IPACHTE# 1(a' 5"3t0-2"\ Harnett County Department of Public Health 2876
Improvement Permit
Authorized State Agent.: ��1 , \yw��Lczl35 Date: 5 16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance oermi°. The permit holder is res onsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement PmAt shali not be affected by a change in ownership of the site. This persist 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 insmilatum requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1950. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout 5�
ISSUED TO: K v c^ bFSL J'4 Ect,. PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: 0 New Expansion ElRepair
Basement.? El Yes X No Basement Fixtuf ? El Yes �o
Type of Wastewater System** aSolo GOUGS,sC)N S (5 iF�Tc\ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
r1S� a Yom, �)5 CQu m� (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size IOOd gallons
Pump Tank Size gallons
Pump Requirements: ft. TDM vs.
Conditions:
Exact length of each trench 1 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: ab - o�' inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. $- I�`- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / andecrtand the system type Jpeciled is different from the type spechfed on the app/ication. / accept the spec&ations of this permit
Signature:
Date:
This Construction u on: r (ion if the site plan, Ilat, or ithe intended use changes. The Construction Authoritarian shall not be transferred when there is a change in ownership of the site. This
Construction Authorintion is subject compliance cans " ns of <he and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 3-4
ConstructionIftrization Expiration Date: 3
A building permit cannot be issued with only an Imp�ovement Pe
Koss \'AD
ISSUED TO:�Z �cnWF' L_N)
GcaiD,4 5(2..
PROPERTY
PROPERTY LOCATION:
SUBDIVISION
LOT # 3
REPAIR 11EJNSION
❑
Site Improvements required prior to Construction Authorization Issuance:
T ofl
Type of mscture: '517,Q)�
Proposed Wastewater System Type:
Projected Daily Flow: 3 60
GPD
Number of bedrooms: 3
Number of Occupants:
max
Basement ❑Yes No
Pump Required: ❑Yes No
Type of Water Supply: ❑ Community
❑ May be required based on final location and elevations of cilities
Public ❑ Well Distance from well m feet Permit valid for.
Five years
Permit conditions:
_
❑ No expiration
Authorized State Agent.: ��1 , \yw��Lczl35 Date: 5 16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance oermi°. The permit holder is res onsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement PmAt shali not be affected by a change in ownership of the site. This persist 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 insmilatum requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1950. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout 5�
ISSUED TO: K v c^ bFSL J'4 Ect,. PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: 0 New Expansion ElRepair
Basement.? El Yes X No Basement Fixtuf ? El Yes �o
Type of Wastewater System** aSolo GOUGS,sC)N S (5 iF�Tc\ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
r1S� a Yom, �)5 CQu m� (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size IOOd gallons
Pump Tank Size gallons
Pump Requirements: ft. TDM vs.
Conditions:
Exact length of each trench 1 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: ab - o�' inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. $- I�`- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / andecrtand the system type Jpeciled is different from the type spechfed on the app/ication. / accept the spec&ations of this permit
Signature:
Date:
This Construction u on: r (ion if the site plan, Ilat, or ithe intended use changes. The Construction Authoritarian shall not be transferred when there is a change in ownership of the site. This
Construction Authorintion is subject compliance cans " ns of <he and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 3-4
ConstructionIftrization Expiration Date: 3
HTE# 5-, � Permit # 6 )
Harnett County Department of PlIblic Health
Site Sketch
ISSUED TO: K
Authorized State Agent:
PROPERTY LO(ATON: RCS5
LOT #
SUBDIVISION
iaz"y0yA3L)-� Date: 3I.1 -I16
16 Sr o6 P1.vmp,.JG n.5 tilcl� Di -5 Paas%PJ L -G.
IM
it
Department of Environment, Health and Natural Resources
Division of Environmental Health
Onsite Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 (39 2ZVJ Design Flow (.1949):-3G Q)t
Location of Site: Property Recorded:
Water Supply: Public❑ Individual C] Well
Evaluation M&hod:a Auger 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.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineral
.1942
Soil
Wetness/
Color
.1943
Soil
D th IN.
.1956.1944
Sapro
Class
Renr
Horiz
I_S
.'r
,�, i}e
six C-
PSas
3
-�
G
G S,L
16-30
SBKS.C_
�5
aS
V ,
it
I
Description Initial Repair System Other Factors (.1946):
Sy
m Site Classification (.1948): �-5
Available Space (.1945) T Evaluated By: (D
System Type(s) � 4 J4D I Qi Others Present:
Site LTAR�� S
i
) T 1'&V- -_ : c �U