IPACHTE#-I '1 5- Harnett County Department of Public Health 28017
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: `4 OZ t -�. ��
ISSUED TO: N9C2 C�w t 1-1. ON SUBDIVISION Cr P 3101- � rzc LOT # `�
NEW' REPAIR " { ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ��9 �5 "i `-
Proposed Wastewater System Type: `mss' o nv Ci5 } 0 �}
Projected Daily Flow: `1G, C) GPD
Number of bedrooms: 2> Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes o ❑ 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: five years
Permit conditions: -. - ❑ No expiration
Authorized State Agent:: Date: WJ 11111 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss nc ther permits. The permit holler 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
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 TO: tvOC�£ -�r ")L , -' -O PROPERTY LOCATION: C'P 101- 1A11-;a.`VS)
SUBDIVISION l.�fkQ l'S Uz- \� � L L LOT # 9
Facility Type: �����`� �`1� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixt res? ❑ Yes ' 1*D
Type of Wastewater System ** Q-!;�;°l,5 vC,1�� (3N SlY E)y'` (Initial) Wastewater Flow: 3�C> GPD
(See note below, if applicable ❑)
Q..5 ° flvc/i'i ON (Repair)
Installation Requirements /Conditions Number of trenches a
Septic Tank Size `® bCI gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 14 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. %1� inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: c) Feet on Center
Soil Cover: �nches
(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: l understand the system type specified is different from the type specifed on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorize i ' b'ect to revocatio the site plan, 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 to co a with thegtftsions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: _ �`� \ � Date:
struction Authorization Expiration Date:
HTE# S- 3� "d-��-
Permit # awl
Harnett County , Health
Site sRetch
MIq
M
ap
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: Design Flow (.1949):XOJJ
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well
Evaluation Method: ❑ Auger Boring Pit ❑ Cut
Type of Wastewater: —9- 1ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ 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
J1Q$
oz-
rA
4Q
T�� SC-1-
i xl
Description
Initia -
S st m
Repair System
Other Factors (.1946):
Site Classification (.1948): 4 -�
Evaluated By:(y�_
Others Present:
Available Space(. 1945)
System Type(s)
QVD
Site LTAR
J1Q$