IPACHTE# I -5- yu3G Harnett County Department of Public Health 29468
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 11 If ,cm, " (51t 155dz
ISSUED TO: Q%Crleb W1 1 61 SUBDIVISION LOT #
NEW ❑ AEPAIR EXPANSION ❑
Type of Structure: Z 62 5 ��
Proposed Wastewater System Type: Z-5�,
Projected Daily Flow: Z X96 GPD
Number of bedrooms: —2 Number of Occupants: max
Basement ❑Yes 11.796
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ❑ No Ld May a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 t feet Permit valid for. 9'Tjve years
Permit conditions•.
i•>"`tl; .n t6e�wzi-abco A3 'ackc -'u foe ❑ No expiration
ru�
ve [> or Po.oet re rn.-,.s.. k
Authorized State Agent: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. 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.
WATER LINES (INICLUDING 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: / understand the syrtem type specified is different from the type spedfled on the application. / accept the sped#cadonr o/ this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use changes. The Constru<don Autlhoritation shall net 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: oillz4Z
/
Construction Authorization Expiration Date: oglx—xz z Z-
Construction Authorization
(Required for Building Permit)
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: G"es 1`40,s3ha11 Te)L
6PROPERTY LOCATION: - 11\43
Tnl n5an �,.rM 2,i. (S2 tSti-c )i
SUBDIVISION
LOT #
Facility Type: Z$2 r
❑ New ❑ Expansion [9`6epair
Basement? ❑ Yes io Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** t_ X h S-7
t r -a o s >'S T 9=
(Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
25%a 5,5ieM (Repair)
Installation Requirements/Conditions
Number of trenches Z -
Septic Tank Size i t,< 0 gallons
Exact length of each trench 00 feet
Trench Spacing: Y Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover: ? inches
Maximum Trench Depth of ` a,t" 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. TDH vs.
GPM
inches below pipe
Aggregate Depth: L inches above pipe
Conditions: AS nole,� ' rt Trvapro,,cw
xt Perm'k ( mo,)
inches total
WATER LINES (INICLUDING 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: / understand the syrtem type specified is different from the type spedfled on the application. / accept the sped#cadonr o/ this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use changes. The Constru<don Autlhoritation shall net 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: oillz4Z
/
Construction Authorization Expiration Date: oglx—xz z Z-
NTE# ! - 5 -y/M
Permit # Z 911 (0 r
Harnett County Department of Public Health
Site Sketch
ISSUED TO: C-kOr-ICS M �� 11 TJnnS 5n PROPERTY LOEATON: II 3 Tolnsks , , Rel (,<4Z Igy�)--
SUBDIVISION LOT #
Authorized State Agent !�ll�is�_����� - Date: dY�/ Z 8/ 1 q -
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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: IApplicant: CI`1 r 3
Address: 11-43 _L601-�a %rmt Q-( Date Evaluated:
Proposed Facility: t&,2- 5ro Design Flow (.1949): Z -YO laPJl
Location of Site -Property Recorded: fief
Water Supply: Public❑ Individual ❑ Well
Evaluation Method:Auger Boa ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed coaa-& l
Ckw, ao Cv,� kl,#kl
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
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space( 1945) Evaluated By: �t �
System T e(s) Others Present:
Site LTAR