IPACH T E # Harnett County Department of Public Health 28916
Improvement Permit
A building permit cannot be issued with only an Improvement Pe t
PROPERTY LOCATION:_ LaFtGH��
ISSUED TO: Ct %9E �PsGcIS� SJ SUBDIVISION LOT #
NEW K REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M PN+ 1A 0 mS:- V3Q, --r%d -)
Proposed Wastewater System Ty e: Gc xs s Ets 1 ors clam—w
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: Co max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well i00 feet Permit valid for. XFive years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 1121 \-b
SEE ATTACHED SITE SKETCH
The issuance of this permit by she Health Department in no way guarantees the issuance a r�permin The permit holdei is respo sibk lar checking with appropriate goreming bodies in meeting their requirement. This
site is subject in revocation if she 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 m conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into thin permit and shall be met Systems shall be installed in accordance
with the attached system layout
ISSUED TO: C—"'QC.ye'�Mc- N PROPERTY LOCATION: ) G z C—� CiiVQ(,^ ZD
/., � SUBDIVISION LOT #
Facility Type: %-4�o rnC C New ��,❑"' Expansion 11Repair
Basement? [I Yes � No Basement Fixtures? 1:1 Yes 1x00
Type of Wastewater System*" ('o0 NJ -4 o N � L (Initial) Wastewater Flow: 6 GPD
(See note below, if applicable Cl) S o
a /< R� • �S - (Repair)
Installation Requirements/Conditions Number of trenches 5
Septic Tank Size I c d 0 gallons
Pump Tank Size gallons
Pump Requirements: It. TDM vs.
Conditions:
Exact length of each trench —70 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. aQ—'i inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover. $ - ) S 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 IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / ondetttand the system type specifed it diherent Jrem the type specifed on the application. / accept the spedfcadonf of this pemlit
Owner/Legal Represents' ture: Date:
This construction Authorization is subject to rero a la4 plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Constmction Authorization is subs compliance with Toru _ e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: N�fNs Date:
Cons tr tion Authorization Expiration Date:
HTE# ��"rj ��� Permit # V�l
Harnett County Department of Vlblic Health
Site Sketch
ISSUED TO:
PROPERTY LOCATON:
SUBDIVISION LOT #
Authorized State Agent \� t) " L�~
Date: —7 I ) A) (
i
A
T
F I
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): �e
Location of Site: Property Recorded:
Water Supply:�,_.,, Public❑ Individual ❑ Well
Evaluation Method: py An er B ring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mined
❑ 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
.194)
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
la'il
gg�G
�n ��sf
tb'-17)1@►J
f'S3
3
ora
G5L
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948):Q5
CIN
Available Space .1945) Evaluated By:
System T e(s .j Others Present: .6, C_.
Site LTAR