IPACHTE# t 6'5 -Y -S- Ga Harnett County Department of Public Health 28942
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
r PROPERTY LOCATION: _IkQDXN0N(L VLD
ISSUED T0: CScn �fLO LOPv �C' S(� 1Y,�7.P� SUBDIVISION LOT # 3
NEW REPAIR ❑ XP
,,!! EAF ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of tructure: sqc) (+0 ruC)'�
Proposed Wastewater System V
T ppg� 'd-Smlo 1Z6t�1vLKt�u Exs
Projected Daily Flow �1�GPD
Number of bedrooms:--
edrooms: ')Number of Occupants: max
Basement ❑Yet e No
Pump Required: ❑Yes '15 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well t feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: S Date:R 1111 T 116SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department he i in no way guarantees tf other permits. The permit holder i�rmponsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation it the site plan, plat, or the intended use changes. The Imist-oirmayst 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 mnswoion and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .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: �sMUzPCuJN VC- PROPERTY LOCATION: Nsi;MON
SUBDIVISION LOT #
Facility Type:New 13 Expansion El Repair
Basement? ❑ Yes asem
No Bent Fixtures? ❑ es�'� 1
Type of Wastewater System*` ��l o DV Ci;I d tJ YS' n (Initial) Wastewater Flow: 40 GPD
(See note below, if applicable ❑)
a ��r
V-53. Sys . (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: \4� inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDH vs.
GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover. _o 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 appfiable� / understand the system type speciffed is different /mm the type sped6ed on the app/ication, / accept the rpec6catiom of this permit
Owner/Legal Representative Signature: Date:
This construction Autho subject to revoanon if the site plan, plan, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to comp cots he pmvismkLQljtht Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
F
rized State Agent: ec-a-V Date: A)
[ons ion Authorization Expiration Date: "F 'i 2')
HTE# JC -5 -59'-A Permit # qL )7
Harnett County Department of Public Health
Site Sketch nn
PROPERTY LOCATON: 11fS 150�GL Ko
ISSUED TO: �— Lp QLDy� P / SUBDIVISION ^ CrtE�-;,R c4Lc LOT # 3
Authorized State Agent: �� 10 rFft i oi���3 hate: Ll 6
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOI"ITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: \
Proposed Facility: 1= ���JL<j\. Design Flow (.1949): xsJ
Location of Site: Property Recorded:
Water Supply: Public[] Individual ❑ Well
Evaluation Metho�uger Bo '
d:ng ❑ Pit ❑ Cut
Type of Wastewater: 0 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.)
SOH, MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Strucmret
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth PI.
.1956
Sapro
Class
.1944
Restr
Horiz
& $1
aILI
z, d
SSI c
IF
3d
53�< c-
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Description Initial Repair System Other Factors (.1946):
system Site Classification (.1948):
Available Space .1945) Evaluated By: G
System T s Others Present:
Site LTAR 3