IPACHTE# 16 �;Aa Harnett County Department of Public Health 29030
Imorovement Permit
A building permit cannot be issued with only an Improvement e P It
PROPERTY LOCATION: CX_ CYiN`10-i
ISSUED TO: Gt v2—/ Ze,,*s S 0 ,d 1-s0 r v C5 SUBDIVISION -7ol1�5 o rg t�V�LM5 LOT # 34.
NEW% REPAIR_ E SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S � ��3 -"'i0
Proposed Wastewater System Type: `�-S 76 PCv 14 rJ 5i5;i- 11
Projected Daily Flow: 360 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑YesNo
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well 1�_ feet Permit valid for. Five years
Permit condidons.� ❑ No expiration
Authorized State Agent: ® �'v=
The issuance of this permit by the Health Department in no way guarantees the issuantt
site is subject to revocation if the site on, plat or the intended use danger. The Improvement
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date:
SEE ATTACHED SITE SKETCH
n. The permit holder R respomible for checking with appropriate governing bodies in meeting their requirement. This
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 requirement of Rules .1950, .1952, .1954, .1955, .1956, AST, .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 Q{�
ISSUED TO: GP2-y 1\OQ��N�N N40M(-5 PROPERTY LOCATION: P�aUG� �Ol-hyuj0y 'D
/ SUBDIVISION "SW-AtL 6.j 'tQ4--5 LOT # DZ-
Facility
aFacility Type: S �9 CLa(�j xl-lQ J New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes �No
Type of Wastewater System" G5'/C;, RGOVGTtON Sys'S6-rn (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
0
as %v
14GD. 3yS, (Repair)
Installation Requirements/Conditions
Number of trenches l
Septic Tank Size l ® O 0 gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 11 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: OL_ Feet on Center
Soil Cover. 0a' inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type spedffed is different from the type rpeci6ed on the app/kation. / accept the spedlrationr of this permit
Representative Signature:
Date:
This Construction Authismati ct to rerocation i( th Bice plan, plat or the intended use changes. The construction Assassination shall not be transferred when there is a change in ownership of the site. This
Construction Authadration is sub m compliance son (the Laws and Rules for Sewage treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 9L-1�%5 Date: 33 I6
Cons �n Authorization Expiration Date: -11�01 al
HTE# ' S-3"1�c�� Permit # &I r-)30
Harnett County Department of Public Health
Site Sketch
PROPERTYLOCATON: �(,-IS- 1'1C4n
ISSUED TO: G;--) %6) L O SUBDIVISION 'byN'SON Tt LN LOT #
Authorized State Agent: GY6�L� fY2�oL(�D�i� Date:
T :
a) )'
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SO►IJS►TE EVALUATION
for ON-SITE WAS- EWATER SYSTEM
Owner: Applir ,at:
Address: Date Evaluated:
Proposed Facility: Lig 2l— Design Flow (.1949):16a t
Location of Site: Property
Recorded:
Water Supply: public❑ Individual ❑ Well
Evaluation M• �od�Auger Bo 'ng ❑ Pit ❑ Cut
Type o
.1
.. Wastewater: Sewage ❑Industrial Process
I
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Sim:
❑ 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
<AR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
IN.
.1956
Sapro
Class
.1944
Restr
Horiz
��30
est G
tR 5�B
�-•C
•5
2
�
� 7L
�ra1Nv
v yY,
Description Initial Repair System Other Factors (.1946): t
S ste Site Classification (.1948): P�
Available Space(. 1945) Evaluated By:
S stem Type(s) Others Present:
Site LTAR