IPACHTE# Ifo- 5 3136 9 Harnett County Department of Public Health 28648
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: B aT t_6 -i S 5� or, 0 9 yZ
ISSUED TO: ��Lca+ -) lya ufhf�a> SUBDIVISION — LOT #
NEW.KI REPAIR ❑ EXPAt�SION 11Type of Structure: S7O L_IS^"3cy,
Proposed Wastewater System Type: 2 -Se/- Qr--Z u.,v S-AstGf,
Projected Daily Flow: 34 n GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes �MNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes --453o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public X Well Distance from well 1n`0 Net Permit valid for. Five years
Permit conditions: c ❑ No expiration
Authorized State Agent:��ti Date:�� r2� 16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guamnro ththe is, of other permits. The permit holder is esponsible for checking with appropriate gumming bodies in meeting their requirement. This
site is subject to revocation if the site plan, pla4 or the intended use changes. The Improvement Permit shall not he 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
squired for Building Permit)
The construction and installation requirement 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 yrs _
ISSUED T0: 3Ccz.Gc4.y � I+oc'r,g� PROPERTY LOCATION: '�aSs-E>� I Laot��S
W
SUBDIVISION LOT # -S
Fadlity Type: S FO C -LS 'a -3L-0 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2M No Baseme t Fixtures? ❑ Yes No
Type of Wastewater System** aS -7e FG.Ok7a'T T e r Sys i —Pry (Initial) Wastewater Flow: 3i 6 GPD
(See note below, if applicable ❑)
-25"1 o RED . S,t 5 . (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size s o o r7 gallons Exact length of each trench 3� o feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. )O inches
Maximum Trench Depth of TQ'-Dr1 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/.I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: (L TDM vs. GPM inches below pipe
r Aggregate Depth: inches above pipe
Conditions: 'Fir-4AL c) Q>L- 0Cy&1,rlxnsrp &Q- ' inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable /understand the ryrtem type specified it different /voce the type spedffed on the app/ication, l accept the rpeaflca6wr of this permit
Date:
This Construction Authorization ' subject ro reraadou if the site plan, plet, or the intended use changes. The Construction Authorization shall not be transferred when dere 4 a change in ownership of the site. This
Construction Authorization isaubLea to t ce with ktrovisiom of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent Date: S
Construction Authorization Expiration Date:
HTE# IC -5— Permit# QA,`q}
Harnett County Department of F`nblic Health
Site Sketch
PROPERTY LOCATON: e)c")L��
ISSUED TO: - e +ori SUBDIVISION — 1 LOT #
Authorized State Agent» LrvEtt ToLrSoo Date: Z.)
I J6
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�$ 3
75 "3�1 I C�Eip A'u`A
abs
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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:�J (3 `�,(`� Design Flow (.1949):.0 ��
Location of Site: �Pnroperty Recorded:
Water Supply: N.""'""" Individual Well
Evaluation Metho�Auger Boring ❑ 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.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure(
Texture
.1941
Consistence
MineralogyColor
.1942
Soil
Wetness/
.1943
Soil
Depth IN.
.1956.1944
Sapro
Class
Restr
Horiz
�5
'a
53x- c-
VG-'
3
5)$
O`KI 4 a_3R
�5
Description Initial Repair System Other Factors (.1946):
System, Site Classification (.1948)
Available S ace (.1945) Evaluated By:
System T e(s Others Present:
Site LTAR
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