IPACHTE# -15-5-3545C Hari.,a County Department of Public Wealth 28199
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
n PROPERTY LOCATION: o Ntiii-'f
ISSUED TO. Gere : SUBDIVISION 9 -,OCE- LOT # 4
NEW REPAIR ❑ E�NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �� a
Proposed Wastewater System Type: `� �'!g IN
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes '�g No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public Well Distance from well ti00 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: C —YZ'5 Date: 3 6(1S SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees s lance of other permits. The permit holder is r sponsible 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. Themovement 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: Q L-0 X-'1 C,
Facility Type: S �O L'' d'"L-\ Q) 1!<' New
Basement? ❑ Yes 'M Ni
Type of Wastewater System**
(See note below, if applicable G
Basement Fj tures? ❑ Yes
z)S"lo o uc;� \ 0 r
PROPERTY LOCATION: Wc,MRc�F
SUBDIVISION �w6g- 2.06f- LOT #
❑ Expansion ❑ Repair
o� GPD
i y'� ti ENS (Initial) Wastewater Flow:
P --'V c) d� ® 4-Z <K-� \a.t\) (Repair)
Installation Require ments/Conclitions Number of trenches
Septic Tank Size G d b gallons Exact length of each trench j ati feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: R inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( 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 applicatiom l accept the specifications of this permit.
Owner/Legal Representative Signature: Date: f
This Construction Authorization is su iila vocation 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 Authorization is.*Lect to compfia8ce wi ro s of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: � % `r 5 Date: 3 1
Con ction Authorization Expiration Date: aC1
M
HTE # \ 'S - LA -6 (o
Permit # —a� � � �
Harnett County Department of Public Health
Site Sketch
ISSUED TO: La PROPERTY LOCATON: \�
SUBDIVISION LOT # Li
Authorized State Agent Date:
Department of Environment, Health and Natu esources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 (3DtV*� Design Flow (.1949): —V.CX)
Location of Site: Property Recorded
Water Supply: ❑ Public❑ Individual
`�'� Well
Evaluation Meth0 uger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I .1940
L Landscape
E Position/
# Slope %
SOIL MORPHOLOGY
.1941
Horizon
Depth .1941 .1941
(In.) Structure/ Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1942
Soil
Wetness/
Color
1943.1956
Soil
Depth (IN.)
Sapro
Class
.1944
Restr
Horiz
1
La
t S=aa
0-'%
G L
\R1-N15INQ
-4a
51;?X- C_
VW s) -P
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Description Initial Re air System Other Factors (.1946):
Syste Site Classification (.1948):
Available Space (.1945)Evaluated By: V :�
System Type(s) ► P Y MP r Others Present:
Site LTAR . X� Dom'
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