IPACHarnettCounty Department Health2818,441,
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
\ PROPERTY LOCATION:
ISSUED T0: �Y rt cLy G5 t tJ �f t �1 C,- SUBDIVISION��rz�sTs Ely Qli,� LOT # �D
NEVI REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Tye: 24'10
Projected Daily Flow: U`'�5GPD
Number of bedrooms: q Number of Occupants: � max
Basement [--]Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l7 d feet Permit valid for: Five years
Permit conditions � ❑ No expiration
Authorized State Agent:: �� \�`_� �� Date: !�— I `ti I i SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan"m-<other permits. The permit holder is reslIonsible 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 TO: `YA-'r-� S -J >vs G`, 0)w �-,) C— PROPERTY LOCATION: Eti v �) - J
SUBDIVISION -7'� i , S-rLs %10 r- V LOT #
Facility Type: S �Eb� SOD X New ❑ Expansion ❑ Repair
Basement? ❑ Yes —'IR, No Basement Fixtures? ❑ Yes X No
Type of Wastewater System" 2S Cra P\F-S:) ki lff rt `d `� (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
5 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size E7� gallons Exact length of each trench 2)-O0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (;—I,— inches
Maximum Trench Depth of: 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: ���im„ �� R o5A.�.. 2�c� 4PL)c,ANiiS 7..S S 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 speciled is different from the type speciled on the application. / accept the specipcations of this permit.
Owner/Legal Representatly �ature: Date:
This Construction Authorization is subject t2 revoc ' if the site 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 Authorizationt to complia with the visions 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:
Construction Authorization Expiration Date: a
HTE# IZ-'�-5-�-���
Permit # �� W C
Harnett County Department of Riblic Health
Site Sketch
\ PROPERTY LOCATON: G t aiy C Icy try 1---1i
ISSUED TO: �l gvs�2�C'� Oar l C, SUBDIVISION -r o , SQ; LOT # 3 y
Authorized State Agent:=5 ��j �1 1 }ocV~ Date:
F
06ggy LN
d5�}�
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot #:
File #:
Code:
Oxvner: Applicant:
Address: Date Evaluated:
Proposed Facility: \ ��,��� Design Flow (.1949): ��QProperty Size:
Location of Site: Property Recorded:
Water Supply: Public❑ Individual El Well El Spring El Other
Evaluation Method: Au eg r Bo 'ng ❑ Pit F1 cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ 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
O—
s5
33—i�1
SQiL. S
C`sti S-5)Nf
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s) Others Present:
Site LTAR Ok.v