IPACHTE# ��-5-3°12 k Deo Harnett County Department of Public Health 29003
Improvement Permit
A building permit cannot be issued with only an Improvement Penni
ii- 2.
`' PROPERTY LOCATION: va�DX
WS.PNEIL- 404, rvC—
ISSUED TO: 3 SUBDIVISION PaTic PN, 0-Aoys,N6
LOT#
11d
NEW ' REPAIR E7SION Site Improvements required prior to Construction Authorization Issuance:
�3`\
Type of Structure: 5C0 "fiJ
Proposed Wastewater System Type: a^Se"[e RCDVG,us �yo x�
Projected Daily Flow: Li 6 O GPD
Number of bedrooms: L-) Number of Occupants: max
Basement []Yes XNo
Pump Required: []Yes ❑ No Nay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well1� Net Permit valid for.
JXFive years
Permit conditions:
❑ No expiration
Authorized State Agent: N Date:A I rad 116 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ce of other permit. The permit holder t respl a for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if 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 Building Permit)
The construction and installation requirement 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: W C—" ext, 'i0rr1LS �v PROPERTY LOCATION:
SUBDIVISION PsTinCmg 5-5)NC LOT# 8�
Facility Type: Syo (3q^� New ❑ Expansion ❑ Repair
Basement? ❑ Yes -�DK No Baseme,nt Fixtures? ❑ Yes �g'No
Type of Wastewater System" `aS/ s RG10Q07�1dN S isTGM (Initial) Wastewater Flow: y`a0 GPD
(See note below, if applicable ❑)
L 9e (Repair)
Installation Requirements/Conditions Number of trenches F
Septic Tank Size 1 Z)0 (5 gallons Exact length of each trench 30 O feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: --6-inches
Maximum Trench Depth of N a inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TON vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: M 1N sen um of oC- CovL'Z- N&6DC0 oyG2 Ocz-NIWF NC Lo inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable: / undemand the ryrtem type tpetiled is different from the type Apeabed on the app/iration- / atrept the rpea6ratioStr of thfr permit
( Owneraegal Representative Signature: Date:
This Construction Authorization h R—uon if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when tlrere is a change in ownership of the site. This
Construction Authorization is \of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent Por ->i5 Date: S
o t<uction Authorization Expiration Date:
HTE# 6'5--1406 Permit # 5 X03
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: FP�¢�ox ()Z_
ISSUED T0: w 6Pv (.9_ k °Mss N G SUBDIVISION ss r,a N n nx�N C LOT #
Authorized State Agent: 'ToWs909� Date: $ j -,A) 4
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: tj (�D(Vr Design Flow (.1949): - ^�
Location of Site: Property Recorded: '\
Water Supply: ublic❑ Individual ❑ Well
Evaluation Metbod;a Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: U 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)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapm
Class
.1944
Rest
Horiz
S stemT s
Lr5
a S
A
O
Others Present:
Site LTAR
, �-,
,'2
Ne'l
Description
Initial
Repair System
Other Factors (.1946):
S sl
f
Site Classification (.1948)W1
Available Space .1945)
Evaluated By:o-,�-
S stemT s
.31z_Q0
Others Present:
Site LTAR
, �-,
,'2