IPAC R.-ITE #J4 Harnett County Department of Public Health 2806-1
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATIO ) W 4ro 41:)�
ISSUED T0: L
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: G P D
Number of bedrooms: Number of Occupants: max
Basement ❑Yes o
Pump Required: ❑Yes ❑ No 0'Ma required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: ive years
Permit conditions: ❑ No expiration
Authorized State A nt:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by &Gth Department in no way guarantees Ne 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, .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 T0: &JI PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: New �❑] — Expansion El Repair
Basement? ❑ Yes No Basement Fixtures? El Yes E3
Type of Wastewater System" c (Initial) Wastewater Flow: � GPD
(See note below, if applicable ❑}
,, ��• 2AS ��° - Repair)
Installation Re uirements /Conditions Number of trenches
Septic Tank Size 6'Z3 Dgallons 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: inches
Maximum Trench Depth of -56W f —56W 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
1,L inches total
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.
* *If applicable: /understand the system type specifed is different from the type specified on the app lication. / accept the specifIcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if 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 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 A ate:
Construction Authorization Expiration Date: P / 7— �°°
HTE# % ' 515 41%Z
i
Permit # z ~'
Harnett County ]Department of Public nea th
Site Sketch
I
LI
r
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot #:
File #:
Code:
Owner: Applicant:
Address: ate Evaluated:
d
Proposed Facility: Design Flow(. 19,49): ` Property Size:
Location of Site: Property Recorded:
Water Supply: -E1 Public❑ Individual ❑ Well ❑ Spring
Evaluation Method,® Auger BtarKk ❑ Pit ❑ Cut
Type of Wastewater: ❑ Sewage ❑ Industrial Process ❑ 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
112-
L.yo-
f-
i
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
Site LTAR
4