IPACHTE# I� "S-�t- 'a�i"� Harnett County Department of Public Health 28024
Imurovement Permit
A building permit cannot be issued with only an Improvement P,g,rmit
` PROPERTY LOCATION: c) V rZi J —
ISSUED TO: C;>'—� C.S (�'_> V ) t..Or t� CJ 4 eJ C_ SUBDIVISION \ la (ZnC-!v V o ) R LOT # f
NEW)K RE PAIR 4 EXP! ION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S Q'D ly
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 'No
Pump Required: ❑Ye �o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: F-1 Community X Public ❑ Well Distance from well �� O feet Permit valid for: Five years
Permit conditions: -- __ ❑ No expiration
Authorized State Agent:: �� �1 -
The issuance of this permit by the Health Department in no way guarantees the iss
site is subject to revocation if the site plan, plat, or the intended use changes. The Impri
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: %I 6 I V� SEE ATTACHED SITE SKETCH
permits. The permit holder is resp nsible for checking with appropriate governing bodies in meeting their requirements. This
it shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: C(> � C6 �?) J ) J_Q t N 6 \ a G PROPERTY LOCATION: JV r.4 a LJcz)-4 C
SUBDIVISION ^T %4 ,s Yd r N , G LOT # \JQZ_
Facility Type: S[9 �� x5 �� New ❑ Expansion ❑ Repair
Basement? ❑ Yes '15\ No Base t Fixtures? El Yes XNo
Type of Wastewater System ** -.3 t- o Qt�w CK t 0 SS �> STS m (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) �/
Q'S L osJ y C;N' \ 0 tom} (Repair)
Installation Requirements /Conditions Number of trenches I
Septic Tank Size t�O o Z) gallons Exact length of each trench a2S' feet
Pump Tank Size gallons 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)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: b inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
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: /under fond the system type s pacified is different from the type pacified on the app lication. /accept the rpecificatianf of this permit.
Owner /Legal Representat Si nature: Date:
This Construction Authorization is subject to re ca f 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 submpliance wi a pgo " ns 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: 1
Construction Authorization Expiration Date:
HTE# ` '� ��� Permit # ��d2aal'a
Harnett (county Department of Public Health
Site Sketch
PROPERTY LOCATON: JU NO 4�)(L\\re
ISSUED TO: CjA b v Lo G y N G SUBDIVISION Qol ?v L LOT
Authorized State Agent: (9 t- Nv6Q-`TOLYSC) r Date: `9,
V(�)�
6QA 12 1
A � �s6
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: 11
Proposed Facility: 3 �OC2c N Design Flow ( I949):U6�12i
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method A B Ping ❑ Pit ❑ Cut
Type of Wastewater: 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
1 .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
5
N��Q
:U
Description
Initial
S ste
R pair System
Other Factors (.1946):
Site Classification (.1948): f'J
Evaluated By: �y(
Others Present:
Available Space(. 1945)
System Type(s)
_ I
Site LTAR