IPACHarnett County Department •
Authorized State Agent.: Date: `I '- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance ermits. The permit holder is esponsible 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 er it 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 TO: L--T mop.
Facility Type:
IN MW
PROPERTY LOCATION:
SUBDIVISION ' . o c- -,(--P � Q-V LOT # Lia.
❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes o
Type of Wastewater System ** `- �-s��o �, �d rw� �G-1 (Initial) Wastewater Flow:
(See note below, if applicable ❑) o
A �;7 1a 01 c--, ) a A sc (Repair)
Installation Requirements /Conditions Number of trenches '`l
Septic Tank Size 2 CQ Q gallons Exact length of each trench —757 feet Trench Spacing: �} Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: )-4 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 10FT. 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: / understand the system type rpeciped is different from the type speciFed on the app lication. / accept the specifIcationf of this permit.
Representative Signature:
Date:
This Construction Authorization is revocati 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 is subject to com ' ce wit o W' s 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: %
onstru ' Authorization Expiration Date:
Improvement Permit
A building permit
cannot be issued with only an Improvement Permit
�' ��E
"�';
PROPERTY LOCATION: �e.14. P Q-O
ISSUED T0:
�'—� ��
SUBDIVISION &sue.
LOT #
NEW REPAIR ❑ EXPANSION
Mp,a %Aov'c � 4 -
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
2
Proposed Wastewater System Type:
`c} S c eCv yt:,,rf U q
Projected Daily Flow:
GPD
Number of bedrooms:
Number of Occupants:
max
Basement ❑Yes No
Pump Required: ❑Yes o ❑ M y be required based on final location and eley tions of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for:
Aive years
Permit conditions:
a
❑ No expiration
Authorized State Agent.: Date: `I '- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance ermits. The permit holder is esponsible 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 er it 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 TO: L--T mop.
Facility Type:
IN MW
PROPERTY LOCATION:
SUBDIVISION ' . o c- -,(--P � Q-V LOT # Lia.
❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes o
Type of Wastewater System ** `- �-s��o �, �d rw� �G-1 (Initial) Wastewater Flow:
(See note below, if applicable ❑) o
A �;7 1a 01 c--, ) a A sc (Repair)
Installation Requirements /Conditions Number of trenches '`l
Septic Tank Size 2 CQ Q gallons Exact length of each trench —757 feet Trench Spacing: �} Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: )-4 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 10FT. 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: / understand the system type rpeciped is different from the type speciFed on the app lication. / accept the specifIcationf of this permit.
Representative Signature:
Date:
This Construction Authorization is revocati 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 is subject to com ' ce wit o W' s 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: %
onstru ' Authorization Expiration Date:
HTE # Permit #
;)4 YA f
IM
vA,
55,
1
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 :�j Design Flow (.1949 rj�
Location of Site: Property Recorded:
Water Supply: _Public❑ Individual El Well
Evaluation MethodAug ormg El 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
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
FD
.1956
Sapro
Class
.1944
Restr
Horiz
rrTexture
5)5-
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: 'Q:0(
Others Present:
Available Space(. 1945)
System Type(s)
i
Site LTAR
s