IPACHTE# /6,.5 —?`fib 7 Harnett County Department of Public Health 28951
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: -SR t T-6 t /ice
ISSUEDTO' � /�'� SUBDIVISION LOT #
NEW fI REPAIR R' EXPANSION ❑
Type of Structure: 5G J rit'- H
Proposed Wastewater System T pe: 264'1V 6 Z"
Projected Daily Flow: -4 GPD
Number of bedrooms: Number of Occupants: max
Site Improvements required prior to Construction Authorization Issuance:
Basement []Yes No
Pump Required: ❑Yes ❑ No 10 Naa required based on final location and elevations of facilities
Type of Water Supply: ❑Community E974.ublic ❑ Well Distance from well feet
Permit conditions:_
Permit valid for.
5live years
❑ No expiration
Authorized State AP- Date: 7-15 -/(a SEE ATTACHED SITE SKETCH
The issuance of this permity the�Aealth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation' e 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 to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1951, .19S4, .1911, .1956, AST, .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: /Z�r A J PROPERTY LOCATION:
—/ SUBDIVISION LOT #
Facility Type: S w tri` Lr New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 01-0
Type of Wastewater System** (Initial) Wastewater Flow: SV d GPD
(See note below, if applicable ❑)
0e;-rl=�- (Repair)
Installation Requirements/Conditions Number of trenches —
Septic Tank Size / ° gallons Exact length of each trench 8e- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z4 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: G inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
Aggregate Depth:
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.
_ inches below pipe
inches above pipe
/7 inches total
*If applicable: / undeatand the ryrtem type rpechfed it different from the type rpecihed on the app/ication. / accept the rpedfcationr of 6ir permit.
Owner/Legal Representative Signature: Date:
This conswction Authorization is subject to reroation if the site pian, plat, or the intended use changes. The construction Authorization shall not be transferred when there u a change in owirenhip of the site. This
Lonstruction Authonzation is reflect to compliance with the provisions of the Laws and Rules for Sewage treatment and Disposal and to the conditions of this permit 8t AI IAI.rtU Hit aRttlm
Authorized StatAeent;/ c�' :- �1 Date: :7 3 - / .2
Construction Authorization Expiration Date: - y 3 -Z1
HTE# T16 39y57
Permit # Z -9q d�
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:
ISSUED TO: 8A4 4 SUBDIVISION LOT #
Authorized State
Date: ?-/3 -/6
,51L 1 , F -M" 11�,
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: ate Evaluated: Z-rZ
Proposed Facility:-S,*Vtd Design Flow (.1949): 3 4--C3
Location of Site: Property Recorded:
Water Supply: ffPubliC❑ Individual ❑ Well
Evaluation Method:❑ huger 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
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
Rear
Horiz
�3Z
;q
o•zH
24- u
JL
Gl..
fj0 .r
Description Initial Repair System
Available S OCer Factors (.1946)-
System
946):S stem Siteassification ) ace(.194Evaluated By.J
System TMe(s) Others Present: