IPACHTE# - 3o)S-1-7 Harnett County Department of Public Health 29018
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
n PROPERTY LOCATION: L jP%vg 'sGf~ �o
ISSUED TO: }� 90LOg "-Z G S SUBDIVISION — LOT # r
NEW REPAIREX ION ❑
Type of Structure: 5c=Q � ^SO�
Proposed Wastewater System Type: �� �o SZeA VCYR O vd �5z
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: 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 .>y Public ❑ Well Distance from well 1 O O feet
Permit conditions:
Authorized State Agent: ---t RQ;a
The issuance of this permit by the Health Department in no way guarantees the
site is subject to "vacation if the site plan, plat or the intended use changes. The Impr
the laws and Rules for Sewage Treatment and Disposal and to Conditions of this permit..
Date:
Permit valid for
Five years
❑ No expiration
SEE ATTACHED SITE SKETCH
other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
fent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1951, .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 p
ISSUED TO: TkT pnd E¢ •�F�j PROPERTY LOCATION: )—AwRfi naGE �Zz
SUBDIVISION LOT # S
Facility Type: SIO (PO'1S6) New ❑ Expansion ❑ Repair
Basement? ❑ Yes ')4 No Basement Fixtures? ❑ Yes )4 No
Type of Wastewater System** 2,SY S9yU \� 0-M (Initial) Wastewater Flow: 3C- O GPD
(See note below, if applicable ❑)
21.,Sm1o U'CP• S'is (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size t e)O d gallons Exact length of each trench 3 b feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: t inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: ft TON vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. L inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
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 Tvstem type spedfed it different fmm the type specified on the app/ica6a. / accept the specibcationr of thir permit
Signature:
Date:
Ibis construction Audmmanon is subl canon If the site plan, plat or the intended we changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subjesito comps ith Vons of the Laws and Rules far Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: :: —"- Q-)JSDate: 9
Authorization Expiration Date:
HTE# ��'- E) 1Permit # Z)n01I
Harnett County Department of Public Health
Site Sketch n
PROPERTY LOCATON: l—�`n1 Q6n C 10
ISSUED TO:�+—T R SUBDIVISION LOT # 5
Authorized State Aeent �5 S �w� l oLa�cS� Date: �11�3116
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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: 3Design Flow (.1949)�3'�0��
Location of Site: Property Recorded:
Water Supply:Public❑ Individual ❑ Well
Evaluation MethoiFs❑ AuEer Boring ❑ Pit ❑ Cut
Type of Wastewater: 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
IN.
.1956
Sapro
Class
.1944
Rem
Horiz
C_
SrC
P?7
3(�
Description Initial Repair System Other " Factors (.1946): p
System Site Classification (.1948): 1 S
Available Space(. 1945) Evaluated By: o �(
S tem Type(s) Others Present:
Site LTAR