IPACHTE#_►b-~-U~ Harnett County Department of Public Health
Improvement Permit
2 6 2 2 3
A building perm
it cannot be issued with only an improvement Permit
ISSUED T0:
3o rr QcL~
PROPERTY LOCATION: 1.._
G2e~N _
SUBDIVISION _ 4L1 nts~ Ets dNg LOT #
LVIS
NEW
Type of Structure:
REPAIR ❑
~NSION ❑
S ';:D Ef b'
Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System T pe: Corr G- -M vV N AL
P
rojected Daily Flow:
GPD
Number of bedrooms:
'
Number of Occupants:
max
Basement ❑Yes
~X.No
Pump Required: ❑Yes
cX No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply:
❑ Community
X Public ❑ Well
Distance from well 1 (-)0 feet Permit valid for
,Five years
Permit conditions:
❑ No ex
iration
p
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the iss ce
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
.15 Date: g 3 N O SEE ATTACHED SITE SKETCH
of other permits. The permit hole er is responsible for checking with appropriate governing bodies in meeting their requirements. This
vement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: N [ 62 rc Cd . PROPERTY LOCATION: Gtz.6EN
Facility Type: S VCS
Basement? ❑ Yes -:S, No Basement Fixtures?
Type of Wastewater System** C D""J
SUBDIVISION C,t' ,__--,~fA E►a~o LOT # L~5
New ❑ Expansion ❑ Repair
❑ Yes )2~No
(See note below, if applicable
Co ,4v Er-AT ~o ,.r Nt.- (Repair)
Installation Requirements/Conditions
Number of trenches u
Septic Tank Size t road gallons
Exact length of each trench 7_ feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of., a'A r inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
(Initial) Wastewater Flow: 4"'0 GPD
Trench Spacing: 1 Feet on Center
Soil Cover ~a a 4 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
12. inches total
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.
**If applicable: /understand the ryrtem type specified it diNerent lrom the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature:
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
Construction Authorization is s%4 compliance wit ovis~3ts~of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
Date:
is a change in ownership of the site. This
SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: a 3 10
struction Authorization Expiration Date: B 3
HTE# IQ-S--a 49LA--~ Permit # a.6~3
Harnett County Deparfineut of Pj J)jic Health
Site Sketch
PROPERTY LOCATON: G Qeao U KK,5 ~)2.
ISSUED T0: 5 "~'r Nc C C'0lNS~ , SUBDIVISION CncoL,NP SSOHS LOT # 1r1jF
Authorized State Agent: S Ozpo(Ur Date: _ B' 3 1 O
i
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: ~x~ Design Flow (.1949): qqc,
Location of Site: Property Recorded:
Water Supply: Public ❑ Individual ❑ Well
Evaluation Method: Auger Boring ❑ Pit ❑
Type of Wastewater. Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
cut
Mixed
P
R
O
F
1
1940
OUL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Teadure
.1941
Consistence
Mineralogy
.1942
soil
wetness/
Color
.1943
Soil
Depth IN.
.1936
Sapro
Class
.1944
Restr
Horiz
Profile
Class
dt LTAR
Description Initial Repair System Other Factors (.1946):
ISystem Site Classification (.1948): S
Available Space 1945) J. Evaluated By: C)
System TYPAS)
Others Present:
Site LTAR
~D,'s 36 r