IPAC RH T E # 9 L+ - 5 r 5 Harnett County Department of Public Health 28040
Improvement Permit
A building permit cannot be issued with only an Im rovement Permit
PROPERTY LOCATION: d®2E5 > R,QGL o�t� LFNpt,6
ISSUED TO: Pi >3�� �-1 rt�►O� C-gy SUBDIVISION LOT #
NEW REPAIR ❑ t EXPANSE ❑
Type of Structure: S '�ZQ
Proposed Wastewater System Type: S °j o ovc-5 ON � (sn
Projected Daily Flow: QoC) ® GPD
Number of bedrooms: --s' Number of Occupants: LQ max
Basement ❑Yes >::�o
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes Flo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 10 Q feet Permit valid for: Five years
Permit conditions: ❑ o expiration
Authorized State Agent:: �"�. Date: °11 --A1 1``t SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan ier 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 lmprovemenrPWit 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 T0: PROPERTY LOCATION: N%acB5- �pE�— �ot;to✓- ts��l�G
SUBDIVISION LOT #
facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No �B gnt Factures? ❑Yes ,
Type of Wastewater System L o << -�,�U c�� sue+ 1 S5 GM (Initial) Wastewater Flow: Q 0 GPD
(See note below, if applicable ❑)
�a �.�..O�GS't Gn, S`I S� (Repair)
Installation Requirements /Conditions Number of trenches I
Septic Tank Size (a50 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench -2 �) feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: IS ° aLl inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: E+ 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 IOFT. 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 an the application. 1 accept the specilcations of this permit
Owner /Legal Representative Signature: Date:
This Construction Authorizafon is subject to revocation if to 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 complADc_lwth-the—ovise the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: --Z 94—)A5 Date:
Authorization Expiration Date: '�
HTE# _� _5- 33�15�z
arnett (v®nnty
ISSUED T0:
Authorized State Agent:
�L�c3 Date: c11� i
. -(,A 0
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):' 0
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well
Evaluation Method:❑ Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F SOIL MORPHOLOGY
I .1940 .1941
L Landscape Horizon
E Position/ Depth .1941 .1941
# Slope % (In.) Structure:' Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
`,
y
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s)
Site LTAR Others Present: