IPACCounty Department Public
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t PROPERTY LOCATION: C) v CZ" ) L-�L-S
ISSUED TO: P,SUBDIVISION LOT #
NEW>< REPAIR ❑ EXPANS ❑
Type of Structure:
Proposed Wastewater System Type: 9v (n (a i o —axr' t 0 A!
Projected Daily Flow: °3 �C� GPD
Number of bedrooms: 3 Number of Occupants: max
Basement []Yes XNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required:.Ms ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
Five years
❑ o expiration
Authorized State Agent:: �� �"`' �\S Date: 913 1 15— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance ry ermits. The permit holder is re ponsible 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 Per II 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: D >'LIs;>'5 \,AG- PROPERTY LOCATION: 0
v'Z�2N' QO
SUBDIVISION LOT #
Facility Type: �' °1�� 10 -New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'X No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** 9u m e Q—S''Jo (?..CS)yCA \ 0 N (Initial) Wastewater Flow: '35(:0 GPD
(See note below, if applicable ❑) 0
Vfnb
t (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench l CD C) feet
Pump Tank Size G gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: t,q, 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)
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 specified is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is ' t 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 ske,St to complthe)Kqyisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
a"a > Date: 113
Authorization Expiration Date:
HTE#
Permit # 165 c3
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: V—s)
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent:
)a e:
M
Ov cco•1)1-4--5 rZo
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: -3 Design Flow (1949):MG
Location of Site: Property Recorded: W
Water Supply: Public[] Individual ❑ Well
Evaluation Method -13, Auger_ Bo ing, ❑ Pit ❑ ( ut
Type of Wastewater: Mso Nage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
Description Initial Repair System Other Factors (1946):
S ste Site Classification (.1248): P.5
Available Space(. 1945) Evaluated By:
System Type(s) 1P p L Others Present:
Site LTAR ,
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
""_IIL MORPHOLOGY
_ .1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
Horizon
Depth
(In.)
t •1
Stns iura'
Te Marc
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
L
S
G -
`�
IJANL
Wyl Q
16 Q
IS -7
5,5
Description Initial Repair System Other Factors (1946):
S ste Site Classification (.1248): P.5
Available Space(. 1945) Evaluated By:
System Type(s) 1P p L Others Present:
Site LTAR ,