IPACHTE# A:57 s -- 3 4- Harnett County Department of Public Health 28214
ImDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION6Q_/ zl V:7 /7 w I S 12V& %�
ISSUED T0: ASUBDIVISION / LOT #
NEW [�� REPAIR 11 EXPANSION ❑ Site Im ovements required prior to Construction Authorization Issuance:
Type of Structure: SF -y7
Proposed Wastewater System Type: 25� 1%P°�11cX7�
Projected Daily Flow:VeP GPD
Number of bedrooms:,. Number of Occupants: max
Basement [--]Yes
Pump Required: ❑Yes ❑ No /May,
required based on final location and elevations of facilities
Type of Water Supply: E:1 Community ❑ Well Distance from well feet Permit valid for: Eeive years
Permit conditions: ❑ No expiration
Authorized State tint:: G-- V Date: / — Z j —/ i SEE ATTACHED SITE SKETCH
The issuance of this permit the alth 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 revocatio ' e 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..
nstruction 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: � yrl¢ ZUC— PROPERTY LOCATION: M /5f Y i /Z4 -.,j6 000 (2Z
SUBDIVISION i LOT #
Facility Type: 2 New �❑l Expansion Repair
Basement? El Yes Z No Basement Fixtures? El Yes LTJ" No
Type of Wastewater System** ZS%jZ'r�c`u¢,p, (Initial) Wastewater Flow: LP60 GPD
(See note below, if applicable ❑)
25"9z'(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 00 gallons Exact length of each trench _ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: q inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 5 Feet on Center
Soil Cover: Z, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
_ 6 inches below pipe
Aggregate Depth: Z inches above pipe
1 L 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: /under fond the system type specified is different from the type specified on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use chanties. The Construction Authorization shall not be transferred when there is a chanve in ownershin 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 Date: 1-2-3 -/-) '
Construction Authorization Expiration Date: / —Z3 -2a
HTE # js = y - 3'9-2 (6 (p Permit # "73 Z /,/
Harnett County Department of Ptiblic Health
Site Sketch
PROPERTY LOCATON: /yy? AhJ/s aa6 ,Z%)
ISSUED T0: <EA 5%iLuGnJit _S L� SUBDIVISION � ,,j,1 '4l�e�sG� LOT #
Authorized State Agent• Date: / —Z3 — /5-
61
5-
13
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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: Gr'vl
Address: Date Evaluated:
Proposed Facility:] Design Flow (.1949)t+i��
Location of Site: Property Recorded:
Water Supply: [3'1�ublic❑ Individual ❑ Well
Evaluation Method: ❑-�(uger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ swage ❑ 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
46
L
C'.
Description
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space(. 1945) Evaluated By:
System Type(s) Others Present:
Site LTAR