IPAC RHTE# /{�— S—��7s 71� Harnett County Department of Public Health 28815
Improvement Permit
A building permit cannot be issued with only an
Insvemen�t Permit
PROPERTY LOCATIOSKIS%ISSUED TO ZZI—
✓f4 4
SUBDIVISION
NEW fREPAIR ❑ EXPANSION ❑ LOT #
Type off S Structure: J�1 ,4/
Sne Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type: ----'6 r&2r5''Q6rZr/J
Projected Daily Flow: �rcef,1 GPD
Number of bedrooms: Number of Occupants: _C�max
Basement ❑Yes No /
Pump Required: Dyes ❑ No Q If a required Ijasfd on final location and elevations of facilities
Type of Water Supply: ❑ Community Public LZ Well Distance from well iOo ' feet
Permit conditions: Permit valid for. f9"five� years
❑ No expiration
Authorized State
Date: SEE ATTACHED SITE SKETCH
The issuance of this per b the Health Department in no way guarantees the issuance of other permit. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i the site plan, plat or the intended use changes. The Improvement 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 construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shill be insmlkd in accordance,with the attached system layout
ISSUED TO: L(/ c4-2/ s PROPERTY LOCATION' / S�
SUBDIVISION`��,
Facility Type: —El
# if
New �� Expansion ❑ Repair
Basement? ElYes No Basement Fixtures? El Yes Ls3 No
Type of Wastewater System" ZSR/o Zirl�u(� f� _ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
ZS / (Repair)
Installation Requirements/Conditions Number of trench
Septic Tank Size/ oU gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: _ 2—q inches
(Trench bottoms shall be level to +/_I/4w
in all directions)
Pump Requirements: h. TDH vs. _ GPM
Conditions:
Trench Spacing: / Feet on Center
Soil Cover: _�_ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: —� Inches above pipe
Z: inches total
WATER LINES (INCLUDING IRRIGATIONS MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
'"If applicable- / understand the rrulem type speah'ed is diNernat from the type specified on the app/ication. / accept the fpetilrationr o!this permit.
Owner/LegalRepresentative Signature:
ihn Construcno Authon:aton is subject to monuon 11 the steplan plat o the tend Is
construction Authorization is uu da get The Ca stumon AuthoIn, �on shag not be transferred when thereeu a change m ownership of the site. This
mhurr I. —IImA A._r ... ...
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+swage treatment ana msposm and to the conditions of thispermit SEE ATTACHED SITE SKETCH
Authorized State ICcVPL-- '
Date:
Construction Authorization Expiration Date: `r _ i _ . 7 t
HTE# /&- Permit # 881 -'5 --
Harnett County Department of Public Health
Site Sketch
ISSUED T0:
PROPERTY LOCATONG�C/SS7� 7
��� ��G,✓< SUBDIVISION LOT # Z
Authorized StateAv n_�r ��
.�� Date:
TKCY-
WV
w
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: > vkz 7
Address: Date Evaluated:
Proposed Facility: pl�� Design Flow (.1949): Bi'¢�Z)
Location of Site:�/ Property Recorded:
Water Supply: L"J Public[] Individual ❑ Well
Evaluation Method:(- Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Ej Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F SOIL MORPHOLOGY
I .1940 .1941
L Landscape Horizon
E Position/ Depth .1941 .1941
# Slope% (In.) Structure/Consistence
Texture Mineralo
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
1942
Soil
Wetness/
Color
.1943
Soil
th IN.
.1956
Sapro
Class
.1944
Restr
Horiz
lrZ
L—Z
D —Jt-)
�v
IVB
°-leg
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): FS
Available Space (.1945) Evaluated By: --�
S stem T e(s , d' Others Present
Site LTAR �,.