IPACHTE# ��—S 3�106� Harnett County Department of Public Health 28918
Improvement Permit
A building permit cannot be issued with only an Improvement Per t
'Q PROPERTY LOCATION: t—Gc� 0�1— L_NC� Ko
ISSUED TO: ) NCl46)NS0 N 1AQm�C- SUBDIVISION CecZ.G LOT # 44
NEW REPAIR ❑ E1,PIfNSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 C �5� x40
Proposed Wastewater System Type: `mss /o ��E9vCS s a�15' EM
Projected Daily flow:L's% O GPD
Number of bedrooms: Number of Occupants: 4Z max
Basement ❑YesNo
Pump Required: []Yeso ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '-F�Z Public ❑ Well Distance from well VZZJ� feet Permit valid for. Five years
Permit conditions: ❑ o expiration
Authorized State Agent:" -1) Date: I" SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department m no way guannmes the issuance r permits The permit whir is res rubh for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat or the intended use lunges. The Improvemem it 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 Building Permit)
The commission and installation requirement of Rules .1950, .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: (' Q'0L1)t'�OvM
tiv �ES LJ -Q-, PROPERTY LOCATION: Lt1—rnyLt gs 4 Cd �-dt
SUBDIVISION Co2T "eJ653, LOT# L1 L)
facility Type: Sc0�`L1C)� New ❑ Expansion ❑ Repair
Basement? ❑ Yes ::R No Basement Fixtures? ❑ Yes �(
Type of Wastewater System** 2S%t P Eov c N v A, Si L M', (Initial) Wastewater Flow: LTA C GPD
(See note below, if applicable D)
"% S --)S . (Repair)
Installation Requirements/Conditions Number of trenches S q
Septic Tank Size 10(50 gallons Exact length of each trench 2iZ)0 feet Trench Spacing: I Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. tZ —gyp inches
Maximum Trench Depth of: 19-1`1 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 TDM vs. GPM
Aggregate Depth:
Conditions:
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. 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: / understand the srstem type spec/fed it different from the type specified on the app/ication. / accept the spedGcadomr of this permit
Date:
This Commission Authorization t revocation i( the site plan, plat or the intended use changes. The Construction Authorisation dull net be transferred when there is a change in ownership of the site. This
Construction Authorisation is subtac�`e-camph n i rovisixg; of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date:
Authorization Expiration Date:
HTE#
ISSUED TO:
Authorized State Agent:
Permit # 2 l \'�
Harnett County Department of 1-�tblic Health
Site Sketch
PROPERTYLOCATON: LcGM)G2L D�PL4 —0
SUBDIVISION G n;6w 65-N LOT # L -i
-71)--� IC
J
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOII✓SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: =A $flQ.h Design Flow (.1949):
Location of Site: Property Recorded: 11
Water Supply:Public❑ Individual ❑ Well
Evaluation Method 11
�gerccB��on""ng ❑pit El cut
Type of Wastewater: �aewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope%
Horimn
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
Salim
Class
.1944
Restr
Horiz
s
vac)
sL
V?L )�P
1
-aa
6 2,
YF� NS i
PN
Cr X
Description Initial Repair System Other Factors (.1946): O
System Site Classification (.1948): ` 5
Available S ace .1945) Evaluated By: a
S stem T s Others Present:
Site LTAR . Ln . L_�'