IPACHTE# )6-5 3�,3Y,1-1 Harnett County Department of Public Health 28779
Improvement Permit
A building permit cannot be issued with only an Improvement ermit (c�� �
SU D
\j PROPERTY LOCATION: 719 45 avaovr AY �9
ISTO: q J C� ` `� T<Y---b `H G SUBDIVISION LOT # _
NEWA REPAIR ❑ EI{PISION El
Type of Structure: GgrO �-)O "b1 ")
Proposed Wastewater System Tjqpe: S'/m NE.oveSC\oKt -Y5.
Projected Daily Flow: 3(00 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement []Yes �9'No
Pump Required: ❑Yes „X No
Type of Water Supply: ❑ Community
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
❑ May be required based on final location and elevations of facilities
Public ❑ Well Distance from well feet Permit valid for Five years
❑ No expiration
Authorized State Agent: ��'�5 Date: TLt SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the muanm o Cher permits. The permit Ilk respon ible 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 in 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 shall be installed in azmrdance
with the attached system layout
ISSUED TO: CA"\l ES I N (� PROPERTY LOCATION: -7 °1350 Ay 9-1)
SUBDIVISION LOT # *—
Facility Type: SVD(7) 16--7 ANew ❑ Expansion ❑ Repair
Basement? ❑ Yes -,-4 No Basemjnt Fixtures? ❑ Yes -FfoS
Type of Wastewater System" 9':!!50L � LovC�e t ON ry516--A (Initial) Wastewater Flow: "YoC) GPD
(See note below, if applicable ❑)
2S "10 2
Installation Requirements/Conditions
Septic Tank Size > o 0 gallons
Pump Tank Size gallons
C-.0 , S-7
Number of trenches -:5
Exact length of each trent— h feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. r', inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Trench Spacing: "Ii Feet on Center
Soil Cover lZ a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
WATER LINES (IN(LUDING 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: / underrtand the r)rtem type rpeciled it different from the type rpeciled an the application. / accept the sped&atianr of thin permit.
Owner/Legal Rel Signature: Date:
This Construction Authorization is subject so\re i(1 a plan, plat or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the sin. This
construction Authorizationgaie�ct to mmpl3Me�with the pr o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �, ��� vy :: .1 Date: �tl )"
Construction Authorization Expiration Date: 4
HTE# \(�—
ISSUED TO:
Authorized State Agent:
Permit # Z'S71
Harnett County Department of INtblic Health
Site Sketch
PROPERTY LOCATON: --I `135 S mm- j m
SUBDIVISION LOT #
`O LII(,iL,"So1:YSD0(�> Date:
cA
0
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: Qj CjOQN' Design Flow 1.1949) fiid Ce�
Location of Site: Property Recorded: JJ
Water Supply: ublic❑ Individual ❑ Well
Evaluation MethodAuK,er�Bon g ❑ Pit ❑Cut
Type of Wastewater: ewage ❑ 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
- S
mya
G Ls
VIS r "Ll
Y
Description Initial Repair System Other Factors (.1946):
System I Site Classification (.1948): 5
Available Space(. 1945) Evaluated By: Q�,
System Typo(s) 1 S' J C1 Others Present: l
Site LTAR •-(
w
3 s 6 @ 01-31