IPACHTE# I(v- `�'3�-`tC Harnett County Department of Public Health 28773
Improvement Permit
A building permit cannot be issued with only anImproveme t Permit
PROPERTY LOCATION: J
ISSUED TO: C%A SUBDIVISION LOT #
NEW ' REPAIR ❑ / EXPAN90N ❑� Site Improvements required prior to Construction Authorization Issuance:
f^�
Type of Structure: liomc CZ6 �S5 J }SkOP
Proposed Wastewater System Type: 9.S 7 e S��ovGs tp�t S7 �SLw
Projected Daily Flow: GPD
Number of bedrooms: _� Number of Occupants: C max
Basement ❑Yes 'P:Ao
Pump Required: []Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well i00 feet Permit valid for. 4ive years
Permit conditions: ❑ No expiration
Authorized State Agent: \ Date: 3 S ,b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Depamnent in no way guarantee nuke of other permits. The permit hol er 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 Inviailmemem 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 for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The concoction and installation requirements of Rules .1950, .1953, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shill be met Systems shall be installed in accordance
with the attached system layout
ISSUED T0: CaicxytCS G a�cL� �2 PROPERTY LOCATION: "3a G �T Goa-�.,ra5 _P
1� � 00 SUBDIVISION LOT #
FacilityType: Ynm ave New ❑ Expansion ❑ Repair
Basement? ❑ Yes -'§K No Basement Fixtures? El Yes EY90
Type of Wastewater System** 2`S to `CLEwc-<Y o J 5y5 E (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable ❑) r�,. ,��]
�V ^� P �� d� <w (Repair)
Installation Requirements/Conditions Number of trenches i
Septic Tank Size in oo gallons Exact length of each trench 3O O feet Trench Spacing: Feet on Center
Pump Tank Size--Z--Inchesgallons Trenches shall be installed on contour at a Soil Cover. 6
Maximum Trench Depth of: Y06— at inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/•1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: F1 Qc L psa l cs V 1 v E C�G— �tr�l yP.D F &I Aggregate
total
�rtiEP t � >—�D.t1-E,9
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 specAed it different from the type spec/bed on the app/icabon. / accept the rpecilcationr of this permit.
Owner/Legal Representative Signature: Date:
This construction Authorization is rocotion if 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 subjen m mmplian< ;;vl!m1s of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this Permit SEE ATTACHED SITE SKETCH
Authorized State Agent:®y -*N� T S Date:
Authorization Expiration Date:
NTE# I G — 5- 3�S' Permit # 3
Harnett County Department of Public Health
Site Sketch
_ PROPERTY LOCATON: So E CA t t 5
ISSUED TO: GAA�5 GC�,�y Jn SUBDIVISION LOT #
Authorized State Agent—�e�5 �Dl oLksoO( Date:
S
'�5'1i UP MAY gE ,�Ip'
7`�I1
CW
6oe- 2p
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Cn Design Flow(. 1949): W3 54)
Location of Site: Property Recorded:
Water Supply: Public❑ Individual [I Well
Evaluation Metho� Auger Bo ' g ❑ Pit ❑ Cut
Type of Wastewater: �3ewage [3 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
!I
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
1
<, 5
5
o N0
G LS
yrs ^+9
_T_
iCiL)y
sex C
FQ S SQ
PSS
a
-16
G Lf
V� >v�INP
N
(1.. ¢. 3 �.
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P S
3
5
o-� �y
G v
JkZ us �tiQ
li �l�
Ic C_
R1 5[sr
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"5
Description Initial Repair System Other Factors (.1946):
S sten Site Classification (1948):f�'
Available Space (.1945) Evaluated By: 07
System Typo(s) �` dD Others Present:
Site LTAR