IPACHTE# t I- 5 -4QY Harnett County Department of Public Health 29350
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Gen Ile 11:11e, Ln iG+/Cn/ZJ 62 Iuz�)
ISSUED SUBDIVISIONLOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required rjor to Construction Authorization Issuance:
Type of Structure: 96 % X /Oo 9
Proposed Wastewater System Type: Zs12E lWl;nn �p 6
Projected Daily Flow: `/8th GPD
Number of bedrooms: Number of Occupants: F_max
Basement []Yes aro
Pump Required: ❑Yes
Type of Water Supply:
Permit conditions:
Authorized State
❑ Norequired based on final location and elevations of facilities
❑ Community ❑ Public E?-We�ll Distance from well 4:P071 feet
Date:
Permit valid for:
❑ F yv er—are
❑ No expiration
SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuanceof other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject an 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 in 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 accordance
with the attached system layout.
ISSUED TO: fA tAAae 1 1 Tess ccs 1) e–e--PROPERTY LOCATION: %,Mdeyc,)Ir Ln ((QE�64 %/d Sky Iq �
SUBDIVISION Cf cwer� C. c n ys {C LOT # _7`
Facility Type: y &I D'0' x /005?'lre—w ❑ Expansion ❑ Repair
Basement? ❑ Yes I o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" Z-6,/ /LcJ c_ .fi ir ,�:. (Initial) Wastewater Flow: o -4T0 GPD
(See note below, if applicable ❑)
ZS% /Z A-C-fr o i% Sys (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I ZGb 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: 0 inches
Maximum Trench Depth of: ZQ 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: h. TDM vs. GPM inches below pipe
Aggregate Depth: 2 inches above pipe
Conditions: t Z inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
If applicable, l understand the system type specified is different from the type specified on the application. l accept the rpecihcationf of thir 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 Authoritanon shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: Gy /oy / f }
Construction Authorization Expiration Date: oy
/6q / 7i.-
HTE# I 5 46gy6 Permit # Z 9350
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: C-en6le Vnljej Ln reoLfon ad 5(L IgZC)
ISSUED TO: nt;c 4eI-+Tt°55;c Aii er —SUBDIVISION CcL.ven La..Gc4LOT#'Z
Authorized State Agent: /�l�r�iG»fig',%S Date: d y! o i� l
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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: M�{c,AApplicant: M'Lttcwt +Te,J5,-e, AlOer
Address: L6V Z (y�ffii<tc \XA1V Date Evaluated: 'Lj(o 3114 —
Proposed Facility: q6(L Jr 9 Design Flow (.1949): '/�6 6106
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual �ell
Evaluation Method: Auger Borin - E] Pit ❑ Cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: 3.6q A-(''
❑ 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
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
1_
o-3
Z
L Z;o
J/rs
SAP-
5/AQ
0.3
466
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5A).
04
F(L SW 5�
8-36
qty L
r 1 SQ
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sem.
see.
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OrJ
6_3
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): pro,
Available Space(. 1945) Evaluated By: A�t
System Te(s) i Others Present: AnJrt,e CJrn,l V4r __s
Site LTAR