IPAC RHTE# I(os - 666 1 2_ Harnett County Department of Public Health 29260
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: �w 9G/ (n) , i �y�/ t) (ZA. C S (L ts+ 3 L
ISSUED TO: Clic,14on QuoyS of _ SUBDIVISION sus ArA W -a LOT #
NEW [9/ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3 G (L m o � .
Proposed Wastewater System Typ e: ZS `/., f2 ede, .4 a S�ZS4Ym
Projected Daily Flow: - 3 (o It';, GPD
Number of bedrooms: �3 Number of Occupants: �e max
Basement []YesRINo
Pump Required: []Yes ❑ No E i' ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. W -five years
Permit conditions: _ —� ❑ No expiration
Authorized State ent:: ��[/ �'� Date: i Y / G 5 Z 0 / G SEE ATTACHED SITE SKETCH
The issuance of this permit the ealth Deparoneat in no way guarantees the issuance of other permit. The permit h— of responsible far thetking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation " 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 Perm jt)
The construction and installation requirements of Rules .1950, .1957, .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: CL u� i r L{ o rssQs aF Ra1ei eL. PROPERTY LOCATION: y `J_ L) I I k I rA-
2c1
SUBDIVISION h/, `
'/ bV/7a n -J . LOT #
Facility Type: 1 Ma- rA%J [/New ❑ Expansion ❑ Repair
Basement? ❑ Yes 51/No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** - z 5 % !Le du c,4- ro a S s '64=a (Initial) Wastewater Flow: ZTC d GPD
(See note below, if applicable ❑)
2 5 % Real u ++ca. 5 s &m (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 1 000 gallons Exact length of each trench 5 feet
Pump Tank Size i n by gallons Trenches shall be installed on contour at a
Maximum Trench Depth of is inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: (t. TDH vs. GPM
Conditions:
Trench Spacing: `1 Feet on Center
Soil (over. �_ inches (1exspsrteJ)
(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.
6 inches below pipe
2 inches above pipe
I Z inches total
**If applicable: / ooderttand the tyttem type fpeciled it different [mm the type rpeciled an the app/iration. / accept the Jpecibcatiemr o(thir permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject an revocation if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Comm ction Authomation is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and
and in the conditions of this permit SEE ATFA(HED SITE SKETCH
Date: 1 o S 1 LG / 6
Authorization Expiration Date: 12 / n is l 7n'L I
NTE#t (o- S -406<, -fi- Permit # _ 2 9 Z G c5
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: 9G/ kJ '/ kuru 2d ( 52 1`I Z�
ISSUED T0:C.Ic. 4r,n (jrx�wn� 6, (L a;5h SUBDIVISION to,'/ dvra - LOT #
u
01
Authorized State nt
� ��Date: _ 1 2 / 05 / Z- O / y
'� 1�k-G-rade. LS% Re.buo�ton Scf-��'
� 1Z�q. T'rencl, Oce{H
G ,A 'Cfn PUr�ed G�11
�{ PuM�. SU k mw� no} btvires� fuse 1 oFF '/a per Fool- yravijj Fc tY
of pP y
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOI JSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Ownef:Slbvetc,N�Applicant: LlwSton OOrneS of
Address: 9 G 1 W; b w n 2,1 Date Evaluated: 11 1 z' I z o: J.
Sheet:
Property ID:
Lot N:
File #:
Code:
Proposed Facility: 3 45R- 14o,i< Design Flow (.1949): 3W q- 1r1µ PropertySize: 1 . S Z At
Location of Site: W , I born R, L -A,,! Property Recorded: y
Water Supply: ymublic❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method:[jKAuger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
I
L.194O
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
N
Horizon
Depth
(In.)
.1941
Structure
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
IN.
.1956
Sapm
Class
.1944
Rem
Horiz
Profile
Class
& LTAR
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jA�ilable
ription jj11mti,,aI Repair System Other Factors (.1946): N, n
sem Site Classification (.1948): S ace (.1945) Evaluated By: mT s °o 2e+. PD PS Others Present: �"`�rc�
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