IPACHTE# ti b j-'��cl Harnett County Department of Public Health 28785
Imorovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: W a ti LUC a s Qp
ISSUF,DTO: 'Z-s�'S\LCl�Yvsi ,NG SUBDIVISION LOT# 3�-_
NEW REPAIR ❑ EXPAINSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S (79 l3 c5 X�3
Proposed Wastewater System Type: �l RMvc o+l SYS n
Projected Daily Flow: 3<0 6 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes `�o
Pump Required: ❑Yes �jo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community�Public ❑ Well Distance from well Q feet Permit valid for. Five years
Permit conditions: ` ❑ No expiration
Authorized State Agent:: Date: 14, SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o r permitx The permit holder 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 Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject in compliance with the provisions of
the laws and Rules for Sewage Treatment and Deposal and to conditions of this permit.
Construction Authorization
Required for Building Permit
The construction and installation requirements of Rules .1950, .1951, .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
ISSUED TO: < t-ts\-\c- C';, �� . it L PROPERTY LOCATION: W u LA -1 S
SUBDIVISION LOT #_
Facility Type: 9 ��1 x�� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes -'X No Basement Fixtures? ❑ Yes O
Type of Wastewater System** a. �o I�6flvr:No r ,isC,ui (Initial) Wastewater Flow: 3�b GPD
(See note below, if applicable ❑)
5 10 1--"' CQ = S-15 (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size T10 oC gallons Exact length of each trench s oo feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 3 C -L (4 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: R Feet on Center
Soil Cover. Ql'� 3 6 inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the ryrtem type rpeci6ed it different from the type spec/bed on the app/kation. / accept the speciftlionr of this permit
Owner/Legal Representatjve ' re: Date:
This conservation Authorization is subject t "Orion. e s plat or the intended use changes. The construction Authorization shall not be transferred when there e a change in ownership of the site. The
Construction Authorinu to mmplian h the prows ws and Rules for Sewage Treatment and Disposal and in the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent. 5 Date:
Construc n Authorization Expiration Date: al
HTE# Vo'S;'j�o\ Permit # '15
Harnett County Department of Public Health
Site Sketch (J
PROPERTY LOCATON: fV iLL Lu
ISSUED T0: t� `� �N� -`rG SUBDIVISION SwccrrA LOT #_
Authorized State Agent: �5 Lx4cd,`70i'Gs'Ki Date:
1� c
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: Dom` Design Flow (.1949): c
Location of Site: Property Recorded:
Water Supply:Public❑ Individual ❑ Well
Evaluation Me[ho� ge Ba Ing ❑ Pit ❑ Cut
Type of Wastewater: wage ❑ 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
Hor=
�,
53y cL
A5
X36
-49x 5 L
36
G5
jo
G 5L
P15D
%K G�
3031
93�-.wt
31
�S
Description Initial Repair System Other Factors (.1946): ,e
S stem Site Classification (.1948):
Available Space(. F94-5) - Evaluated By: <n
System Type(s) Others Present:
Site LTAR