IPACHTE #I — S'lclfo t��56Harnett County Department of Public Health 28640
3��5 s tiA6e Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C.aiia, QD
ISSUED TO: Ny GayS pact n_L-S SUBDIVISION LOT # Z
NEWWN0 REPAIR EAP+ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SC_O
Proposed Wastewater System Type: B ADUe;s I ON _-Z) --.157 ZW%
Projected Daily Flow: <;eQ GPD
Number of bedrooms: 5 Number of Occupants: 6 max
Basement ❑Yes '�KNo
Pump Required: []Yes —IB�No ❑ May be required based on final location and elevations of facilities
Type of Water So ISo l . ❑❑ Community Public ❑ Well Distance from well t Met
Permit conditions:
Permit valid for. XFive years
❑ No expiration
Authorized State Agent: � Date: 1 t I6 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu wy�f other permin. The permit hol r is res nsibk for thxlting wish appropriate governing bodies in meeting their requirenwna This
site is subject m revocation if the site plan, plaS or the intended use changes. The Improve or 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
(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: �4uG11-7) 1JaiiW_5 PROPERTY LOCATION:
SUBDIVISION LOT # a
Facility Type: �
Y"� s� XNew ❑ Expansion ❑ Repair
Basement? ❑ Yes �:k No Basement Fixtures? Yes
1-1Yes No
Type of Wastewater System" a5tl�a VZEyG+ ri r -15) G, rr, (Initial) Wastewater Flow: r3 Q GPD
(See note below, if applicable ❑)
e
CS L
U tJ (Repair)
Installation Requirements/Conditions
Number of trenches Li
Septic Tank Size I a.S-o gallons
Exact length of each trench S O feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 9, Li inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDH vs.
GPM
Conditions:
Trench Spacing: Cl Feet on Center
Soil Cover: I J, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATIONS MUST BE IOFr. 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: / undetstand the system type speah'ed is different ham the type spedfed on the app/ication. / accept the specibcationr of this permit.
Owner/Legal Representative Signature: Date:
Thu Construction Authorization u subject to revocation if the site pian, plat, or the intended use changes. The construction Authorization shall not be transferred whm there is a change in ownership of the site. This
construction Authorintion is subject to co wit a provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: )35 Date: I S lb
Construction Authorization Expiration Date: 16-h,)
3755
HTE#—S-3T�tb
ISSUED TO:
Authorized State Agent:
a�
Permit #
Harnett County Department of 11�iblic Health
Site Sketch
PROPERTY LOCATON: C - r, LL D
�u,L-CCi6 SUBDIVISION \ LOT #
Date:
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: rj 8fl(Lfl Design Flow(. 1949): r;oq
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Au or g [3pit El 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.)
SOIL MORPHOLOGY
.1941PROFILE
OTHER
FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
L3
vFi -45IKv
S v
4
2-
O -4z
G 5
V Ffi a5 vP
S .tel
Description Initial Repair System Other Factors (.1946):
SYS Site Classification (.1948): S
Available Space(. 1945) Evaluated By: Dr,�
S stemT s 26- c Others Present: ly G7: 5�L>•Gt
Site LTAR L