IPAC RHTE# 1(-- 5--;Sc� V, Harnett County Department of Public Health 29419
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t, PROPERTY LOCATION:
ISSUED TO: �1t i P% n9 ��! \0 Ga T��115`16s t SUBDIVISION LOT #
NEW REPAIR E7 INSION ❑
Type of Structure: 5Fp
Proposed Wastewater SystemTy e: �°le S2CoV GSSo lYY,�v�
Projected Daily Flow: 4Z GPD
Number of bedrooms: 4i' Number of Occupants: max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes o ❑be required based on final location and elevations of facilities
Ma
Type of Water Supply: ❑ Community Public ❑ Well Distance from well Net Permit valid for: Five years
Permit conditions—
El No expiration
Authorized State Agent:: Date: 9 T") SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees ce of other permits. The permit holde is nulPlinsible 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 Impibiessent Permit shall not be affected by a change in ownership of the site. This permit is sublets 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 requirements 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 atcardana
with the attached system layout.
ISSUED T0: '�A SPa"-V 4Q,VN9 k ,�ta.�S:LN PROPERTY LOCATION: Gs-ACLS
RZ
SUBDIVISION — LOT #
Facility Type: s C'� "'i5J New ❑ Expansion ❑ Repair
Basement? ❑ Yes Z No Base t Fixtures? El Yes No
Type of Wastewater System"` a-15 0 P,C-fluL'r10 ra Sys � t=sn (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
P" int -T. a5°/o Pla) -(Repair)
Installation Requirements/Conditions Number of trenches 3 —01
Septic Tank Size t 0 40 o gallons Exact length of each trench 100 feet Trench Spacing: Feet on (enter
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: C -,—k- inches
Maximum Trench Depth of: ) a� inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TON vs. GPM
Aggregate Depth:
Conditions:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type spec/fled it different from the type spetilled on the app/rcadon / accept the specibcationr of this permit
Owner/Legal R e Signature: Date:
This construction Authorization is subject ton if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership tel the site. This
Construction Authorization Iscift to compliant the I the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:Date: 3 t l l
Cons Philition Authorization Expiration Date: 3_ ZG�
HTE# �6-53� QZ
Permit #
Harnett (bounty Department of Public Health
Site Sketch
ISSUED TO: VC
4twNor6
v PROPERTY LOCATON: C-4-A2u-
SUBDIVISION
LOT #
Authorized State Agent:
`o )Ne2"Tbt_YSQoDate:
I-2
I S�
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOUAITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): 'j 6
Location of Site: Property Recorded: 0
Water Supply+PublicO Individual D Well
Evaluation Method' )R_ Boring D pit ❑ Cut
Type of Wastewater: Sewage D Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
D Spring
D Mixed
D Other
P
R
O
SOIL MORPHOLOGY
OTHER
1940
L Imtiow
Horizon
.1941PROFILE
FACTORS
E Positiod Depth
# Slape Yo (
S .1��1ne
.1941
CoosisimceSoi!
.1942
Soil .1943 .1956
.1944 Profile
LS
Tuture
Mineral
� Salk-Resror
IN. CIM
Class
Horiz & LTAR
I 1.5
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6 �
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Hv 75
CR 1 Qi 3a1'
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Description
Initial Rep
"r System
Other Factors (.1946):
S st
Site
Classification (.1946): ��
Evacuated By:
Others Present:
Available Space .1945
S stem T s U
Site LTAR t�