IPACATE0 L� - G --�/J G(:�) 2�- harnett County Department of Public Health 28157
Improvement Permit
A building permit cannot be issued with only a Improvement Permit
PROPERTY LOCATION: Vd NC)E, . 5 cN '�-9
ISSUED TO: SUBDIVISION C.P, <Q—oL} >v P., o >J S LOT # �1_
NEWX REPAIR ❑ EXP ION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:�� �
Proposed Wastewater System Type:
Projected Daily Flow: 3�® GPD
Number of bedrooms: Number of Occupants: �O max
Basement ❑Yes No
Pump Required: ❑Yes No El May be required based on Final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t0 0 feet Permit valid for: Ive years
Permit conditions: ,c ❑ o expiration
Authorized State Agent:: � `65 Date: 1) 1517! } SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees 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 Impro 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 TO: iL `I--?- C— i-,(- \A®m GS PROPERTY LOCATION: 90 NnG52o��
SUBDIVISION C.PEls. 1 -�,tp. 0 M 5 LOT # 1 °I
Facility Type: SF'Q ''� �s�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes '�4 No
Type of Wastewater System ** as �l - �iwc,,� 0'ri (Initial) Wastewater Flow: o� GPD
(See note below, if applicable ❑) nn --
��'� } ON (Repair)
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size S ®® ® gallons Exact length of each trench ! S ® feet Trench Spacing: C1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 2,4-) inches
Maximum Trench Depth of: 4�-) 3C- 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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 speciTed is different from the type speciped on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization ii-subieet— tatevocation if the site Dian, 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 subjtctto coompliance w visio ticthe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: - A 5 Date: 1 i "
on tion Authorization Expiration Date: ��
HTE # °5- 3�� ®a Permit #��5
Harnett County Department of Public Health
Site Sketch
M
M
4,k,
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: 3 Design Flow (.1949):,A C) F
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method. Au er Boring El pit ❑Cut
Type of Wastewater: Sewage El Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
jLan�s.apeH
Repair System
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
S st m
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
1942
Soil
Wetness/
Color
1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
(lQ°
�(
Others Present:
Site LTAR
G
c
c�s
5 --I
Description
Initial
Repair System
Other Factors (.1946):
S st m
Site Classification (.1948):
Available Spacj(I 5)`
Evaluated B Y
System Types_;
(lQ°
�(
Others Present:
Site LTAR
G
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