IPACHTE#/,5--S= 3&16,,ir Harnett County Department of Public Health 28395
Improvement Permit
T
A building permit cannot be issued with only an Improvement Permit
/ (� PROPERTY LOCATIONC�tJ 2 044 f .r l�
ISSUED TO' /�5��,� - 14 6gM/''4--L) ' SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M 6 i�
Proposed Wastewater System T pe:
Projected Daily Flow: `4 0 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 9No
Pump Required: ❑Yes ❑ NoM e required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
2 Five years
❑ No expiration
Authorized State Ag Date: r�% �/ 5" SEE ATTACHED SITE SKETCH
The issuance of this permit by talth 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 t 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..
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: PROPERTY LOCATION: 6--A-J' (t Z C -A -4&Z f'w
SUBDIVISION LOT # - t�
Facility Type: a'f`t-D J�> ER "New �❑�Expansion El Repair
Basement? El Yes El No Basement Fixtures? 11 Yes L_f No
Type of Wastewater System** 2�®� ; L.�A�"Y-'�-- s �-�`- (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
ZS"Q)u
C-" C)C� — (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench/_ 0 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 4-!� 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)
Aggregate Depth:
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.
inches below pipe
t inches above pipe
/L' inches total
**If applicable: / understand 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 changes. The Construction Authorization shall not be transferred when there is a change in ownership 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. JCC AI IALHtIJ Jllt MIUt
Authorized State ent: Date: '7 - l -7 --
Construction Authorization Expiration Date: ') - r '? 7-6
HTE# l5 — �.. �3(a,1(e 1 Permit #
Harnett County Department of Public Health
Site Sketch
PERTY
ISSUED T0: ZO � C/ SUBDIVISION DTH� �Z�
� � LOT #
Authorized State A t: Date: —7—/ �:Z
l
/L„'h
52 I LJ 17 C411k'5 i1_�)
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:
r' Lot #:
File #:
Code:
Owner: Applicant: ice4--" ' 5.-, VI r
Address: �^ �,�,'✓� Date Evaluated: t0
Proposed Facility: [ w Design Flow (.19441?D Property Size:
Location of Site: ,�/ Property Recorded:
Water Supply: ��J Public❑ Individual ❑ Well ❑ Spring
Evaluation Method: ❑�luger�BonJ� g ❑ Pit ❑ Cut
Type of Wastewater: � ewage ❑ Industrial Process ❑ 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
i�
SL
$44)
3.1ir
a) -K,
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): S
Available Space(. 1945) Evaluated By'
System Type(s) Others Present:
Site LTAR