IPACNTE# 16-5-3Y,'�� 62,R HarnetL County Department of Public Lalth 28736
Improvement Permit
A building permit cannot be issued with only an Improvement Perglit
v l PROPERTY LOCATION: C1•RG�=F 1�a1L O2,
vt�ISSUED TO: C 1 L E s �� ,a 1 N C' SUBDIVISION C) D r �0 n?i LOT # 11 )
NEW REPAIR ❑E(QANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 6'Z-0 ,5 a�x51 r
Proposed Wastewater System Type: a S�� r, ova s0 s s SYSZE r
Projected Daily Flow: �' GPD 1415
Number of bedrooms:_ Number of Occupants: --r"Q`d max
Basement []Yes �KNo
Pump Required: ❑Yes e?<No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '�K Public ❑ Well Distance from well L C) feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: \ X37 Date: 51 3 11 6 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the a of other permits. The permit holder is responsi for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat or the in" use changes. The Impro eat Permit shall not he affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the laws and Rules for tewane Treatment and Disposal iiiltan.candi ermit_
Reauired for Buildin¢ Permit
The construction and installation requirements o1 Rules .1950, .1951, .1954, .1955, .1956, .1951, .1958. and .1959 an incorporated by references into this permit and shall be met. Systems Shan be installed in accordance
with the attached system layout
ISSUED T0: C CU(1-- "0 Mt, -5 PROPERTY LOCATION:
SUBDIVISION 0RZ; o ,--, LOT # 15�
Facility Type: `�� L5 L �j 5 New ❑ Expansion ❑ Repair
Basement? ❑ Yes '!E( No Basemgnt Fixtures? 11 Yes �No
Type of Wastewater System** eci`' !U (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑� yyp
v rnc?-p yYC\r L L. a a.ca,4— (Repair)
Installation Requirements/Conditions Number of trenches 5 e,y 1
Septic Tank Sizey JS 0 gallons Exact length of each trent 00 feet Trench Spacing: c Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over. C— ):)t- inches
Maximum Trench Depth of: A Ql� inches (Maximum soil cover shall not exceed
"ipgi (Trench bottoms shall be level to +/.I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TOM vs. GPM
Aggregate Depth:
Conditions:
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 below pipe
inches above pipe
inches total
**If applicable: / anderstand the r/rtem type spedled it different from the type spedled on the application. / accept the rpeciflcatiom of this permit.
Uwner/legal Representative Signature: Date
This construction Authoolghom is subject to revoadon if the site plan, plat or the intended use changes. The construction Authomadon shall not be transferred when there is a change in ownership of the site. This
construction Authorization is s & t m com th the ions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent " v4yo Date: 3 )4
2c�s40 1.0 ) 1 ( „> Col ction Authorization Expiration Date: 5 z a )
HTE# `I6-538 -L0fL
Permit # Q-1'13 b
Harnett County Department of Public Health
Site Sketch
\PROPERTY LOCATON: CA" qty
ISSUED TO: F 1���^Cs LLG SUBDIVISION 0 OniS LOT # Tom_
Authorized State Agent. G L-TOI-K'W Date: 5 6
as
CvGZQ-1 N1iL -02
rn -
Department of Environment, Health and Natural . sources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow(. 1949):
Location of Site: Property Recorded:
Water Supply: Public[] Individual ❑ Well
Evaluation Metho� Au4B g ❑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%
Horimn
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structmw
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Salim
Class
.1944
Resn
Horiz
L5
-)
0-3
L
y �g
G
L�
l,
1
VF�^LS1N
5 Ly3Yr
Sg sl L
i� �5
f �
Description Initial Repair System Other Factors (.1946):
S st Site Classification (.1948
Available Space (.1945) Evaluated By:
S stem T s 'V! o VN,r,_, a) (XV Others Present:
Site LTAR