IPAC RHTE#).6'S=3BSr6Q Harnett County Department of Public Health 28938
Improvement Permit
A building permit cannot be issued with only an 1=provement Permit
PROPERTY LOCATION: l rL al GL-ov f= Qd
ISSUED TOO:TAQ,,- Gv5'7 ocV. � l o mG'g I N C, SUBDIVISION Y,51, I E LOT # %
NEW,' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Srp 31 y'35;)
Proposed Wastewater System Type: YV trey¢ o o S-ArT n
Projected Daily Flow: `5 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes XNo
Pump Required: '12YOs ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '' Public ❑ Well Distance from well Y O Ci Net Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: ��' �����oc � Date: % )1\ lb SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in na way guannmes the ode of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subixt to revocation it the 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 previsions of
the Laws and Rules for Sewage Treatment and Disposal and to renditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and instillation requirements of Rules .1950, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated lel references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout 1
ISSUED T0TM C_ys t9cn �� o tnES 1w, PROPERTY LOCATION: S 2vELUv E Q�
Facility Type:
Basement? ❑ Yes A
Type of Wastewater System**
(See note below, if applicable
SUBDIVISION Y P) ayn le O v -J iG LOT #
New ❑ Expansion ❑ Repair
No Basement Fixtures? ❑ Yes 'X No
9V+-, --o QS m[I, 9-G)UVt)0N g73`C—rte (Initial) Wastewater Flow: GPD
*tNQ%O%NG 2"? (Repair)
Installation Requirements/Conditions Number of trenches `6L
Septic Tank Size 10 o Q gallons Exact length of each trench 1 T S' feet Trench Spacing: Feet on Center
Pump Tank Size I000 gallons Trenches shall be installed on contour at a Soil Cover: 6 inches
Maximum Trench Depth of: IB 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: h. TON vs. GPM inches below pipe
!1 Q 9 Aggregate Depth: inches above pipe
Conditions: ~GLm 1� `�s'��GP O ^e `2oP AL Rorer �Pt-�C.� r.sis S—SS inches total
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.
**If applicable: / undeatand the ryJtem type specified it different from the type specified on the application. / aaept the specilcatiom of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change m ownership of the site. This
Construction Authorization is sac 1 ce with t ovisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit ILL AI IALHLU lilt IRLILH
Authorized State Agent Date: 8 1 a 1 ,6
struction Authorization Expiration Date: 'g -i a"
HTE# "5' 3-05b6q-- Permit # Mc1-W
Harnett County Department of Public Health
Site Sketch
\ PROPERTY LOCATON: Irl -06L0,46, F0
ISSUED TO: A S0I Notes iNC. ( SUBDIVISION L�XL YO,1,4—,C LOT #
Authorized State Agent:
\�LQL tio CSDoi� Date:
'7o
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
S011JSITEEVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 $Dq^ Design Flow (.1949): ; 60 �T
Location of Site: Property Recorded:
Water Supply: Publico Individual ❑ Well
Evaluation Meth Aug 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
Positiont
Slope%
Horizon
Depth
(In.)
SOH. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure)
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wemess/
Color
.1943
Soil
Depth W.
.1956
Sapro
Class
.1944
Restr
Horiz
—
16 -az;
2
-a5
37 i
L<
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): �/
Available Space (.1945) Evaluated By: V �
System Type(s)) Others Present:
Site LTAR
S@G: LSS OV.M6JR��