IPACNTE# y Harnett County Department of Public Health 29317
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Cic ee4soj/ 61( (IJ. (5(1_ t170yff,
ISSUED T0: � (-,%A\ClS (v(T (1 SUBDIVISION r LOT # i
NEW f� REPAIR ❑ EKPANSIO ❑
Type of Structure: ; t Q- � y.0 X �$1)
Proposed Wastewater System Type: _ ` VX
Projected Daily Flow: 3G(5 GPD
Number of bedrooms: Number of Occupants: max
12--, My -u„
Pump Required: ❑Yes ❑ No
Type of Water Supply: ❑ Community
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
Bray e required based on final location and elevations of facilities
Public ❑ Well Distance from well OW4 feet
Permit valid for.
LWFive years
❑ No expiration
Authorized State Agent:6/Date: O Z/ f-3 /Z-6 / -7,— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permit. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirement of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in aaordance
with the attached system layout.
ISSUED TO: c s?p— & 01166 C )Cr -A PROPERTY LOCATION: Qe&($a[r%,3h '(I�. (Ut- Z0140
SUBDIVISION �— LOT # I
Facility Type: 3gcZ. SV7n��ae><��LM'New ❑ Expansion ❑ Repair
Basement? ❑ Yes 56o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 7,S% 20a1,v4ArofN Sy -Ir /ir-/7v (Initial) Wastewater flow: 36.0 GPD
(See note below, if applicable ❑) r
Z5% Q46 UC4fCaL) S'4L5 ! (Repair)
Installation Requirements/Conditions Number of trenches -Z-
Septic
Septic Tank Size //>d 0 gallons Exact length of each trench 5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: -1,0 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
Trench Spacing: 2 Feet on Center
Soil Cover. /8 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: / ondeatand the ryrtem type rperaled it different from the type aped zed on the app/kation- / accept the speulcniiom of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocations if the site pian, plat or the intended use change. The Construction Authorization shall not be transferred when there is a change in ownership of the site. Thu
Construction Authorization is subject to compliance with the provisions of the taws and Rules for Sewage Treatment
�and
Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
ed St3hiAecn . Date: 0 Z /Z '5'// Z
o2c , Construction Authorization Expiration Date: 0 z/Z31 Z Z
HTE# I ' S " go69q Permit # 2 %3 /
Harnett County Department of Public Health
Site Sketch
PROPERTYLOCATON: Be{l+el Qragb;SF se ZoyB�
_ SUBDIVISION LOT # a—
V3 rN L- (3 A? --v � 5'T- 20 A
C52- zaw$)
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:_(�� A plicant: lbw,91u8
Address: �1 5� QA, Date Evaluated: G z/Z3//-4
Proposed Facility: 36rL 5f: t) Design Flow (.1949): J GC6�4Jj
Location of Site:4.r;^' L,,A,_ a Property Recorded: ) X0
Water Supply: �T ! Uv Public❑ Individual ❑ Well
Evaluation Method:2r�AugerBo F-1pit El Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: `L Av
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943.1956
Soil
Depth IN.I
Sapro
Class
.1944
Restr
Horiz
i
L 216
0 -3t
L_S
M $gyp
Others Present:
rn �rprly 12�!%s
Site LTAR
6.
31-38
5 L
fi. 6* 561e
38-0
(G L -S
A, 30
S
+qj
L
f7. S5 S
yg
0.(0
2
Z%
0'36
6r• ES
vr(. s SE
3G 44
fit. S r
> ,SyP f
P5
44-ld
5 Q S
44?
0-(6
3
L Z*
0-y9
(mc. 1-6�sL
5cv
PS
yuaK
'XV
0•(0
Description
Initial
Repair System
Other Factors (.1946):
Systenj
Site Classification (.1948):
Available Space (.1945
`-
Evaluated By:
�1 ,,
u>r-rl r\
System T s)
ZS°
Others Present:
rn �rprly 12�!%s
Site LTAR
6.