IPACHTE# 1-7 5-9 0-1I a Harnett County Department of Public Health 29414
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
\, PROPERTY LOCATION: 41LA M )LLS '"0 V5 - Z.n
ISSUED T0: T v nn �6i1i I �PLCi(L6p'r*1 SUBDIVISION LOT # i
NEW)' REPAIR ❑ EXPANSION ❑
Type of Structure: 51Z�3y "Sw-)
Proposed Wastewater System Type: QLSP v VCDVC;::v o" asYS�E n
Projected Daily Flow: 'J\4 b GPD
Number of bedrooms: e. Number of Occupants: L4 max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: []Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community %* Public ❑ Well Distance from well 1C7 a feet
Permit conditions:
Authorized State Agent:: w�
The issuance of this permit by the Health Department in no way guarantees the issuance
site is subject to revocation it the site plan, plat, or the intended use changes. The Impn
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date:
Permit valid for. )RIive years
❑ No expiration
SEE ATTACHED SITE SKETCH
u. The permit holder is res'onsible for checking with appropriate governing bodies in meeting their requirements. This
shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1958, .1951, .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: K1Mp6L-\.;V GA'-act�ai a PROPERTY LOCATION: L-VIL4 MLT -5 )Joy SE Lu
SUBDIVISION — LOT # 1.
Facility Type: SC U New ❑ Expansion El Repair
Basement? El Yes -^'.&L No Basement Fixtures? El Yes �No
Type of Wastewater System** 50/0 v CA � a s.1 S75 i EM (Initial) Wastewater Flow: a-'40 GPD
(See note below, if applicable ❑) S
P
21l. S to
RG -0U G, a 0 N -Y5 (Repair)
Installation Requirements/Conditions
Number of trenches 3 Pti
Septic Tank Size 100 O gallons
Exact length of each trench 5 O 7 S feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 4% inches
(Trench bottoms shall be level to +/•1/4"
in all directions)
Pump Requirements: ft. TON vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover._ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
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.
**If applicable: / ondeatand the system type specified is different from the type specified on the application. / accept the soedhiationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject 'on if the site plan, plat. or the intended use changes. The Construction Authorization shall not be translerred when there is a change in ownership of the site. This
Construction Authorization is subje t m compliant h the n a Laws and Rules for Sewage Treatment and Disposal and m the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agenty-� Date: a y7
Consti a Authorization Expiration Date: Y a2
HTE# �1-5-'-1Cn12� Permit # a-�1)tj
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: N0115b
ISSUED TO: V k ing 1� AQ6o S1- SUBDIVISION LOT #
Authorized State Agent: �� duYG2 oLFO(6�Date: aI c�1�1
FCNcE
L.L)
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOLUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: i''' L/% Design Flow(. 1949):aL)FS,�
Location of Site: Property Recorded:
Water Supply: 'Public❑ Individual ❑ Well
Evaluation Method:�uger Bodring ❑ Pit ❑ Cut
Type of Wastewater: aSewage ❑ 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
-PROFRE FACTORS
Profile
Class
& LTAR
.1941
Structure!
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Resb
Horiz
o
sg Y,Lk
_a�
o10
Description Initial Repair System Other Factors (.1946): p
S st Site Classification (.1948): f -S
Available Space(. 1945) Evaluated By:(V,,)
S em T s C/' :-> Others Present:.,._
Site LTAR • �— — �>