IPACHTE# )a-E�3�4 O-% Harnett County Department of Public Health 28948
Improvement Permit
A building permit cannot be issued with only an6" rovement P}q�It
c� PROPERTY LOCATION: +—�p�lE KD
ISSUED TO: St., T4 G64 . Co (• SUBDIVISION ILOT # 1
NEW%' REPA❑PANSION ❑
Type of Structure: 5401A- eros-�K
Proposed Wastewater System Type: o o 1RGoU051 9vg /Siem
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: 6 max
Basement ❑Yes "K NO
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: Dyes --"KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well X00 Net
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent: �a� \�\RE�+S Date: �2� �l G SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaremees the i a%ce of other permits. The permit holder is respo Lble 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 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 Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
Required for Buildine Permit
The construction and installation requirements of Rules .1950, AM. .19S4, .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: SoGEN , -tt'%T• PROPERTY LOCATION: Z�OyE'.D
\ SUBDIVISION _ LOT #
Facility Type: S �� ���5r J -X New ❑ Expansion ❑ Repair
Basement? ❑ Yes '4R, No Basement Fixtures? ❑ Yes Xhlo
Type of Wastewater System** 2.S °% REO v Cil O N �`)� SG^ (Initial) Wastewater Flow: 3fO GPD
(See note below, if applicable ❑)
oc1.S'10 • 'x -A - (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size )Opts gallons Exact length of each trench "i feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: 6 inches
Maximum Trench Depth of lib 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. TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions:
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: / understand the iwem type rpecih'ed it different from the type specified on the application. / accept the rpecificadonr of thir permit
Owner/Legal Representative Signature: Date:
inches total
This Construction Authorization is subject to revocation it the site plan, plat or the intended use changes. The construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authosizatiis subject to xv -visions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ,?S Date: )6
truction Authorization Expiration Date: :z;:y I -rA1
H T E # 16- s-3'IL-)0'� Permit # a.4ZA1-N
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
Authorized State Agent:
N)1Cr�.f ALL
Q.c�ovG� P.NO
PROPERTY LOCATON: Ci0'J I- Rfl
Geo. CxJN� . SUBDIVISION `— LOT # 1
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Date: '$W °\
00'd G 9-�) L-- ,x..50 -�
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOHJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: _:�, c�, ®2IY\ Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual Well
Evaluation Method:n-Au er Boring ElPit E] cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mined
❑ Other
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope %
Homurn
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure!
Texture
.1941
Consislence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth W.
.1956
Sapro
Class
.1944
Resp
Horiz
O-)Uj
C� 5 L
S
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LyJ�c,
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. L�
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P7
Description Initial Repair System Other Factors (.1946):
SysteSite Classification (1948):(4-�
Available S ace (.1945) Evaluated By:
System Type(s)) Others Present:
Site LTAR 5