IPACHTE# 1'7 -5 -/40 -AL Harnett County Department of Public Health 29436
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
(� PROPERTY LOCATION: (%s ZtsNS QD
ISSUED T0: ROlvv L P<cs RDL'VI c1 G Gal SUBDIVISION K7 -Yl -a 5 V) LST" ka LOT # 4'.'41
NEYM REPAIR ❑-�xPANSION [I Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 6V9l5 t "t -i 0
Proposed Wastewater System Type: a5°%n �cAVGS tt a Syss�m
Projected Daily Flow: Li",C) GPD
Number of bedrooms: "'I Number of Occupants: _max
Basement []Yes `'Nis
Pump Required: []Yes ❑ No 'X May be required based on final location and elevations of facilities
Type of Water Supply: ElCommunity A Public 11Well Distance from well )00 feet Permit valid for: Five years
Permit conditions: c _ ❑ No expiration
Authorized State Agent:: Date: 3 l ' T� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees t once of other permits. The permit holder a responsibfe 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 or conditions of this permit.
Construction Authorization
(Required for Building Permjtt
The construction and installation requirements of Rules .1950, .1957, .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: PROPERTY LOCATION: NN Kl a5
SUBDIVISION i?%, Y--\ s \1 6E LOT # itD-
Facility Type: Q5 New ❑ Expansion ❑ Repair
Basement? ❑ Yes '1� No Basement Fixtures? ❑ Yes No
Type of Wastewater System** a-S;/e Q Feu C7<l a s. Sys TEm (Initial) Wastewater flow: LJ% (Z) GPD
(See note below, if applicable ❑)
-aS7its '�:k' vz�)• S (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size s ocoa gallons
Pump Tank Size gallons
Pump Requirements: IT. TDM vs.
Conditions:
Exact length of each trench 31 O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: `aa inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. 10 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: / understand the s}rtem type specified is different from the type spedfed on the app/icaaon. / accept the rpecilcationc o/ this permit.
Owner/Legal Representative Signature:
Date:
This Construction Authorization is—slubliDt4onvocation 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 subject tp mm . Mf®ptvisions of the Caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: it T)5 Date: 3
"tftruction Authorization Expiration Date:
HTE# Permit # QL 1l -)3k
Harnett County Department of Public Health
ISSUED TO: T�lLQ)riQ
Authorized State Agent:
165
63�
Site Sketch
PROPERTY LOCATON: P17 Y—)N-5
SUBDIVISION N6 LOT # 4
N5l0uv�oUc eft�Aate:
PO O NO Iyi 10 +.z
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1
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: l
Proposed Facility: Lj eQ Design Flow (.1949): I'iV je
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method:q Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: 'j;j Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
�.5
G 4-5
r,
3,1
45�
d0
G L5
16
Y3�5 (l
FZ 5
..
cxa
Pi
3
d '8
CJS
Vr'c, wOINP
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): P j
Available Space (.1945) V Evaluated By: C
System Type(s) S;- LGu Others Present: _.
Site LTAR