IPACHTE# 16-5-At-1f6Harnett County Department of Public Health 28790
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
QW69 PROPERTY LOCATION: PI"r-- 11 ILLS
ISSUED TO:sov*TI s y,y t-p�S caG CAa66;Y SUBDIVISION 91- G -'i 1-1-5 LOT #
NEW REPAIR 4 E"SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S F l5 ] A-70-)
'
Proposed Wastewater System Type: Q,Sm o CQVCr'\Ovii 78;G1-1
Projected Daily Flow: 36o GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 'X No
Pump Required: []Yes ',e No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 10 d feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Sl(cN Date:' `1 1 I' SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is I other permits. The permit holder is responsi le for checking with appropriate governing bodies in meeting their requirement. 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 pmvisions 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 shall be installed in accordance
with the attached system layout.
90,s,65
ISSUED TO: vn sEc rfss cr Cib Y. • "F C, -QC- PROPERTY LOCATION:
SUBDIVISION + r L N aL-,-5 LOT #
Facility Type: 5�20t `'2 X-1 OD XNew ❑ Expansion ❑ Repair
Basement? ❑ Yes ;K No r'� Basement Fixtures? El Yes
Type of Wastewater System** aGoIc
o 1 ao'ta Ciil (Initial) Wastewater Flow: 366 GPD
(See note below, if applicable ❑) /
q Ea (Repair)
Installation Requirements/Conditions Number of trenches Q Q
Septic Tank Size ' gallons Exact length of each trench N b b feet Trench Spacing: I Feet on [enter
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. S inches
Maximum Trench Depth of IQ inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/.I/4^ 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM �J� inches below pipe
1V Aggregate Depth: inches above pipe
Conditions: inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable• / anderrtand the tyttem type specified it dihereot ham the type specibed on the application. / accept the rpedfeationr of this permit
Owner/Legal Representative Signature: Date:
This Constmctio zation 4 subject to revocation if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there u a change in ownership of the site. This
construction Authorization is, 'a rich the prorisi f the laws and Rules for Sewage Treatment and Disposal and m the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 9
0- on Authorization Expiration Date: 4
HTE# ' S "3 146 S Permit # aY19
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: P N E w L.L5
ISSUED TO: �V vs UBDIVISION � r � �� � LOT #
Authorized State Agent: �+5 ��w�2 Cot tSflo L& Date:
�� u U56
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOHJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): 3(.0 c,
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method: ager Boring ❑ Pit ❑ Cut
Type of Wastewater: wage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
MineralogyColor
.1942
Soil
Wetness/
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
fie. 1_5
t_5I
i4 *w
Yvj;7n
155
u
r
sq
s5 x X. -L
`i() sIS/*
y
D `_
G s
x s�i
Fn 3
-t. io
•�
Initial Repair System Other tactors (. t Y4o):
S t m Site Classification (.19485
Evaluated By:
b f Others Present: -
a>))c� C- A," PM 0 6tOjr-