IPACHTE# 16-5- b33-� Harnett County Department of Public Health 28776
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
U PROPERTY LOCATION:_ wL
ISSUED TO: _ W a s 6r1_ 1k 0 rn6.s \ ns C„ SUBDIVISION C cQ a s 5 Ts l LOT #
NEW REPAIR ❑ E)iP7SI0N ❑ Site Improvements required prior to Constmction Authorzation Issuance:
Type of Structure: SFS �L:Fi'cii`-)
Proposed Wastewater System Type: 2-S 7 a VCT I 0 at
Projected Daily Flow: 36O GPD
Number of bedrooms: 3 Number of Occupants: '6 max
Basement ❑Yes No
Pump Required: ❑Yes o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well LO C) feet Permit valid for. Five years
Permit conditions '-� c Q ❑ No expiration
Authorized State Agent: Date: `i 16 h b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaramees the issuan other permits. The permit holder is rrsponsible 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 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, .1957, .1958. and .1959 are incorporated by references
into this permit and shall be met. Systems shall be installed in accordna
with the attached system layout.
ISSUED T0: PROPERTY LOCATION:
r SUBDIVISION
r�� �'� «l-1�
LOT # Q-`1
facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes '-8. No Basement Fixtures? 1-1Yes�No
Type of Wastewater System" c�-5'Lo 'P� U GS R U )Q SiE-M
(Initial) Wastewater Flow: 3(-() GPD
(See note below, if applicable ❑)
Q-zo I Ste-
(Repair)
Installation Requirements/Conditions Number of trenches t'1
Septic Tank Size YO C'Qc) gallons Exact length of each trench C feet
Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Soil Cover. r—inches
Maximum Trench Depth of: 5'$ 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. TDM vs. GPM
Aggregate Depth:
Conditions:
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: / understand the system type sruecifed is different bpm the type spedbed on the app/ic2don. / accept the cpec6cadonr o/ this pilitmit.
Owner/Legal Representative Signature: Date:
This construction Authorization is subjectm �on if thesgre plan, plat, or the intended use changes. The Construction Authorization shall not be tonsfemed when there is a change in ownership of the site. This
construction Authorization is s to complianu the 's the caws and Rules for Sewage Treatment and Disposal and in the conditions of this permit. SEE ATTACHED SITE SKETCH
[Authorized State Agent: Date: LA 4 1, .
Coni"n n Authorization Expiration Date: st 16 1
HTE#
IC-s-333-� pr. ;# #
ISSUED TO:
IVA
Authorized State Agent:
ei
Harnett County Department of Public Health
Site Sketch
a6
PROPERTY LOCATON:_ VN�a�aA DLIV G
SUBDIVISION P�-s;�„L,) (-�t45s1\N C LOT # a9
i (CFLm L i0o4,-%1113>Date: �tIb1�6
4�`\� tiovSE
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: (yt, Design Flow (.1949):3 J -
Location of Site: Property Recorded:
Water Supply:����....,,,,....ublic❑ Individual ❑ Well
Evaluation Method Bo Ing ❑ Pit ❑ Cut
Type of WastewZ 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
Restr
Horiz
3G
Description Initial Rep iSystem Other Factors(
.1946):
(.1948
)^:S stem �
Available -Space (.1945) V Evaluated By.
System Type(s) a;. F - Others Present:"
Site LTAR