IPACHTE# /6—S--38 s Harnett County Department of Public Health 28863
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION aA-N "Z 1�
ISSUED—TO//�2c /�uL�¢—�lL SUBDIVISION / c LOT #
NEW C; REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: cSF''�)
Proposed Wastewater System Type: 25% 1LR=6'u LILO)')
Projected Daily flow: "Z C..-4 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ITNo
Pump Required: ❑Yes
Type of Water Supply:
Permit conditions:
❑ No May be required based on final
location and elevations of facilities
❑ Community Public ❑ Well Distance from well
feet Permit valid for:
YJ live years
❑ No expiration
Authorized St ens:: Date:S —I-) —116, SEE ATTACHED SITE SKETCH
The issuance of this permitth Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i 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 perma..
Construction Authorization
(Required for Building Permitl
The construction and inscallation requirements of Rules .1958, .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: PROPERTY LOCA�TsION:/ ]
N
SUBDIVISION Ara�LOT # �oa
Facility Type: & New 171 /Expansion ElRepair
Basement? Els Yes No Basement Fixtures? ElYes L No
Type of Wastewater System**Z �%v �1�sB U CnrZ W--�*sf f3- — (Initial) Wastewater Flow: 36-6 GPD
(See note below, if applicable ❑)
Installation Re uirem/Conditions Hill of trenches 3
Septic Tank Size / gallons Exact length of each trench i0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of.. 20 )/A inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TON vs. GPM
Conditions:
Trench
Spacing: Feet on Center
Soil Cover. 2 --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 fatal
If applicable: / understand the spem type spedfed is different from the type specfded on the app/icadon. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation 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
Commction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit ltt AIIAI.ntU lilt SUM
Authorized Sta Dat Ste) 9 -) le
Construction Authorization Expiration Date: 15--1 -2
NTE#
r
Permit # 2-BS6 3
Harnett County Department of 1'uhlic Health
Site Sketch
/� PROPERTY LOCATON:,tJH37 13aIJi+�cj
ISSUED TO: 490"d
�ct---/7 ANG /SUBDIVISION LOT #
Authorized State nt Date:
(}
Imo--
�� 1 44,
C°� v- 1j.
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Al
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method: ❑
Type of Wastewater:
Sheet:
Property ID:
Lot #:
File #:
Code:
>licant: µ'ms—i wiv f6,
Datrevaluated: b
Design Flow (.1949): 31041 Property Size:
Property Recorded:
Public❑ Individu ❑ Well ❑ Spring
Auger Bo g Pit ❑ Cut
Luf Sewage ❑ Industrial Process ❑ 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 W.
.1956
Sapro
Class
.1944
Restr
Horiz
C�12tIsr7r
r
L4
-cc
1 /t�I'.s..
341 3G jy%
3�
Description Initial Repair SysI Other Factors (.1946):
system Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s)) Others Present:��
Site LTAR