IPACHTE# III X6`1 �1 Harnett County Department of Public Health 28537
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: RNJD SS
ISSUED T9: S E+2CM 1 N)A �s t ON �yT SUBDIVISION E3 �A C u& Q.,) ya LOT #
NE REPAIR ❑ ESION [ISite Improvements required prior to Construction Authorization Issuance:
Type of Structure: Moo C G6 alai
Proposed Wastewater System Type: 'ab' • Ue`lo vas—„n
Projected Daily Flow: t•k�C) GPD
Number of bedrooms: 1-t Number of Occupants: max
Basement []Yes XNo
Pump Required: ❑Yes ''No ❑ May be required based on final location and elevations of facilities
Type of Water Soppl : ❑ Community Public 1:1Well Distance from well I C70" feet Permit valid for. Five years
Permit conditions: k ❑ No expiration
Authorized State Agent:: \ S Date: 91 \� I If SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the Cg of other permits. The permit hal r is re pansihle for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i1 the site pin, plat, or the intended use changes. The Imps i sent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provision 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 .1958, .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: �EfLC 1\ p.) -i CKLt ov4 G -.1.L PROPERTY LOCATION: P'No `6-T
SUBDIVISION P ABLE Q v >J LOT #
Facility Type: W1oo Cc2'`a� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes � No Basement Fixtures? ❑Yes No
Type of Wastewater System** as0f& RGovt-r v 0 � CD SEM (Initial) Wastewater Flow: 14 GPD
(See note below, if applicable ❑)
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 ayrtem type tpeciled is different from the type rpecifed on the application. / accept the rpecifvcationt of this permit
Owner/legal Representative Signature: Date:
This Construction Authorization is n to revoa[ian it the site plan, plat or the intended use changes. The Consvucnon Authorization shall not be transferred when there is a change in ownership of the site. This
construction Authorization is p-complian the Proneness of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: V6s Date:
ACruction Authorization Expiration Date:
aC'--� 10
%-4\C__�pUcK)0 PJ (Repair)
Installation Requirements/Conditions
Number of trenches a -L
Septic Tank Size 1 007 O
gallons
Exact length of each trench ` O feet
Trench Spacin : _9 Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover. - 1 r _ inches
Maximum Trench Depth of: 193-36 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 ayrtem type tpeciled is different from the type rpecifed on the application. / accept the rpecifvcationt of this permit
Owner/legal Representative Signature: Date:
This Construction Authorization is n to revoa[ian it the site plan, plat or the intended use changes. The Consvucnon Authorization shall not be transferred when there is a change in ownership of the site. This
construction Authorization is p-complian the Proneness of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: V6s Date:
ACruction Authorization Expiration Date:
HTE#3C`Y� Permit# a�53�
Harnett County Department of Miblic Health
Site Sketch
PROPERTY LOEATON: ST
ISSUED TO: GL / SUBDIVISION C3��cx-e- Qu nt LOT #
Authorized State Agent: (d�S iq Date:
2LIA3-
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ONSITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 1�s Design Flow (.1949): 4''kOSe�
Location of Site: Property Recorded:
Water Supply:Public❑ Individual [3Well
Evaluation MethodAuger Boring ❑ Pit ❑ Cut
Type of Wastewater: T�LiSewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
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/
Cut"
.1943
Soil
Depth IN.
.1956
Salim
Class
.1944
Restr
Horiz
c\ -AK
cn�
� 5
V�RN�INc
Description Initial Repair System Other Factors (.1946):
SysteW Site Classification (.1948): 'FS
Available Space (.1945) Evaluated ByKSC
System T e(S) Others Present:
Site LTAR .''z