IPACNTE# Harnett County Department of Public Health 29275
Improvement Permit
A building permit cannot be issued with only an Improvement Permit ,921Aa.l.7lrmnlb 3rs:ajy /Ld•
PROPERTY LOCATION:1ti; nes 13Pr40 Liz f S2 t /4 Z9
ISSUED TO: aicrd 4uaref6 SUBDIVISION Vgllr d LOT# /04 -
NEW &�' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Y&L 5F
Proposed Wastewater System Type: .1 P.wwt • 5 fiwa Pte^'
Projected Daily flow: y96 GPD
Number of bedrooms: Vii/ Number of Occupants: R' max
Basement ❑Yeess /914o
Pump Required: [res ❑ No [J May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community I�blic ❑ Well Distance from well feet Permit valid for. Mive years
Permit conditions: ❑ No expiration
Authorized State Agentt� 1'r( - Date: / 7--7 ' b(_ SEE ATTACHED SITE SKETCH
The issuance of this permit by the 24 Department in no way guarantees the issuance of 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 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 lam 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, .19S2, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in ac(ordane
with the attacked system layout.
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ISSUED T0: �gs'P tsAyere>LF PROPERTY LOCATION: [A"nera l S�nrnsd G7. l s(L 7 u �
,�` SUBDIVISION A vers Peed LOT #
Facility Type: 432 5 rD E4 ew ❑ Expansion ❑ Repair
Basement? ❑ Yes [4"No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ZS/ l6kAsyk0n fl (Initial) Wastewater Flow: .+ (P �n,4,"-,Fd GPD
(See note below, if applicable F-1)/
ZS% A&d'Aa'&1 J s/F•e%v .'r) (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 16o6 • /tom gallons Exact length of each trench /yo feet
Pump Tank Size /Am -1Z56 gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of-. 19 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the s}rtem type sereeiled it different /rem the type specified on the application. / accept the strerih'cationr of ii& permit
Owner/Legal Representative Signature: Date:
This Construction Authomamm is subject to 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
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for
�Sewage
LTreatrumt and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: i��—s Z. le � ` ` Date:
��—� Construction Authorization Expiration Date:
NTE# /G" 5 - yD /39 Permit # Z1Z-1-.5
Harnett County Department of 1"ublic Health
Site Sketch
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PROPERTY LOCATON:_ n1 A erk! 5 r; of s In I 52 r V$F
ISSUED TO: 15,A �� r2 A v [rc�� SUBDIVISION Aver., (>o�n! � LOT # / 1<
Authorized StateAgEniL /L% rJi r 5 Date: / 2 - LO
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Department of Environment, Health and Natural Resources
Sheet:
Division of Environmental Health
On -Site Wastewater Section
Property ID:
Lot N:
SOIL/SITE EVALUATION
File k:
for ON-SITE WASTEWATER SYSTEM
Code:
Wnn
Owner:(u/15fr 'Ipplicant t-Ciw,44 4vcrGff`
Address: L4f /L/ rh;.ru-=.I Sp�»l �� Date Evaluated: Iz �oH /ib
Proposed Facility: y /,j2 5/D Design Flow (.1949): y�o 54�/dy Property Size: G 11 Ar
Location of Site: A,49
19v,g,��' Property Recorded: re --,Water Supply: LSIrI'ublic❑ Individualt,. ❑ Well Spring El Other
Evaluation
Method:❑ Auger Borin pit ❑ Cut
Type of Wastewater: ^ewa
e
u+" 8 ❑ Industrial Process ❑ Mixed
P
R
O
1 194U SOIL MORPHOLOGY
- OTHER
.1941
L landscape Horizon
PROFILE FACTORS
.1942
E Pmitiod Depth .1941 .1941
N Slope% (N.) Structure! Consistence Soil
Wetness/
.1943
.1956 .1944
Profile
Texture MincaI Color
Soil
D th IN.
Sapro Restr
Class
Class
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Description Initial Repair System Other Factors (.1946):
N��t
System Site Classification (.1948):
Available S ace .1945)
7
5 stemT s) u Evaluated By:
Site LTAR ZS Others Present:
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