IPAC RNTE# Harnett County Department of Public Health 28736
Improvement Permit
A building permit cannot be issued with only an Improvement Pe it
v PROPERTY LOCATION: C>-`ic "L— �il
ISSUED T0: M G F+=rc ° MG w+ e, SUBDIVISION C) DC44+NO nfi LOT # 16 1
NEW REPAIR ❑ ANSION ❑
Type of Structure: 6V-0,5 �� 5sn
Proposed Wastewater System Type: a.5'J , ovC TWd S�STFm
Projected Daily Flow: G.00 GPD
Number of bedrooms: , Number of Occupants: T O max
Basement ❑Yes �No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes oto ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well l0Q feet
Permit conditions:
Permit valid for.
five years
❑ No expiration
Authorized State Agent: \ \'s-:1 Date:y b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees die epee of other permits. The pemtit holder is respansib for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the sire pian, plat or the intended use changes. The Improv rent Permit shall not be affected by a change in ownership of the site. This permit is subject to tumpliana with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Pump Requirements: ft. TDH vs. GPM
Aggregate Depth:
Conditions:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: /underhand the system type specibed it different from the type rpecif'ed on the app/iemion. / arrept the rpeci6caiiam o/ this permit
Owner/Legal Representative Signature: Date:
This Construction Au tion is subject to revoation d the site plan, plat or the intended we changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Aushoriation is sjo& to mm the 'iota of the laws and Rules for Sewage Treatment and Disposal and to she conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v G1cY+3 Date: 9
CAIRALction Authorization Exuiration Date:
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rues .1950, .1952, .1954,
.1955, .1956, AM, .1958. and .1959 are incorporated by references
into this permit and shall be met Systems shall be imtalled in accordance
with the attached System layout
(�
ISSUED TO: C^L�CE "0 M(,-) Ne, PROPERTY LOCATION:
Facility Type: `5IFD (5T'r-,5 50
SUBDIVISION QAld-sh0 �'
New ❑ Expansion ❑ Repair
LOT # 15)
Basement? ❑ Yes �K No Basemgnt Fixtures? ❑ Yes '5110
Type of Wastewater System** e�S�(o
QCpVG:I On SvySGx
(Initial) Wastewater Flow: C60 GPD
(See note below, if applicable ❑�
(Repair)
Installation Requirements/Conditions
Number of trenches 5 2 1
Septic Tank Sizegallons
Exact length of each trench 6G 3 OO feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover. (Z— If inches
Maximum Trench Depth of: 'K a� inches
(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Aggregate Depth:
Conditions:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: /underhand the system type specibed it different from the type rpecif'ed on the app/iemion. / arrept the rpeci6caiiam o/ this permit
Owner/Legal Representative Signature: Date:
This Construction Au tion is subject to revoation d the site plan, plat or the intended we changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Aushoriation is sjo& to mm the 'iota of the laws and Rules for Sewage Treatment and Disposal and to she conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v G1cY+3 Date: 9
CAIRALction Authorization Exuiration Date:
HTE# � (,-5 3t",J-16'L Permit # aT-73b
Harnett County Department of Public Health
Site Sketch
\ PROPERTY LOLATON: C.i1E2S7y N -
NL -L S)
ISSUED TO: M F vNq, SUBDIVISION OPxmo),SS LOT #
Authorized State AgentDate: 5 6
TOd
C,a&Wt-! "IZL C<L
� -)
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: Design flow(. 1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Meth Au Bo 'ng ❑ Pit ❑ Cut
Type of Wastewater: \ Sewage ❑Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
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
L5
Po
L�
-G
s
VF'J_
P�
3
o -)t
fC
U �U
e --
o
Description Initial Repair System Other Factors (.1946):1
S st Site Classification (.I 948'D S
Available S ace (.1945) Evaluated By:
System Type(s) Rs'r'1 G Others Present:
Site LTAR , 1�