IPAC RHTE# 1107-3y731 Harnett County Department of Public Health 28129
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L, c ,,-r td
ISSUED TO- —j s & tcke.,rl SUBDIVISION LOT #
NEW 7 REPAIR ❑ A . EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: C V d
Proposed Wastewater System Type: dj�. ,2 e= M
Projected Daily Flow: ,-160 GPD
Number of bedrooms: Ll Number of Occupants: max
Basement []Yes 210
Pump Required: ❑Yes IJ No ❑ May be required based on final location and elevations of facilities ,�,/'
Type of Water Supply: El Community L�Public El Well Distance from well feet Permit valid for: I- FIVe years
Permit conditions: ❑ No expiration
Authorized State Agent:: ,4z�-- zt' &� 'k -"T Date: l-/17t/2D'// SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the 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: PROPERTY LOCATION:
SUBDIVISION - LOT # /s"
Facility Type: SF.%6 0"New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 7. u4'•GA fiJl�e/--
(Initial) Wastewater Flow: V80 GPD
(See note below, if applicable ❑)
ZS -7 eed cx,�-;on (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /000 gallons 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. / 8 -,Y I- 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: /ft A- co-,' rt -o � k %,�1���e� c� f�o�,;ti'3' J- /e .rll.- k(, 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 specified is different from the type specified on the application. / accept the specifications ofthispermit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site olan. plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershiu 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
c
[Authorized State Agent:yf Date: 12 /7° l it
Construction Authorization Expiration Date: /a / ---,
HTE# !I/®r-7` 7J/I-
DepartmentHarnett County
Site Sketch
Permit # a 6 1 d,9
_ PROPERTY LOCATON: . ( I Lsr ec%
ISSUED TO: JJ�J 3SUBDIVISION Q �w� ✓' LOT #
Authorized State Agent: .u,� !"�,/i� .��'�i Date: /027 1
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: /°/Z y
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: D/Public❑ Individual ❑ Well
Evaluation Method: ❑ AugerB ng El 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/
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Texture
Z
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): �f
Available Space (.1945) Evaluated. By.-gA--
System Type(s) f Others Present:
Site LTAR