IPACHTE# �'��5-�Harnett County Department of Public Health 28514
Improvement Permit
A building permit cannot be issued with only an Improve mf �t Permit
PROPERTY LOCATION: Rpi-) "�='
ISS U D TO: �Rc�3 C SUBDIVISION LOT #
NEW) REPAIR ❑ EXPANSION ❑
Type of Structure: M Pal • )^Lc> (: �d � 1 Q�)
Proposed Wastewater System Type: �1 o V U c..•; )CY NI
Projected Daily Flow: `36 GPD
Number of bedrooms: — Number of Occupants: JQ' max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes o ❑Ma be required based on final location and elevations of facilities
Type of Water Supply: ElCommunity Public ❑ Well Distance from well Icy® feet Permit valid for: Five years
Permit conditions: "'�� ., ❑ No expiration
Authorized State Agent:: l 5 Date: 'q 1-7 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holdeble 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 Permt 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: `� �+"I GC--. S5
PROPERTY LOCATION: Q—r.".4
SUBDIVISION LOT #
Facility Type: Cl� (-NN . ® c�66 -1 ^i CD New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basemen Fixtures? E] Yes 'XNo
Type of Wastewater System" �•�o RcaV C -c) C) 'Q S -Is ' C. (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
QL c' s.,! (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size t 0 0 0 gallons Exact length of each trench 5 a feet Trench Spacing: '�J Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 1 = L- inches
Maximum Trench Depth of: QIA-3 C inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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 speciled 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 subj t temcompliance with the�SronslDns t� Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Constructio thorization Expiration Date: ZL
HTE# \S—
ISSUED TO:
Authorized State Agent:
Permit #
Harnett Connty Department of niblic Health
Site Sketch
PROPERTY LOCATON:
SUBDIVISION LOT
Ll OW) Date:
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: ��Q �"1 Design Flow (.1949): 3 6
Location of Site: Property Recorded:
Water Supply: Z Public❑ Individual ❑ Well
Evaluation Method: uger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
SOIL MORPHOLOGY
.1940 .1941
Landscape Horizon
Position/ Depth .1941 .1941
Slope % (In.) Structure/ Consistence
Texture Mineralogy
OTHER
PROFILE FACTORS
--
Profile
Class
& LTAR
.I942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
1
G
G
AQY
Q,
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space(. 1945) Evaluated By:
System Type(s) J a Others Present:
Site LTAR �,