IPACHTE# y- s--vi45 4 Harnett County Department of Public Health 29495
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: �cJ f—"�/y n �r �o)8
ISSUED T0: CA Ons llf( _6 J /sC SUBDIVISION 0 A � � � 0 cels LOT # Z -
NEW Ct REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 362 5 FV�> ( &y Vg'
Proposed Wastewater System Type: ZSic 5,5
Projected Daily Flow: 3c.o GPD
Number of bedrooms: 3 Number of Occupants: —C -max
Basement ❑Yes
Pump Required: Ws ❑ No ❑May be r�e9ffired based on final location and elevations of facilities
Type of Water Supply: El Community f�blic ❑ Well Distance from well—feet Permit valid for. 9"F—ye—ars
years
Permit conditions:❑ No expiration
Authorized State Agent: Date: !2� SEE ATTACHED SITE SKETCH
Zo 1 "4
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.
Construction Authorization
squired for Building Permit)
The construction and installation requirements of Rules .1958, .1952, .1954, .1955, .1 9S6, .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
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ISSUED T0: 1 3 F1\canS (lerg ll>) TjTc PROPERTY LOCATION: �y ��. fon tJr . ( U1� 5{ QA c�J
SUBDIVISION O x cGr1 \A25C�& LOT # 22:)
Facility Type: `� 5 rt> 60 0 --New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" wrnp TS%• (ln� yt + S �_— (Initial) Wastewater Flow: 3 GPD
(See note below, if applicable ❑)
Conditions:
C
Trench Spacing: J Feet on Center
Soil Cover. Z' inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INICLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
F' inches below pipe
inches above pipe
I
inches total
**If applicable: / understand the system type spedffed is different from the type specified on the application. / accept the specilicadons of 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 construction Authorization shall not be transferred when there is a change in ownership of the site. This
win, m, provisions or me taws and aures for ewagq Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: f ���/����// f�S Date: 06/04/Z3t=1(
Construction Authorization Expiration Date: rid iia / Le»
Zbib 44A� S' (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size t wy gallons
Exact length of each trench _7 feet
Pump Tank Size t oC> a gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of 3c> inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
C
Trench Spacing: J Feet on Center
Soil Cover. Z' inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INICLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
F' inches below pipe
inches above pipe
I
inches total
**If applicable: / understand the system type spedffed is different from the type specified on the application. / accept the specilicadons of 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 construction Authorization shall not be transferred when there is a change in ownership of the site. This
win, m, provisions or me taws and aures for ewagq Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: f ���/����// f�S Date: 06/04/Z3t=1(
Construction Authorization Expiration Date: rid iia / Le»
HTE# 1a'S-4WSV
Harnett County Department
ISSUED TO:
Authorized State Agent:
Permit # `1 q yS
Of Public Health
Site Sketch
5 z I o0C,
PROPERTYLOCATON: VI c- Glct 5-&} 0--A N�
_ SUBDIVISION ✓XForc� oad s LOT # 0-6
Date: G� (Lo
-41
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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: k'V'f10d 441% 5;,/
Address:4W LG 9 tikn 9r . Date Evaluated: ° S /3/ /
Proposed Facility: 302 5 F I,- Design Flow (.1949): °3,10 GP
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ElWell
Evaluation Method: ager Bor❑ Pit ❑ Cut
Type of Wastewater:0 Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File#:
Code:
Property Size: 0_f-7� /L
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
.1941 .1941
Sttuc[ure✓ Consistence
Texture Mineralo
OTHER
PROFILE FACTORS
1942
Soil .1943 .1956 .1944
Wetness/ Soil Sapro Rear
Color De th (IN.) Class Horiz
Profile
Class
<AR
0- 7,4
zay4
L5
VA_ su
,�/ S P
7sY2
4q t
C)./
2
L 510
o Z8
� LS
Fr( Sf!
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): eo ff f y4G
AvailableS ace(.1945) PrVj,St
S stein T s d Evaluated By: A ��� / 2�
Site LTAR �) Others Present: An C✓fr