IPAC RH T E # � C�' 5-3�5Harnett County Department of Public Health 28937
Improvement Permit
A building permit cannot be issued with only an In rovement Permit
PROPERTY LOCATION: TrriVc_J. v QD
ISSUED TO: AM �y asn�O S >>vL SUBDIVISION %Pr/soC1, Pas STS LOT#
NEWX REPAIR ❑ E)p NSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFC' (;1116 z" 1-a5
Proposed Wastewater System Type: Pu awme_70 c%5lo 'R4pum -o.,r S )sSE
Projected Daily Flow: 3Cc GPD
Number of bedrooms: —L Number of Occupants: fo max
Basement ❑YesNo
Pump Required.'X1fes No ❑ May be required based on final location and elevations of Facilities
Type of Water Supply: ❑ Community )K Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: �\, !\�_ QHS Date: B b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu of other permits. The permit WW is re ponsible for checking with appropriate governing bodies in meeting their requiremerm This
site is subject to revocation if the site plan, plat or the intended use changes. the Improve nt 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, .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
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ISSUED T0:—�A2� �vS�oM �s
12uUc
PROPERTY LOCATION: y-4 f, lez
SUBDIVISION 1 Py 102 0 v vTC; LOT # -7
❑ Expansion ❑ Repair
cDu0stow (Initial) Wastewater Flow: X0 GPD
Facility Type: S� z ts/ n; New
Basement? ❑ Yes No Basement Fixtures? ❑ YesNo
Type of Wastewater System** Pi ZS°/e
(See note below, if applicable ❑) r�
11NP.FSa.O a,c., fl2�:' (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 000 gallons
Pump Tank Size look gallons
Pump Requirements: ft TDH vs.
Conditions:
Exact length of each trench a'?S feet
Trenches shall be installed on contour at a
Maximum Trench Depth of:�1 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFL FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type spec/fled it different bom the type stledfed on the application l accept the sped#rations of this permit
Date:
or the intended use changes. The Construction Authorization shall net be transferred when there is a
Construction Authoriaatiouksubiect Oft aaance will ilm-provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Authorized State Agent: cRU)-) } Date:
Authorization Expiration Date:
SEE ATTACHED SITE SKETCH
HTE# X6-5- 3�STo� 2
ISSUED TO: � t,
Authorized State Agent:
Permit # 'Mci
Harnett County Department of 1"nblic Health
Site Sketch
PROPERTY LOCATON: E4.0yt;
0ML6 L, _. SUBDIVISION 4-02 ' oa) r-vL- LOT #
�ivgLCourSaoCirl Date: g�R�lb
�IE7.�61-Cori C�
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: 3 Vj 9 7,Jr Design Flow (. 1949):u a ��
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Aug o 'ng ❑ Pit ❑ Cut
Type of Wastewater:` �' wage ❑ 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
& LIAR
.1941
Structure/
Texture
.1941
Consistence
mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
LS
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): Pi
Available Space( 1945) Evaluated By:�
System Type(s) Others Present:
Site LTAR
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