IPACHTE# -� yr�j Harnett County Department of Public Health 27981
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: RAP.
ISSUED TO, R�/c ,i { r Cc 1I'f�� e:� SUBDIVISION �w���'�..}�ts LOT # .3 d
NEW Rf REPAIR ❑ f r EXPANSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: d37 X.39
Proposed Wastewater System Type: oU-7 -1,
Projected Daily Flow: JC 6 GPD
Number of bedrooms: .3 Number of Occupants: 6 max
Basement ❑Yes C'No
Pump Required: ❑Yes Q No ❑ May required based on final location and elevations of facilities
Type of Water Supply: El IJ ,� Community Public ❑ Well Distance from well feet Permit valid for 2 ive years
Permit conditions: ❑ No expiration
Authorized State Agent:: ? %,ryr.__�, ,�:.,,�k'� J' Date: 22 2cry SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. 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, .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 T0: PROPERTY LOCATION: L,Q, (�vCor .PcD.
SUBDIVISION LOT # 3 Q
Facility Type: -1-ro 2"'New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System — J-5--Z. Jed (Initial) Wastewater Flow: 3 (t� ° GPD
(See note below, if applicable ❑)
as-7. A- A (Repair)
Installation Requirements /Conditions Number of trenches l
Septic Tank Size 60 G gallons Exact length of each trench feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 33 - f/e inches
Maximum Trench Depth of: d%- (6",1 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: �P 'C,.,, %� fc, Cc�.11 P� :�, f ' ^(1'` `�` ;� %� 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: /under Land the system type .specified is different from the type specified on the application. 1 accept the rpeciCcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chanee in ownershin 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
Authorized State Agent:/— In'+:_ �:_ �2e�%f% Date: Zey-r /a "f"/
Construction Authorization Expiration Date: 7/Az j2uul
HTE # Y ✓- j ` lb/ Permit # J 7 9 6t
Harnett County Department ent of public Health
Site Sketch
) PROPERTY LOCATON: �S`. f I �.uc�r td_
ISSUED TO: /g�� i %L •ctt✓'uJ k11% SUBDIVISION, LOT # 3G
Authorized State Agent: ! — f 0-- Date: 7 !zz (2otCF
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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: 7// 7� /`i
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Ef`Public❑ Individual ❑ Well
Evaluation Method: ❑ uger Bo 'ng El Pit El cut
Type of Wastewater: [Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
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1
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#
.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
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yz 7z
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✓� �1��
S?v
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948)."f
Available Space (.1945) Evaluated Byd-
System Type(s) v2 Others Present:
Site LTAR g