IPAC RHTE# Harnett County Department of Public Health 29340
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Oars, c t 6 L n c 55> )
ISSUED T0: Sr - SUBDIVISION LOT # t
NEW &K REPAIR ❑ EXPANSION ❑
Type of Structure: 2432 5 e= 4� 350`9" X 66'611%
Proposed Wastewater System Type: ZS°, 5>s it"
Projected Daily Flow: Z 4 L7 GPD
Number of bedrooms: Z Number of Occupants: _max
Basement []Yes
Pump Required: ❑Yes ❑ No ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public ell Distance from well /-r-, feet
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
Permit valid for.
ars
❑ No expiration
Authorized State Agentca:�i���!/—!�� Date: 03 / 2v/ / -!�LSEE 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 camtmction and installation requirements o1 Rules .1950, .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: N)tty, Mere,
. LL,=/
S r. PROPERTY LOCATION:
wr« (3c. t -F (-n 55,)
SUBDIVISION
LOT # /
Facility Type: 2q2 6FsA
So59"X(04"
1174ew ❑ Expansion ❑
Repair
Basement? ❑ Yes o
Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**
-Z-5i,
o c 4"e,, e\ Sues s.,
(Initial) Wastewater Flow: Z4'G GPD
(See note below, if applicable ❑)
.>aw n
-Eli 2.✓/0 Q, -JL • S s eivs (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size loco
gallons
Exact length of each trench
feet Trench Spacing Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: to inches L'am gps—IzeA
Maximum Trench Depth of: t Z inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: (t. TDM vs. GPM
(Maximum soil cover shall not exceed C(N-k--9
36" above the trench bottom)
Aggregate Depth:
Conditions:
`„ tiPoro�Tq u c mer; ProrT < ILA* a-{ r c( Iv
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
Z inches above pipe
t
-Z— inches total
**If applicable: / understand the swem type speciled is different from the type speci ed on the application. / accept the roecifcations of permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization 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. not
cnnshucnon authon:aton is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit Stt AI IALHtU Slit MtILR
Authorized State Agent: Date: '-7
Construction Authorization Expiration Date: x.3/701 z Z
HTE# 1(e - 5 - 410 Z042 Permit # Z ef 3 4 o
Harnett County Department of Public Health
Site Sketch
PROPERTYLOCATON: b\yc, 55)
ISSUED TO: Dano, rtlkml; b1 52 SUBDIVISION LOT #
Authorized State Agent:—_���� Date:
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Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On -Site Wastewater Section Property ID:
Lot #:
SOLI/SITE EVALUATION File #:
for ON-SITE WASTEWATER SYSTEM Code:
Owner: S//v"Z Applicant ed. rttcq,c ./h„jr
Address: (�,-�t. ;,,44 1_,1 Date Evaluated: 0 3 / 1-7 / I-4
Proposed Facifity: 26.2 Design
�' b Flow (.1949): ZUU s/a Property Siu:
Location of Site: C o r�C� L /f �ropetty Rocorded: }c j
Water Supply.
uc� Individual ell O Spring �
Evaluation Method; Auger��=oriryi ❑
B' Pit ❑ Cut
Type of Wastewater. Itd'Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F SOIL MORPHOLOGY
1 07MM
.1940 .1941
L Landscape Horizon PROFHF FACIORS
E Position/ Depth .1941 .1942
# Slope Yo 00.) Strucnvd .1941 Soil .1943 .1956
Consistence Wetness/
.1944 ofile
Texture MID Sefeo
Colort Class
Rent Class
lass
� �<Z/v a -i8 �2 54 �CSy'S'
Horm <AR
Ig-ZV
PS
M46 n� c P 5 sYVI, G am” 3o
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2636 6v c F/SPS �s�✓2�t�Zy" 36
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IL'ZZ /i
u 3o d� c GI 5 e 75�/I 3 22" 3�>
Description Initial Repair Syst Other Factors
S
tem Site Clessi6cation (.]948): Q��„ S�j/u,11
Available S e .1945 6/e_
S emT s Zsio !4�. Evaluated By: �11
Site LTAR Others Present: �'�v�e� C ✓r/,n
1PA4�"A.
1 "
Gt,',k C"�tL 17_10/11%