IPACHTE# Harnett County Department of Public Health 28772
Improvement Permit
A building permit cannot be issued with only anx�Improvement P�p['� 1t
PROPERTY
ISSUED TO: L—ohng ono a
�a874 6 31M �ZN SUBDIVISION CATIONQ,L�sG� LOT # PN
NEW '5< REPAIR❑ RPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: T' bi No me, �a� "I-1�O
Proposed Wastewater System Type: QSS'/o kfe2yc i ops
Projected Daily flow: Sr o GPD
Number of bedrooms: 3 Number of Occupants: Jr. max
Basement ❑Yes No
Pump Required: []Yes '>(No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community >� Public ❑ Well Distance from well 1 b O feet Permit valid for. )4ve years
Permit conditions: ❑ No expiration
Authorized State Agent: eF:
The issuance of this permit by the Health Department in no way guarantees the imuan
site is subject to revocation if the site plan, plat or the intended use changes. The Imprh
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date:
SEE ATTACHED SITE SKETCH
u. The permit holder is responsibld for checking with appropriate governing bodies in meeting their requirements. This
shall not be affected by a change in ownership of the site. This permit is subject to complianu with the provisions of
Construction Authorization
Required for Building Permit
The construction and installation requirements of Rules ASO, .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 I�Z
ti `1
ISSUED T0: CO"t�LSJ \ a\vC�IE SM��H PROPERTY LOCATION: Doc
/ SUBDIVISION Rent .)CSS LOT #'I fS
Facility Type: Mc>t c-4 4t1MC G2'd�>�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes '�R No Basement Fixtures? ❑ Yes �Xl o
Type of Wastewater System** -/ tl sv Syg: G n (Initial) Wastewater Flow: T�4 GPD
(See note below, if applicable ❑)
a.5°Zci - S. (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 10 c:)iZi gallons Exact length of each trench "tQ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: al", aA inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing, ("'I Feet on Center
Soil Cover. \a- NG 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 LOFT. 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 specified is different from the type spenfed on the appfcation. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is su fie wont if fis 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 subject to complilm a wit roThsaps of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v t4 --)-s5 Date:
fbuction Authorization Expiration Date:
HTE# Permit # a371-3.
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: CGS
ISSUED TO: EO RV8 �- SUBDIVISION 9-04 LOT # ,
Authorized State Agent: Date: l-:O\l-6
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Date Evaluated:
Proposed Facility:
Design Flow (.1949):
Location of Site:
Property Recorded:
Water Supply:
❑ Publico Individual ❑ Well
Evaluation Method:❑ 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
Mineralogy
.1942
Soil
wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Resn
Horiz
'
Q)SJ
S
o-1 o
Nw, NSP
IU-MoSgt
c
sA
,-
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5
O -S
L
W�L
2L Q4'
53Y. SQ-
}?2 5-.04
>� occG
Description Initial Repair System Other Factors (.1946):
S st / Site Classification (.1948): GS
Available Space .1945 Evaluated By: cid
System Type(s) O -.S' Others Present: —
Site LTAR S