IPACHTE# �LA -5 3L-)pc1 Harnett County Department of Public Health 28023
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: `j u n d�'D sL\ v E
ISSUED TO: LJD\'�' C. G- SUBDIVISION \ s a GC- r Y d \ v )C=- LOT # 1-] 0
NEWX REPAIR ❑ EXP ION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ��
Proposed Wastewater System Type: Q�� 0 0 C � \ 0 N
Projected Daily Flow: `�� o GPD
Number of bedrooms: -25 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__,>F�,Public ❑ Well Distance from well 10 U feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: �1� � =`1� �1� Date: -S I G SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance its. The permit holler is r sponsible 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 Perm, 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, .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�4',5 GS y t L_0 \ N Q. C_ PROPERTY LOCATION: J u
SUBDIVISION 1 l G- ,Q LOT # 0 O
Facility Type: 5 New ❑ Expansion ❑ Repair
Basement? F-1 Yes �No Basement Fixtures? El No
Type of Wastewater System ** �L e GD y C;�' \ Q) N S 7's _� N (Initial) Wastewater Flow: 3� Q GPD
(See note below, if applicable ❑)
mac; Y o QC-A) V G' \ tai (Repair)
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size 1 6 O gallons Exact length of each trench 2l'-C-D 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: JQ1 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: /understand the system type specified is different from the type specified on the application. /accept the specifications of this permit.
Owner /Legal Representattv ure: Date:
This Construction Authorization is subject to revocation 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 sumo compliance *h h the- &rrkisi he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date:
Construction Authorization Expiration Date:
NTE #
Harnett C o-anty
Permit #
Health Department of Public
Site Sketch
PROPERTY LOCATON: S N o cZ
ISSUED T0: Cc>, �Ulao�ra(, �^�G SUBDIVISION > LOT # 1-
Authorized State Agen�- ��(�t.1C�DR� Date: 81 bllt'1
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
c \, SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: ;j eo%\ Design Flow (.1949)3k0_r
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method -tiger Bo 'ng ❑ 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 %
Repair System
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mine(r�alogyP
,1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
[� '
�S -3`ba
5 K SO
�'SZ
, 7
Description
Initial
System/-
Repair System
Other Factors (.1946):
Site Classification ( 1948):
Evaluated By: ((
Others Present: _
Available Space (.1945)
V
System Type(s)
A !b-
Site LTAR
35-
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