IPACHTE# 16-5-3513 Harnett County Department of Public Health 28800
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: G.or<vp L C.
ISS Eli D T0: M h c-; a s Ear6n.Q �� 5E S SUBDIVISION "1 AQ 6 0 '. C_ LOT # 1 �
11 REPAIR ❑ �ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _Sc p LSyR n5 O
Proposed Wastewater System Type: eZ4-�0I0 VNSQvex toff lss� a
Projected Daily Flow: '360 GPD
Number of bedrooms: 3 Number of Occupants: 6 max
Basement []Yes >rJo
Pump Required: ❑Yes �No ❑ May be required based on final location and elevations of facilities
�Type of Water Supply: ❑ Community.Psiblic ❑ Well Distance from well S -O O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized Stare Agent:: Date: 5LL SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is me of other permits The permit holder is respollsible 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, .1951, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the ausiched system layout.
ISSUED TO: M \LSCm4 tG(\k0. S G5 PROPERTY LOCATION: MPq 5 L^ -o kN C
SUBDIVISION W NQ F— YO G LOT #
Facility Type: SAO Gil t xs� New ❑ Expansion ❑ Repair
Basement? ❑ Yes -9( No Basement' tures? El Yes )5 No
Type of Wastewater System" ��`l r 9yC7i \ 0 rr a -7S TCtr (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) �y
QLS°lo 1'\60. z"-$-576 !" (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size T a0 C) gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench \ OO feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: Si inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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: l anderstand the system type specified is different from the type specified on the application. / accept the stiecillevions of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is su voatian if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization i_iubject to mmplleasp`wn m s of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: :!!�7 � %off Date: S
Con tetion Authorization Expiration Date:
HTE# 13 Permit # 3�(30
Harnett County Department of Public Health
Site Sketch
PROPERTY LOEATON: � crP > s3 L A NO t N C,ISSUED T0: M t Li pct P2 SUBDIVISION \J ;-,OF— PO) v; G LOT # 1�
Authorized State Aeecm Q(c�1}�t,yG,� —1o xso Date: SI12��6
I 10
Cjrjj-9A ss i-A.D l q e
3Or
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: 3 ��)^ Design Flow (.1949): �oQ x 1
Location of Site: Property Recorded:
Water Supply:ublic❑ Individual E] Well
Evaluation Method o g El ❑Cut
Type of Wastewater: 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(
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
v a—
O
/Texture
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948): 0_3
Available Space (.1945) y Evaluated By:
System Type(s) Others Present:
Site LTAR