IPAC RHTE# Harnett County Department of Public Health 28737
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C -a',- f vLZ N
ISSUED TO: { -,t LSC, SUBDIVISION Oo+�na T -S LOT # i5 �4—
NEW � REPAIR ❑ EXPAN3�ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of tructure: `�� (-5 C)
C) )n
Proposed Wastewater System Type: <9,57a t ov[z s v as S t5'G r -r\
Projected Daily Flow: 3Co0 GPD
Number of bedrooms: -:�> Number of Occupants: _max
Basement ❑Yes )KNo
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ o expiration
Authorized State Agent.: Date: 5 d1 b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the a cher permits. The permit holder is respo sible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revoation if the site plan, plat or the intended use changes. The Impro rmit 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 BuildingPemjtl
The construction and installation requirements of Rules .1950, .1957, .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 attached system layout
ISSUED T0: �' �br\P b LLC PROPERTY LOCATION: G�N15,gCZ) �i,Lz. 10 4-
TS
SUBDIVISIONC7A-'�s-Mo LOT IF
Facility Type: `�C� CS—�^"� �� New ❑ Expansion ❑ Repair
Basement? ❑ Yes -'N', No
Basement fixtures? ❑ Yes �Ao
Type of Wastewater System**
a50/ w
t Sy S i 6 ,
(Initial) Wastewater Flow: 3b (i GPD
(See note below, if applicable ❑)
a
aS /�
(�
C-Dvc.:� ti-il (Repair)
Installation Requirements/Conditions
Number of trenches S
Septic Tank Size N (Z) 10 U
gallons
Exact length of each trench 30 0 feet
Trench Spacing: Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: C` inches
Maximum Trench Depth of: T$ 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: h. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the system type speadled is different hnm the type spelled on the app/kation. / acrept the specifications of this permit
Owner/Legal Represettative Signature: Date:
This Construction Authorization u subject adon 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
Constmaion Authorization u su m complihasli withl*;k
AtAkns of the laws and Ruin for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 G.
Co ction Authorization Expiration Date: 3 �7
Permit #
-5 3`etia� Q
HTE# De artmenof Public Health
Harnett County t site Sketch
PROPERTY LOCATON:
G oMCs
L—, SUBDIVISION
SUBDIVISION
G
ISSUED T0: t Lo>�sao Date:
Authorized State Agent
YliC)
� may,. >>-• � �
' � v
,� 65
IVol
(�N6(Ltl`I Nlly OCL
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: Is 5?2 n Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method[32,Au er 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
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOH. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
&LIAR
.1941
Structure/
Texture
.1941
Consistence
lifinciialogy
.1942
soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
ea -v0
s9xszi
� ssi w�
P
�$
6
:59� C_
�5
1 36
513x, sw_
vA S�S,e
X53
�& NN
T_
Description Initial Repair System Other Factors (.1946):
S t Site Classification (.1948): e5
Available Space(. 1945Evaluated By: O�
System T e(s Others Present:
Site LIAR