wastewater System Type: �� %j ve ` t ON -
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: C. max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes -_-JR�No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 feet Permit valid for: Five years
Permit conditi ❑ No expiration
Authorized State Agent:: Date: �7 g �� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua mits. The permit holde 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 Improveme t 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
Reauired 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: � � °� L— ot�1 LG - `�2�5'S+`, PROPERTY LOCATION: C- 0V."T/ l _,:.t&
SUBDIVISION LOT #
Facility Type: M �''�`' 1%rnE�i'A' �?�� New Expansion El Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes o
Type of Wastewater System ** �.�°® — UC;'Tr 0 ' -;�Gg- (Initial) Wastewater Flow: O GPD
(See note below, if applicable ❑)
�I Q: 'S\ 4 N -Z-D% ,&t l (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size LOS gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. V% �a inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: i Feet on Center
Soil Cover: (Z.—)a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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: 1 understand the system type speciled is different from the type specired on the application. / accept the specipcationa of this permit.
Owner /Legal Represents ive Signature: Date:
This Construction Authorization � subject to re ' the site p fat, 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 sf"�bje� pliance wit rovis� the and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Constru ion orization Expiration Date:
Authorized State Agent:
F
Date: ill —
13� "
E� G G C.O v -j'V't G
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: L\9;JU'N Design Flow(. 1949):
Location of Site: Property Recorded:
Water Supply: '°Public❑ Individual ❑ Well
Evaluation Methodb_�Aug r Boring ❑ 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
4
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
G -3�
�E3x e,�
�
05
c0 Zd
1, ®3i
s3
755 )IR
Description Initial Repair System Other Factors (.1946):
S st m Site Classification (.1948):Q_5
Available Space (.1945) Evaluated By: 6<
System Type(s) Others Present:
Site LTAR