IPACNTE#16-51:� 1—A Harnett County Department of Public Health 28768
Ito -S- 3s/79 Improvement Permit
A building permit cannot be issued with only an Im rovemmit
gnt Per
` PROPERTY LOCATION: a1 W
ISSUED TO: NK -4r faLpv \V E.s-5C_� SUBDIVISION Pwy%Fx S0nl LOT #
NEW)' AEPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M o O V L (ST-31�
Proposed Wastewater System Type: SS"io css I o .-r>�
Projected Daily Flow:�3 GPD
Number of bedrooms: _-S Number of Occupants: G max
Basement []Yes >< No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Publics, Well Distance from well SC!7)0 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: a--', Date: 3 115 1 IL SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is of other permits. The permit hol r is respo Bible br chxking with appropriate governing bodies in meeting their requiremenu This
sin is subject to revocation if the site plan, plat or the intended use changes. The Improve ent 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 Mr Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permjt)
The construction and mutilation 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.
ISSUED TO: 9;"1 PROPERTY LOCATION: Q�7 U
�3^� � SUBDIVISION E� PMEJ71ZO LOT #
facility Type: 000 37� New ❑ Expansion ❑ Repair
Basement? ❑ Yes '�E< No Basement Fixtures? ❑ Yes _1A0
Type of Wastewater System** ®/o 'R60y 0, s 0 . S y 5Eav\ (Initial) Wastewater Flow: 3C 0 GPD
(See note below, if applicable O) a
�S _/c'
CO VX i dtJ S�3 (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size 1000 gallons
Exact length of each trench 5 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: a®inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover, '% - '156 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: / onderstand the system type specified 9i different from the type specified on the app/icaiion. / accept the rpeubcadvar of this permit
Representative Signature:
Date:
This Construction Authorization is ruble enation it the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is wbjec 10 compliant e"philisom 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: J S 1 b
�truction Authorization Expiration Date: 3 T:
HTE# (�D 5-''N 1�6 Permit # 6�
► 5- 3 2ffa .nett CountyDepazIment of Public Health
Site Sketch
PROPERTY LOCATON: a'--� \-j
ISSUED T0: e G El SEN SUBDIVISION LOT #
Authoriu
Lay cD
i'� DpwroGD
3 16,
15u^O-)P6E Oc-
1vn1
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: Design Flow(. 1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public[] IndividualWell
Evaluation Method: Au er Boring ❑ Pit ❑ Cut
Type of Wastewater: _Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
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
Wetnas/
Color
.1943
Soil
Depth W.
.1956
Sapro
Class
.1944
Restr
Horiz
5
X5\1 (Q
p
3
35
G 5
rv� 4V
Description Initial Repair System
Other Factors (.1946):
Site Classification (.1948)::Q>
System
Available Space(. 1945)
Evaluated By�
System Type(s)
Others Present:
Site LTAR - .�