IPACNTE# Harnett County Department of Public Health 29525
Improvement Permit
A building permit cannot be issued with only an Imrovement Per it
\ 1 L PROPERTY LOCATION: (�nt? L.S�
ISSUED TO: W 1 t4TCRA5 � ra04bw s +t A SUBDIVISION LOT #
NEW 13< REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 6tq�0 L -7C ' ""Y
Proposed Wastewater System T pe: ua+vp le QS`oVCSsoN S-J:I-t (
Projected Daily flow: 3 GPD
Number of bedrooms: 3 Number of Occupants: Co max
Basement ❑Yes )<No
Pump RequiredWes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community � Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: N Date: 5 /Z.3 I M SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees rhe of other permits. The permit holder is respon le 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 Improve t 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
squired for Building Permit)
The construction and installation requirements of Rules .1950, .19S2, .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: VANrfi6CLS ��QE^ad � F_¢.NICi>1 PROPERTY LOCATION: ?6PE 94
Facility Type: 6�fl ��6S� New
Basement? ❑ Yes �R No Basement Fixtures? ❑ Yes
Type of Wastewater System" PO m2 -Tb a��s
SUBDIVISION
❑ Expansion
X No
Cxsi+owt
LOT #
❑ Repair
gys;resr (Initial) Wastewater Flow: 36� GPD
(See note below, if applicable [3)p > asle 9, (Repair)
Installation Requirements/Conditions Number of rrenrhee S
Septic Tank Size 101Z) 0 gallons
Pump Tank Size 'QC) gallons
Pump Requirements: N. TDH vs.
Conditions:
Exact length of each trench 30b feet
Trenches shall be installed on contour at
Maximum Trench Depth of: 1'311 rhes
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: I feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 system type spedled is different from the type specified on the application. / accept the rpeciinaiims of this permit
Owner/legal Representative
Date:
This Construction Authorization is subject to re 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 tgtomplia a wi Is h�Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �� RETI) Date: S )7
Construct) R Authorization Expiration Date: Sa:
HTE# 4J — 5-4O1lO1
Permit #
'aCj sass
Harnett County Department of hiblic Health
Site Sketch
ISSUED T0: W 1 v
`� �^+o�.+
PROPERTY LO(ATON: Po?
` C�/rk� SUBDIVISION
6 R -c>
LOT #
Authorized State Agent:
+�5 �i`MEZ a Li6Db
l
Date: S I� 3I i7
PDP6 QQ
„S
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:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Publico Individual ❑ Well
Evaluation Method:❑ Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ 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
1
L 1*
b -9
rax o`rq
K la
sc
Or. sy
Q+
GR 5 `
62 Aff -r
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Description Initial Repair System Other Factors (.1946):
System/- Site Classification (A 948):P )
Available Space (.1945) Evaluated By: Q�
System Type(s) O Others Present:
Site LTAR
tis �- Ig•a�•.
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