IPACAarnett CountyDepartmentPublic Health 28511
1
Improvement Permit
A building permit cannot be issued with only an Improvement Permit 4 trx e 4t 4`2j
PROPERTY LOCATION: to
ISSUED TO: O p' (L) Q V10cvSV�C�(24 SUBDIVISION U tz LOT #
NEW �< REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -W- rles rs N O c'n� 1111-)c --G Q
Proposed Wastewater System Type: 2Z'*/ o 60 UCG-: N V 4)
Projected Daily Flow: '� Q GPD
Number of bedrooms: 3 Number of Occupants: _max
Basement []Yes No
Pump Required: ❑Yes o be required based on final location and elevations of facilities r
Type of Water Supply: F-1 Community
Community Ma Public ❑ Well Distance from well 1 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: _'`111- � �z ��'�%t Date: % I e-;7 ) tS- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the-!Zsother 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 Improveme it 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
Reouired 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: 'C�q'aN 0 �Y% PROPERTY LOCATION: ;, u
/ SUBDIVISION tDyieS31(': \ A LOT # �.
Facility Type: �� ����� -�q, New ❑ Expansion ❑ Repair
Basement? ❑ Yes -�M No Basement Fixture 1 ❑ Yes �No
Type of Wastewater System** c�~Sj taQQ5� I vTrJ �`1���,r+ (Initial) Wastewater Flow: � GPD
(See note below, if applicable ❑)
LI -S; L® YNCDUC.;J-J (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size t ® ® G gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 0) Feet on Center
Soil Cover: C 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
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type speci(ed on the application. / accept the specifications ofthis permit.
Owner/Legal Representati Signature: Date:
This Construction Authorization is subject to re . n if the site Ian, 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 su compliance with ions he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Cyt Date: 'C
Authorization Expiration Date: y _ 0
HTE# , � 5 -� '�-moi Permit # 2C61
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: �N1-GCS �
ISSUED T0: ��2� U V(= SUBDIVISION OIG lam LOT #-
Authorized State Agent: Date: 1 1sl i
M
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: 3r t� Design Flow (1949): St
Location of Site: Property Recorded:
Water Supply: Public[] Individual ❑ Well
Evaluation Methom
Auger Bo g ❑Pit ❑Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
L 3
C)
(' S L,
\5577 '
o -Ya
CO -
Description Initial Repair System Other Factors (.1946):
System/ Site Classification (1948)"
Available Space (.1945) Evaluated Byxo"�
System Type(s) Others Present:
Site LTAR L1�