IPACHTE # as=s=360. ® Harnett County Department of Public Health 28290
Improvement Permit
A building permit cannot be issued with only an Improvement ermit
// PROPERTY LOCATION: /tics) Obi 6. d ��5c,. 4,,t.
ISSUED TO: � QA � sem. Can.'s' --a c t: ti SUBDIVISION LOT #
NEW 2 REPAIR ❑ t EXPANSION ff
Type of Structure: EEO (.9x 64
Proposed Wastewater System Type: c2 r;?
Projected Daily Flow: O GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 0-90
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes VNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: [I Community 121;'Public ❑ Well Distance from well /60 feet
Permit conditions:
Permit valid for:
E2'Five years
❑ No expiration
Authorized State Agent:/:/,/
Date: S��l/Zae1' SEE ATTACHED SITE SKETCH
The issuance of this permit by he 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. p
ISSUED T0: �oe�cl %may. �ca �✓ro.��=.i� PROPERTY LOCATION: .��{ o� la.� �e✓rs�
SUBDIVISION LOT #
Facility Type: _r0 2'New ElExpansion F]Repair
Basement? E]Yes ElNo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** o2,C,� leek Q 4`1 s ,f J f e,` (Initial) Wastewater Flow:
(See note below, if applicable ❑)
LZ -1—c- le— (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size /�J� 0 0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench /d o feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: /e -2y inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
36 0 GPD
Trench Spacing: 9 Feet on Center
Soil Cover: C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
i Aggregate Depth:
Conditions: /v- P Lam! %-' .4 'C,:, -k e4,c—k
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type speciFied on the application. I accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site plan. Dlat, or the intended use chanties. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to complian 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 Agen • cw-- • Date:
Construction Authorization Expiration Date: '-S—//,,/2° z
HTE# Permit # 0
Harnett County • . 1' of iHealth
Site Slketch
PROPERTY LOCATON:
ISSUED TO: CC rv. �e��=mow. �c� ��o c� ,�,; SUBDIVISION LOT #
Authorized State Agen • .,� Date:
J,aJ,� 4 A+%— c�, 4-^
414
=-te
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Apl
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method: [/�
Type of Wastewater:
Sheet:
Property ID:
Lot #:
File #:
Code:
tlicant
Date Evaluated: , 18
Design Flow (.1949): Property Size:
Property Recorded:
[//Public❑ Individual ❑ Well ❑ Spring
Auger B ing ❑ Pit ❑ Cut
Sewage ❑ Industrial Process ❑ Mixed
❑ Other
P
R
O
F
I .1940
L Landscape
E 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
LSA-�
f Lf'
/L
L_8
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s) Others Present:
Site LTAR