IPACHTE# Harnett County Department of Public Health 29128
Improvement Permit
A building permit cannot be issued with only an Improvement Plrmit
PROPERTY LOCATION:
ISSUED T0: -SUBDIVISION LOT # $N
NEWS REPAIR R� ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S �� �E� _):x31" �
Proposed Wastewater System Type: `Q�'/o 0 t.1L�M
Projected Daily Flow: LIDS d GPD
Number of bedrooms: C'i Number of Occupants: _max
Basement []Yes sr_§�o
Pump Required: Dyes ❑ No �ay be required based on final location and elevations of facilities
Type of Water Supply: ❑Community �Gyublic ❑ Well Distance from well ,�Q feet Permit valid for. Five years
Permit conditions: \ ❑ No expiration
Authorized State Agent:: Date: 17�1��T� l SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department inno way guarantees the f other permits. The permit holder for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation H the 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 u 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 constructions and installation requirements of Rules .1950, .1951, .1954, .1955, .1956, .1951..1958. and .1959 are incorporated by references into thin permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
4 _
ISSUED TO: M L� GP NCf) MScC�GS1 N 6 1^t v G3T PROPERTY LOCATION: 1 s N G 6 s RD
SUBDIVISION �CciQn� 6�e�AGfi LOT #
Facility Type: `�� L�'a'�3y� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Baieffrent Fixtures? ❑ Yes _XN¢
Type of Wastewater System** L e �EtJ VUS 5 cJ r J Y5 S Gln (Initial) Wastewater Flow: 410 GPD
(See note below, if applicable ❑)
0
2� 10
RL—p IsGt\0V- 'S� (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size So(Zyd gallons
Exact length of each trench `� feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of 2KLinches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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: l understand the system type specified It different from the type spetified on the application. / accept the specifications of this permit
Representative
Construction Authorization is
Authorized State Agent:
Date:
if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when then
t rovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
R/ �S Date: VD- 114 S G
ly uction Authorization Expiration Date: S1 11
SEE ATTACHED SITE SKETCH
HTE# V�_S - }t3 N Permit # X� 1-)N
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:\ 1n16c-0
ISSUED TO: — ns�cr aG ' I J� ICs SUBDIVISION 1 Ia2�cL��LAck LOT #_
Authorized State Agent: V&?6 016L7-,3oSiF Date: S'al��l�l
Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On -Site Wastewater Section -Property ID:
Lot #:
SOLUSITE EVALUATION File #:
for ON-SITE WASTEWATER SYSTM E Code:
Owner. Applicant
Address:
Proposed Facility: )�_ Date Evaluated: \_ >>\a) .b
GJ2 c� Design Flow (.1949): y, �j ; ��l Property size:Location of Site: Property Recorded:
Water Supply: Publico Individual
Evaluation Metbodr , Auger B •ng ❑Well Spring
Type of Wastewater: \ ❑Pit ❑Cut
Sewage 0 Industrial Process
❑ Mixed
R
O
F
1
1940
SOIL MORPHOLOGY
L
Landwepe
.1941
E
#
Position/
Slope%
�.1901
(h.).1941
.1942
.1941 Soil
Texture
Consistence Wetness/
L 3
Minerwo Color
L,5'a L0 -a
�-s
-o?1G5
v�
VN7�t
R2
ss
1945 Site Classification (.1948): �)
75 Evaluated By: O
Others Present
0 Other
OTHER
ILE FACTORS
1943
Soil .1956
.1944I Profile
Restr Chas
Ifotiz & LTA.
P5
.S
PS