IPACHTE# Harnett County Department of Public Health 28643
Improvement Permit
A building permit cannot be issued with only an Improvement Pe
PROPERTY LOCATION: S i v C i s
ISSUED T0: C amt3t3LuaN0 HOt'�6S `rvC, SUBDIVISION LOT # i
NEW ' REPAIR P EXP SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO P.
x Cs
Proposed Wastewater System Type: fir/ a tL c c a a r4 is ; 6.'^
Projected Daily now: 360 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes �UNo
Pump Required: ❑Yes -:aK No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well In Oi feet Permit valid for. Five years
Permit conditions: `__� ❑ No expiration
Authorized State Agent: 7!z���
The issuance of this permit by the Health Department in no way guarantees the m
site is subject to revocation if the site plan, plat, or the intended use changes. The
the laws and Rules for Sewage Treatment and Disposal and in conditions of this in
Date:
SEE ATTACHED SITE SKETCH
other permits. The permit holder is relponsible for checking with appropriate governing bodies in meeting their requirement. This
hoes Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
Reauired for Buildine Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, AST. .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: 0 )-) camc=— IQG PROPERTY LOCATION: SQ 2W G �L o N625
SUBDIVISION C—s2rJLLJ� 5ECaSOX5 LOT # )iH
Facility Type: 56 -AD LCAS ^'`� � X New ❑ Expansion ❑ Repair
Basement? ❑ Yes 1' No Basement Fixtures? ❑ Yes )<No
Type of Wastewater System** eiSylo �f�]uC1CsU,r S y�i c-" (Initial) Wastewater Flow: '�CO GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: c) Feet on Center
Soil (over. T ), 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 ]OFT. 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 ipecibed is different /tom the type speaTted on the application. / accept the xpecifcationr of thin permit
Owner/Legal ep ive Signature: Date:
This Construction Authorization is subject cation if the site plan, plat, or the intended use changes. The Construction Authmdution shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is sublett to compbamll tk visions of the laws and Rules for Sewage Treatment and Disposal and in the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v� ��'�\�� 5 Date: I 1r. )6
Construction Authorization Expiration Date: t 1`1 a'
aS "l0
V—Z-0. 5'a`5 -S (Repair)
Installation Requirements/Conditions
Number of trenches I
Septic Tank Size 10o0
gallons
Exact length of each trench 15p feet
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: a. y inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements:
M. TDM vs.
GPM
Conditions:
Trench Spacing: c) Feet on Center
Soil (over. T ), 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 ]OFT. 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 ipecibed is different /tom the type speaTted on the application. / accept the xpecifcationr of thin permit
Owner/Legal ep ive Signature: Date:
This Construction Authorization is subject cation if the site plan, plat, or the intended use changes. The Construction Authmdution shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is sublett to compbamll tk visions of the laws and Rules for Sewage Treatment and Disposal and in the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v� ��'�\�� 5 Date: I 1r. )6
Construction Authorization Expiration Date: t 1`1 a'
HTE# Permit # QIS�,-j'3
Harnett Countv Department of Public Health
Site Sketch
PROPERTY LOCATON: SP a, ry 6 VLc ,., r=Q5
ISSUED T0: CUM
SUBDIVISION Co Z0 � W A S ec,so A43 LOT # Ste'
Authorized State Agent: Date:
I -�,I 1-10 U.S c
1 D
Lad R
v
C-
6ftt,w E T:Z , 6'24 flCL,
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: Dace Evaluated:`O
p
ProposedFacility:}do(LA Design Flow(. 1949):' cJ\
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method�u Boring ❑ Pit ❑ Cut
Type of Wastewater: 'Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
OOTHER
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
PROFILE FACTORS
Profile
Class
<AR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wemess/
Color
.1943
Sod
Depth W.
.1956
Sapro
Class
.1944
Restr
Horiz
0-:;LLk
16-A rJ)�'t
S ,.6
C) LK
qPj
Description ]nitial Repair System Other Factors (.1946):
S stem Site Classification (.1948
Available Space (. 1945) 1 Evaluated By: 6
System Type(s)Others Present:
Site LTAR < C_ • 6