IPACHTE# 15 -53b-l►Harnett County Department of Public Health 28534
Improvement Permit
A building permit cannot be issued with only an Imrovement Permit
PROPERTY LOCATION:
ISSUED TO: �AmFs MPo �_ C42allVl SUBDIVISION� et15t�N LOT#
NEW>< REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: TnPw4- orrr-0p
Proposed Wastewater System Type: QGO G oN `� i�Sv�
Projected Daily Flow: 3 t�0 GPD
Number of bedrooms: 3 Number of Occupants: C, max
Basement ❑Yes >tNo
Pump Required: ❑Yes etg No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community V Public ❑ Well Distance from well l 00, feet Permit valid for. Xfive years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: n ) s " SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guuancees the i¢ua er permiU. The permit holds is cespo Bible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site pian, pla4 or the intended use changes. The Improveme it 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, .1957, .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: -- "!s' 0%Cnal V)GAcb C'J(ULLt ry PROPERTY LOCATION: N LP Nt
SUBDIVISION g $ LOT # �o
Facility Type: VIP," 1AoM6-C11't'�%CD New El Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? 1-1Yes� No c
Type of Wastewater System** a S��0 (9EUVU'S S U to �YS<E1h (Initial) Wastewater Flow: 3>C 0 GPD
(See note below, if applicable ❑)
s X16 "�CDyGs N O r1 (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size S o o a gallons Exact length of each trenchC� feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: SB inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. G—Ja. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / undeatand the 1/rtem type specified it different from the type ipecifed on the app/icadon. / accept the cpecifca6onr of this permit.
Owner/legal Representative Signature: Date:
This Constructions 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 i ub' a to comp a provisiatis of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: -h5 Date: `f
Con ion Authorization Expiration Date: GI P571 a.6
HTE# (Z;-1 �y Permit # a-t53`i
Harnett County Department of 1'nblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LO(AT(
PKV— CAXaY',S SUBDIVISION
CLI
Date: 11)i -T
Ds�
LOT #
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):
Location of Site: Property Recorded:
Water Supply:Public❑ Individual ❑ Well
Evaluation Met hot)rAuger Bo ing ❑ 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
#
.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
Ls
-1R2_051 vQ
D"
` Xk,
'�FT
Description Initialair System Other Factors (.1946):
S em Site Classification (.1946:
Available Space (.1945) IV Evaluated Bmd<
System Type(s) Others Present:
Site LTAR 4 �s I,6