IPAC R'-ITE#_1 1A - 5,-:3 4 15 1 R, Harnett County Department of Public Health 2 8 3 3—At
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
a t PROPERTY LOCATION: w' V C} g �--�
ISSUED TO: W %t �" �o Ns'S cZ'\) C- � l Q g�j SUBDIVISION -ro-a, D LOT # LiO
NEK-A REPAIR ❑ - PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ��L> CoQ x60
Proposed Wastewater System T V v rn 1 0 o uGi t o sJ
Projected Daily Flow: GPD &00
Number of bedrooms: S Number of Occupants: ® max
Basement ❑Yes XNo
Pump Required:�(es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: D No expiration
Authorized State Agent:: v N� Date: ko IV"� l� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuancether permits. The permit holder is responsi le 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 ermit 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, .1957, .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: �i `1 N N �— 0 Ci, � 0 0 PROPERTY LOCATION:
/ SUBDIVISION 74 scc 5—AO LOT # d
Facility Type: `J V 0' P- New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes -�k N Goo
Type of Wastewater System** �)V rr)o 0 r)—i�;®I1tG�s d'i"J (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) _
Q 'S p c" 10 Gp (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Siz Ag
ons Exact length of each trench —90feet
Pump Tank Si ons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: el Feet on Center
Soil Cover: la 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 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 speciTed is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Represen a ' tures Date:
This Construction Authorization is subject to revoc ion ' site p at, 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 s kIlompliance with rovision and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: a
Expiration Date:. --2, --"b
HTE# 11-t -S- I � 151P,
ISSUED TO:
Authorized State Agent:
I
Permit # �.�30C)
Harnett County Department of INiblic Health
Site Sketch
PROPERTY LOCATON: C"4--1 "
SUBDIVISION '\ (—ILS C LOT # Ll
(,0L-)v4a TOLY-5p4 Date: 0 4
MW%
—34D,/
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:
Proposed Facility: Li e)OQ,4n Design Flow(. 1949)AR(O c�
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method Auger Boring El Pit F-1cut
Type of Wastewate{: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
.1940
Landscape
Positions
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
-
Cr
t11A
3
S3 Sc I
if s/S,v
/° e7
)rq
G/GLS
� ,ter
'S
t„S
5; 7
13-48
Description Initia R air System Other Factors (.1946):
Sys m Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s) U r^P o Others Present: BM
Site LTAR
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:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method:❑ Auger Boring pit ❑cut
Type of Wastewater: Sewage —[]"hidustrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
S _-7
Q
L_
"J- %9
2r
Ci A
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948):
Available Space (.1945) Evaluated. By:
System Type(s) Others Present:
Site LTAR