IPacNTE#ICS S 34��8 Harnett County Department of Public Health 28957
ImDrovement Permit
A building permit cannot be issued with only an Improvement Permit
// ,, �// s PROPERTY LOCATI N: `y7
ISSUED T0: 4 (.G/G aJd CCz W5'4 C.b'z._ SUBDIVISION A e� LOT #
NEW f�� EPAIR ❑ EXPANSION ❑ Site ImpAvements required prior to Construction Authorization Issuance:
Type of Structure: S%i
Proposed Wastewater System Type: ZS�e i�F_�p LtTA�
Projected Daily Flow: yB0 GPD
Number of bedrooms: Number of Occupants: 19 max
Basement ❑Yes o
Pump Required: Ea es ❑ No ❑ Maaat,�e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 5a Public ❑ Well Distance from well feet Permit valid for:
Permit conditions:
IJ five years
❑ No expiration
Authorized State ent:: v Date: / / i `/6 SEE ATFACHED SITE SKETCH
The issuance of this permit by health 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 if sim 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 lam and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The comstmttion and installation requirements of Rules .1958, .1952, .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: :42=36&� PROPERTY LOCATION: Z
n�— SUBDIVISION LOT #
Facility Type: 7 Z New O Expansion ❑ Repair
Basement? ❑ Yes Fzr NoBasement Fixtures? 11Yes F'No
Type of Wastewater Systerl 'P ft,2�>`�0 l2 a"U(� u�— (Initial) Wastewater Flow: V�y GPD
(See note below, if applicable ❑}t
'—^Y) c!`b ZcS�' ��% (kiP� (Repair)
Installation Requirements/Conditions Numbir of trenches
Septic Tank Size MZ> gallons Exact length of each trench ZQO feet Trench Spacing: �9 Feet on Center
Pump Tank Size /140 gallons Trenches shall be installed on contour at a Soil Cover: inches
Pump Requirements: ft. TDM vs.
Conditions:
Maximum Trench Depth of: ZZ—)M inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
(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
2 inches above pipe
inches total
**If applicable: / u#der sand the system type rpecifled it diHereN Imm the type rpsdhed on the app/ication. / accept the Jpenhcationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to reviation if the site plan, plat or the intended use changes. The construction Authorization shall not be transferred when there is a change in ownership tithe site. This
Construction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the Modicum of this permit. 5tt AI IACntU Nit =11.11
Authorized State Z�, %`y� �Date:
Construction Authorization Expiration Date: Z5 — Zi/
HTE# 1—'S ---5!264L Permit # Z 0 S -5-7
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: /4 ZS
ISSUED TO: A.),O SUBDIVISION LOT #
�2�ts -7 -
Authorized State Age t: Date:
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: %'�I yb�, ll
Proposed Facility: 514% Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ 'rublic❑ Individual ❑ Well
Evaluation Method:8 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
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
Sopm
Class
.1944
Restr
Horiz
U sal
o-ZK
SL
Z� Ng
5%i
d�3.�
rt 3•�
1
23
L' 1_d
�, I
SL
�Sxlyr
Sp
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): )Ira
Available Space (.1945) Evaluated By:
System T e(s Others Present:
Site LTAR .3