IPACHTE# Sr."Harnett County Department of Public Health 29048
Improvement Permit
A building permit cannot be issued with only a Improvement Permit
`N 4 PROPERTY LOCATION: oxvs�o7A QD
ISSUED TO: LY a ^7 u v SUBDIVISION LOT #
NEWX REPAIR ❑ r EXMION ❑
Type of Structure:
Proposed Wastewater System Type: -IS7-n iZG9uL'Sv00 �e-01
Projected Daily Flow: 3C-0 GPD
Number of bedrooms: -�o— Number of Occupants: rQ max
Basement ❑Yes llo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑YesN0 ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '�4 Public ❑ Well Distance from well 100 Net
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent: �\ a Date: T OJa>>ILb SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss other permits. The permit holder is responsible 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 Improrem t 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 into this permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: LiosJ L PROPERTY LOCATION: �oNaElzpS� Pan,
��"� SUBDIVISION LOT #
//
Facility Type: S �� (51 -es New �❑v., Expansion ❑ Repair
Basement? ❑ Yes -R No Basement Fix res? ❑ Yes ,�ry0
Type of Wastewater System** aS �/e a�1,9vC-t \ o f./ syg--Syr (Initial) Wastewater Flow: 31QO GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: c 1 Feet on Center
Soil Cover. S1= inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATIONS MUST BE LOFT. 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 rpeciled it different from the type spedled on the app/intron. / accept the rpedhiatims of thir permit
Representative Signature:
Construction Authorization is
plat or the intended use changes. The construction Authorization shall not he transfers
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Date:
Authorized State Agent: Date: I0 1
nstruction Authorization Expiration Date: fo
SEE ATTACHED SITE SKETCH
S -/S. (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size IOO O gallons
Exact length of each trench 6 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of 30'-f� inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: c 1 Feet on Center
Soil Cover. S1= inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATIONS MUST BE LOFT. 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 rpeciled it different from the type spedled on the app/intron. / accept the rpedhiatims of thir permit
Representative Signature:
Construction Authorization is
plat or the intended use changes. The construction Authorization shall not he transfers
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Date:
Authorized State Agent: Date: I0 1
nstruction Authorization Expiration Date: fo
SEE ATTACHED SITE SKETCH
HTE# IC- —5— Permit #
ISSUED TO: y o "I
Authorized State Agent:
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: Po NO(12{Yj�
v) LoGgs \-4 SUBDIVISION LOT #
1903l0642g5.a R._D
Q
E
5 �7, I 16003E
� ZGPq�rZ��
M
Date:
7d1
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 Design Flow (.1949): 360'd
Location of Site: Properly Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method'�ager Bo 'ng ❑ Pit ❑ Cut
Type of Wastewater: tysewage ❑ 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.)
SOH. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Resb
Horiz
Lj
0-30
Description Initial Repair System Other Factors (.1946):
System _ Site Classification (.1948):
Available Space(. 1945) V Evaluated By:
System Type(s) -9r Others Present:
Site LTAR S