IPACHTE#ID'S-3`l�i Harnett County Department of Public Health 29017
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: NC,'a.10
ISSUED TO: C0( Coat C.o'sS"S • CO • SUBDIVISION I LOT # IZ
NEW
REPAIR ❑ EKNSION ❑
Type of Structure:
rcnF0 Cil X5 Ci%
Proposed Wastewater
System Type: a`i "ay a RCoxi Cr i to 5 -)5-7 C,
Projected Daily Flow:
'360 GPD
Number of bedrooms:
'> Number of Occupants: I^o max
Basement ❑Yes
�'No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes �' No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well IC� c� feet Permit valid for. Five years
Permit conditions: c ❑ No expiration
Authorized State Agent: Date: `1 113' 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the inti ,�ther permits. The permit holder ids responsible for checking with appropriate governing bodies in nations their requirements. This
site is subject in revocation n 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 requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references inns this permit and shall be met. Systems shall be instailed in accordance
with the amched system layout.
ISSUED TO: Ccs oa,., CaNtr, ( o, PROPERTY LOCATION: NC.Q'lO
� SUBDIVISION LOT # E
� L X SO
Facility Type: 5 X New ❑ Expansion ❑ Repair
Basement? ❑ Yes —'A No Basement fixtures? ❑ YesDk N
Type of Wastewater System** aSo/a �twt�yU,T SysSGM
(See note below, if applicable ❑) o
�.S to V_icpyCi;lORepair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size S 0 d C7 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench Coo feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 1$ inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
(Initial) Wastewater Flow: 3CO GPD
Trench Spacing:
9 Feet on Center
Soil Cover: C� inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
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 total
**If applicable: / understand the system type speriffed it different from the type speriffed on the app/nation. / accept the sperifycatiom of this permit
Date:
This Construction Authorization is m Dation if the site plan, plat or the intended use changes. The Conswction Authorization shall not be transferred when then is a change in ownership of the site. This
Construction AuthorizatiosFl�w1(p\cr\to comphan a prowl Qd_s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
L tion Authorization Expiration Date:
HTE# I ( "-5 ��c1
Permit # ac)Q) 1:)
Harnett County Department of I'Vblic Health
Site Sketch
PROPERTY LOCATON: A1C a O
ISSUED TO: C -J N C-0 . SUBDIVISION LOT #
Authorized State Agent: QCyY �L�-4CfiioaxSD)LVF Date:
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: Design Flow (.1949): "�� 1e ')
Location of Site: Property Recorded:
Water Supply: �0 Public❑ Individual ❑ Well
Evaluation Method: Ok4uger Boring ❑ Pit ❑ Cut
Type of Wastewater: flsewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
P
R
O
F
I
L
E
#
.1940
Landsape
Position/
Slope %
Homan
Depth
(In.)
SOH. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure!
Texture
.1941
Consistence
Minerrilogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
L
Q
G 5
��
34
g'g
J
Description Initial Repair System Other Factors (.1946): S S
System Site Classification (.1948):' -
Available Space(. 1945) Evaluated By:
System Type(s) Others Present:
Site LTAR ' 3