IPACHTE#M-5-41au5 Harnett County Department of Public Health 29519
Improvement Permit
A building permit cannot be issued with only an Improvement
i n PROPERTY LOCATION: 1VG �.n-j FEZ WLL�S SC(s�erXLC LN
ISSUED TO: �6-c�s�C G(L S zogEcc' �Pvy SUBDIVISION LOT #
NEW>r REPAIR ❑ EKPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M{S.d N-10 .E. C►��X 36�
Proposed Wastewater System Type: a QE Qc C. t t �YSTG•n
Projected Daily Flow: -L1% O GPDNu
Number of bedrooms: - mber of Occupants: _max
Basement []Yes XNo
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1<Public ❑ Well Distance from well feet Permit valid for:
Permit conditions:
Five years
❑ No expiration
Authorized State Agent:: : Date: 5 /as ) '%-1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarante uance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requiremenn. This
site is subject to revoadon it the site plan, plat, or the intended use changes. Thelillfairientent permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the pmvisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
squired for Building Permit)
The construction and installation requiremenn of Rules .1958, .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:7:ZF-�s�N V'r � 61; W Ky PROPERTY LOCATION: NG ',)M 61(F-' L s SsG,,,ePOA LN )
SUBDIVISION LOT #
Facility Type: MTNt4 i3 DME, ��b �6� �k New ❑ Expansion ❑ Repair
Basement? ❑ Yes "'�No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** a.F3 01 e ReD V G; s. u i Sy5T6 M (Initial) Wastewater flow: L41 GPD
(See note below, if applicable ❑) / n
Pu �j � o '�,S`! w c-y� 3 (Repair)
Installation Requirements/Conditions Number of trenches Y
Septic Tank Size n gallons Exact length of each trench L-+ o 0 feet
Pump Tank Size 'Lot 00cellons Trenches shall be installed on contour at a
w.tC
v� 6OC�� Maximum Trench Depth of: 11 a1'y inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: r% 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: / undentand the grtem type rpeciled it different from the type rpeciped on the application. / accept the speulcatianr of this permit.
Uwner/Legal Representative Signature: Date:
This Construction Authorization is on 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 is subject to compliat " the prow Caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 v S 51
Construction u horization Expiration Date: S ti3 7
NTE# 1 - 5-L4 Saun Permit # ZA 5T 5
Harnett County Department of I'><iblic Health
Site Sketch
r PROPERTY LOCATON: NG -.124 ]an (r-LuC ' T— c,NM L'v J
ISSUED T0: — N� t S ��C(Lq A SUBDIVISION LOT #
Authorized State Agent: �fi�L+GLS a Date: S ( 1
,4s
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: p
Proposed Facility: [� q>,0(2-vrM Design Flow (.1949): "QQ o
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Methodk.�51 A Boring ❑ pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet.
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
t=1
Aw.1941
Landscape
Position/
Slope%
a S
Horizon
Depth
(In.)
6 t`.
SOIL MORPHOLOGY
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
C 5
. 1941
Consistence
Minemlo
vt� i^tS
1942
Soil
Wetness/
Color
.1943
Soil
th (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
CQ Q@ 3
U�
Iv, L
a�
s3k sct,
Fn s3)5r
lo-3Ct 7iZ�-�a
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (1948)i P,�
Available Space .1945) Evaluated By: d'(
S stem Type(s)
Site LTAR Others Present.