IPACNTE# T Harnett County Department of Public Health 28624
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
VIN \/ " I C PROPERTY LOCATION:
ISSUED TO: G C oc.`,,-S SUBDIVISION cmc c<�o", LOT #
NEW -g REPAIR ❑ ERPA(CSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: �s�lw vc:tK , 1W 4 SxSiG^r+
Projected Daily Flow: (o'U0 GPD
Number of bedrooms: 5' Number of Occupants: 10 max
Basement []Yes AND
Pump Required: ❑Yes 14 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -K Public ❑ Well Distance from well 1 ho Net Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent: 5 Date: S `v a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other its. The permit holder is responsible for Checking with appropriate governing bodies in meeting their requirements. This
site is subjea to revocation if the site plan, plat or the intended use changes. The Improvement 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
Reauired 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 amthed system layout
ISSUED TO: M Gy�2C 100-164> I L1 PROPERTY LOCATION:
SUBDIVISION _�?cAg\ov LOT #
SP9 `� qTrJ6
Facility Type: � New ❑ Expansion ❑ Repair
Basement? ❑ Yes N No Basement Fix res? ❑ Yes >� No
Type of Wastewater System" iS�Glo 1)VcsS 1 t)zJ S-;iSirF \ (Initial) Wastewater Flow: �--o 0 GPD
(See note below, if applicable ❑)
Zi C) 1ZEo. S-yn. (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size 1aSU gallons Exact length of each trench ;k O feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. 6-)"b inches
Maximum Trench Depth of. )'% ---'s 0 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: iC TUN vs. GPM inches below pipe
C� � regale Depth: inches above pipe
Conditions: fly uy't Q o 0 �J y ` � ��Tt� c)rn 111n 9 tv 4,Ea_,9 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: / onderstand the system type specified is d%teryt from the type specified on the app/icatiom / acrnpt the specihcationr o/ 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 he transferred when there h a change in ownership of the site. This
construction Authorization is subjttl ro c it provisions of the taws and Rules for Sewage Treatment and Disposal and to the Conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: W Y l�
onstruction Authorization Expiration Date: 72
HTE# S3(l Permit #
Harnett County Depa.ilinent of Mihlic Health
Site Sketch
v PROPERTY LOCATON:—oyNs(Ly5 �� ��G
ISSUED T0: M G��GE ��ME� C �i SUBDIVISION OA�IMa*� 1 LOT #
Authorized State Agent: 77 Q��S �0� wF'LN01X5�C1%I Date:
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOHJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility:�5'1 Qq_"_ Design Flow (.1949): 6'0
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Mathod-: a Bo 'ng ❑ Pit ❑Cut
Type of Wastewater: Sewage ❑ 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.)
SOH. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
IN.
.1956
Sapro
Class
.1944
Resn
Hor z
1
SL3 7
033
G s
Nj + 4vC '
C i-5
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vr, nl•�p
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)1140
C 5 L
JFrl Z Y
kD
,
Description Initial Repair System Other Factors (.1946):
Systom I I j Site Classification (.1948
Available Space (.1945) 1 Evaluated By0 x
System Type(s)) Others Present: �.
Site LTAR G