IPACHTE# -5 -3 -�� Harnett County Department of Public Health 28047
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
(� PROPERTY LOCATION: pv--P'A% y " (fir
ISSUED TO: CA (LNS- SUBDIVISION cz..l cc5 'V-kQa . LOT #CMG
NEW"Y REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S-'b � '� 15-N-)
Proposed Wastewater System Type: Q.S` O - y��o�l SYs�Lsr
Projected Daily Flow: I-IN GPD
Number of bedrooms: 4 Number of Occupants: max
Basement []Yes X No
Pump Required: ❑Yes ❑ No A May be required based on final location and elevations of facilities
Type of ly/a'n, Sup 1 : ❑ Community Public ❑ Well` Distance from well -JC)0 feet
Permit conditions:
Permit valid for
Five years
❑ No expiration
Authorized State Agent:: ���\ V Date: 1,012n 114 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Departn Qn no way guarantee ace of other permits. The permit holder is resp sible 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 lm—p�iOwent 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:
Facility Type: ��fl l� New
Basement? ❑ Yes No Basef ent fixtures? ❑Yes
Type of Wastewater System ** j ov o�yU y)
(See note below if a licable ❑)
PROPERTY LOCATION: Q *3v-� �--w
SUBDIVISION (.-, - C-5 KZ,� LOT # C30 r�.
❑ Expansion ❑ Repair
No
Sv<
(Initial) Wastewater Flow: Li'$O GPD
PP t
c �dla �ESJvt :tam 9`)�-'-VC-41' (Repair)
Installation Requirements /Conditions Number of trenches Z.
Septic Tank Size \OOcD gallons Exact length of each trench 1150 feet Trench Spacing: CII. Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: C-W4 inches
Maximum Trench Depth of. \%-3-C 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 1OFT. 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 specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representativ ' nature: Date:
This Construction Authorization is subject to rev if the,, fife 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 suhj ompliance the 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: a --Zi
truction Authorization Expiration Date: TO
MI
HTE#
Permit # '�O�
Harnett County Department of Public Health
Site Sketch
CVIZ�Ni"�
L 15-7
I
M
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):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: A er Bo ing ❑ Pit ❑ Cut
Type of Wastewater: ��� Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
•G
p5
73 y
!,(l G
®-40
S
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): S
Evaluated. By:
Others Present:
Available Space (.1945)
System Type(s)
Site LTAR
•G