IPACNTE# ��—S 3�c1 Harnett County Department of Public Health 28908
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
Q PROPERTY LOCATION: NC—'ni.17
ISSUED TO: a dz �a9w ALL �A i Sj�� SUBDIVISION LOT #
NEW'4 REPAIR ❑ d KPANSION ❑
Type of Structure: O`SProposed Wastewater System Type:
�a C`j'�
Projected Daily Flow: SC.Q GPD
Number of bedrooms: '!;, Number of Occupants: max
Basement []Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes K No ❑ May be required based on final location and elevations of facilities
�1
Type of Water Supply: ❑ Community ❑ Public Well Distance from well L Q feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 6 a� SEE ATTACHED SITE SKETCH
The issuance of this pennit by the Nealth Department in no way guaan e,zssuame of other permits. The pemdt holder is resp nsibfe for checking with appropriate governing bodies in meeting their requirement. This
site is subject to revocation it the site plan, plat or the intended use changes.iprovement 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 ro conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirement of Rules .1958, .1952, .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: e2oeq'IVd &L" H ewC "A Go— PROPERTY LOCATION:
r SUBDIVISION LOT #
Facility Type: 5F4 C3� x�0� New ❑ Expansion ❑ Repair
Basement? ❑ Yes `1k No Basement Fixtures? ❑ Yes 'XNo.
Type of Wastewater System** a s'�c RGD v,S �t t)" Y5 GM (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
!.S m/ a
FlJ v c„ S of 1,3 (Repair)
Installation Requirements/Conditions
Number of trenches 4
Septic Tank Size IOO gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth ofd" ay inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 6- SQ, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
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: l understand the system type specified it different hom the type spedfed on the application. / accept the spedfcafons of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is voation d 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 'ic, Mesa to tomolia i ions of the Caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 21�W Date: `'
Co ion Authorization Expiration Date:
HTE# �� 5 34°+3Z Permit # �� ONJ
Harnett County Department of Public Health
Site sketch
ISSUED TO:
Authorized State Agent:
lip
am
PROPERTY LOCATON: NCai-I
_ SUBDIVISION LOT #
ov t (� oyDO Date: 11711 b
Gso'
C -)e
BP2r�
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOILlSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: y 9DQ.� Design Flow (.1949):31] d,<�
Location of Site: Property Recorded`
Water Supply. E]Public❑ Individual I74'i�w. ell
Evaluation Method,Auger Boring ❑ 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
PosthoN
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structural
Texture
.1941
Consistence
Mineralogy
.1942
Soil
wanes/
Cot"
.1943
Soil
.1956
Sapro
Class
.1944
Rear
Horiz
O -a
G se-
`
`�_ry t -v
1 3 tl
SQ1t- S,GL
F'�i. J 6�I�Q..
O-+aI�
CGj�S,L�
551
i '�5
Q5 s�
� ��1N�
2y-
52125
RL 5�-v
Description Initial Repair System Other Factors (.1946): 2
S sten Site Classification (.1948): Q
Available Space(. 1945) Evaluated By: Q?
SysT e s S" r Others Present: i
Site LTAR • $`s