IPAC RHTE#I 6— 5 Harnett County Department of Public Health 28935
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: OLs� VStij' l
ISSUED T0: W Marl Gil � o w+r�t, n U SUBDIVISION 'SlOMgg V)NP rz2 LOT # a
NEW REPAIR ❑ EKPANSIQN ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 F
Proposed Wastewater System T e: l m4 � c `i5 o F9�sGCs p N
Projected Daily Flow: TA GPD
Number of bedrooms: -1 Number of Occupants: max
Basement ❑Yes XNo
Pump Required:. ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 14 Public ❑ Well Distance from well 1 O O feet Permit valid for. ,Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: \ �\ ltd:
The issuance of this permit by the Health Department in no way guarantees she its
site is subject m revocation if the site plan, plat or the intended use changes. The Impr
the laws and Rules for Sewage Trutment and Disposal and to conditions of this permit..
Date:
SEE ATTACHED SITE SKETCH
other person. The permit holdei is relponsible for checking with appropriate Remaining bodies in meeting their requirements. This
na0t Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirement of Rules .1950, .1953, .1954, .1955, .1956, .1957, .1959. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system IayouL
ISSUED TO: r t>Ner2— M&S C, PROPERTY LOCATION: � OwS�
U
T�
SUBDIVISION t Ndn cks Mwn cwt LOT # QZ2-
Facility Type: S fl �5`B'rT S ,X New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 'Pu.�P�'n OSoi FSS\Jc"7yOrg (Initial) Wastewater Flow: 410 GPD
(See note below, if applicable ❑) e
9V n S15, (Repair)
Installation Requirements/Conditions Number of trenches L-?
Septic Tank Size s o 0 o gallons Exact length of each trench Hca feet Trench Spacing: Feet on Center
Pump Tank Size t o its O gallons
Pump Requirements: It. TDM vs.
Conditions:
Trenches shall be installed on contour at a
Maximum Trench Depth of. Vdi inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Soil Cover: �—)` 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
inches total
**If applicable: / o#demand the system type speciled /s dh%re#t /rem the type fpeafied on the applocation. / accept the speuftcadoar o/ this pemrit.
Date:
This Construction Authorization is subject to revocation site plan, plat or the intended no changes. The Construction Authorization shall not be mensferred when there is a change in ownership of the site. This
Construction Authorization is su compliance wit romisio %LawZand Rules for Sewage Treatment and Dispoul and to the cendnions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: P6"y.5 Date:
Construction thorization Expiration Date:
H T E # (0 3°T02AIZ Permit # an 15
Harnett County Department of Miblic Health
Site Sketch
PROPERTY LOCATON: CL -0 051jal
ISSUED TO: W — VE2 1 N L SUBDIVISION Auo(L LOT # as
Authorized State Agent: Gk oLwCtl 10!M V)Date:
R,�sUac< CN
K
Inj
D" 3C
E d,
houaE 11 160'
��NgcL-
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: Lj 4yRcaS Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Auger Bo 'ng ❑Pit ❑
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
Cut
❑ Mixed
P
R
O
F
1
L
E
#
.1940
landscape
Position/
Slope%
Horizon
Depth
(in.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Clercs
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapm
Class
.1944
Rear
Horiz
L 5
O�K
a
c736
G >
v )J
3i\
5gx i
Fl s hi,
PSS
Description Initial Repair System Other Factors (.1946):
;ystea Site Classification (.1948): S
Available Space(. 1945) Evaluated By: (D -�
System Type(s) Others Present:
Site LTAR.