IPACHTE# 11-5-4641—)1 61-11--1 Harnett County Department of Public Health 29541
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
p \l PROPERTY LOCATION: aYyt FA\RFPot �2���
ISSUED TO: W gcAyC' 1 'oMG� �' t— SUBDIVISION Q sTiMfas sj CA" 55NO LOT #
NEWWWX REPAIR❑ EXR ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF ) (3 -5 ,
Proposed Wastewater System T pe: 9 5 e to �1asv6r
Projected Daily Flow: '360 GPD
Number of bedrooms: _'e" Number of Occupants: 6 max
Basement ❑Yes ''No
Pump Required: ❑Yes �9No ❑ 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:: J Date: fol T I A 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaramees t uana of other permin. The permit holder is resp Bible for checking with appropriate gemming bodies in meeting their requirements. This
site is subject to revocation it 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.
Installation Requirements/Conditions
Septic Tank Size 1000 gallons
Pump Tank Size gallons
Pump Requirements: ft. TON vs.
Conditions:
Number of trenches t
Exact length of each trench 300 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: eI Feet on Center
Soil Cover. Q 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: l understand the system type tpeafled it different from the type tpeciffed on the application. l accept the rpecilcatiom 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 he transferred when there is a change in ownership of the site. This
Construction Authorization is sub ct %with mvisions 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:
action Authorization Expiration Date: 6 T1 a
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
thin permit and shall be met Systems shall be installed in accordance
with the attached system layout
ISSUED TO: WIsRJ�
��^�GS,Nc
PROPERTY LOCATION: alq
VP)9FP�4 + Q+ NA6
X35
xSL)r
SUBDIVISION ps i Tsn�
�c55tN G LOT # N 1
Facility Type: se+i
New ❑ Expansion ❑ Repair
Basement? ❑ Yes �X No
Basement Fixtures? ❑ Yes No
Type of Wastewater System**
o1S;-o
LW—T" 01"' isXs�6tr
(Initial) Wastewater now: 340 GPD
(See note below, if applicable ❑)
e
a� 4
Rep- 5is . lRonairl
Installation Requirements/Conditions
Septic Tank Size 1000 gallons
Pump Tank Size gallons
Pump Requirements: ft. TON vs.
Conditions:
Number of trenches t
Exact length of each trench 300 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: eI Feet on Center
Soil Cover. Q 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: l understand the system type tpeafled it different from the type tpeciffed on the application. l accept the rpecilcatiom 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 he transferred when there is a change in ownership of the site. This
Construction Authorization is sub ct %with mvisions 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:
action Authorization Expiration Date: 6 T1 a
HTE# F?-5-Li)S4y
ISSUED TO:
Authorized S
Permit # ailS Ii 1
Harnett County Department of lliiblie Health
Site Sketch
ounccary inrnTnu- V&NOG(w QQ_
G LOT # l 1
Deparrmcnt of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOI JSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Focality: Design Flow (.1949): +
Location of Site: Property Recorded: _
Water Supply. ❑ Public❑ Individual ❑ Well
Evaluation Method:❑ Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ Sewage ❑ Industrial Process
Sheet
Property ID:
Lot N:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
Description Initial Repair System Other Factors (.1946):
S Site Classification (.1948):
Available S (.1945 v Evaluated By.
S em T s "n 6n Others Present: .3
P
R
O
P
1
.190
SOH.MORPHOLOGY
.1441
OTIM
-PROFILE FACTORS
L
E
a
landscape
Posrtioa/
Slope%
Horizon
Depth
(lo.)
.1941
Structure
Texture
.1941
Consistence
Min
,1942
Soil
Wetness/
.1943
Soil
.1956
Class las
Class
s
.1944
Rertr
Horiz
Profile
(ossa
& LiAR
G
V- L
JV7
Description Initial Repair System Other Factors (.1946):
S Site Classification (.1948):
Available S (.1945 v Evaluated By.
S em T s "n 6n Others Present: .3