IPACNTE# V% -5' ) I Harnett County Department of Public Health 29540
Improvement Permit
A building permit cannot be issued with only an Improvement Permit p —
PROPERTY LOCATION: GvM ) �N
ISSUED TO: : ok-s r KN L C7�-iT SUBDIVISION LOT # L
NEWX REPAIR ❑ _ E�NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:6�/
Proposed Wastewater System Type: 2,5 00c'tE7 r y3 Gc
Projected Daily flow: 3C:0 GPD
Number of bedrooms: -3, Number of Occupants: G max
Basement []Yes ><No
Pump Required: ❑Yes A!S No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �X Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent: �\ Date: hl 1`� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaran carte of other permits. The permit holder i ?r in—ml fer 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 provement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the taws 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, .1952, .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: SUsst'r —%-41CPi PROPERTY LOCATION: Cu., Vti jjr165Q,p
��=9 1 z� SUBDIVISION LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes A No Basement Fixtures? ❑ Yes "5<N§
Type of Wastewater System** a57- P�Gfly�ria v JY� �CJ_ (Initial) Wastewater Flow: 3CC5 GPD
(See note below, if applicable ❑)
:LS"�. (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size 10 40 d gallons Exact length of each trench a00 feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: "u-6 inches
Maximum Trench Depth of: 60 --Iq 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. TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: otrr� 4 Dara N S N EE J &.s:;) Aggregate
total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the sweet type Jpealed /r different from the type speciled on the application. / accept the rped9cationr of this permit.
owner/Legal Representative Signature: Date
This Construction Authorization is :17
u revondo `4Q
site plan, plA or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorisation is s o complian the pro s of the Laws and Rules for Sewage Treatment and Disposal and to the mnditiom of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: RfT Date: 1-J
tgtion Authorization Expiration Date:
HTE# Permit # 0
Harnett County Department of 1-�tblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: Joy+ �h �ri5 SUBDIVISION LOT # I
Authorized State Agent: 5 �' ��� ���Y�9b(�� Date: GI l�1 T
ANO SS GQ OOwnes NEGp6D
(-- Vfnrn1NGS YLp
(;;% I ---�>
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:3E$Z)Q'� Design Flow (.1949): 11� 6
Location of Site: Property Recorded:
Water Supply: Public❑ Individual El well
Evaluation Method:a A er ring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property 1D:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
L
E
4
.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
L-5
036
JL5
i�
ase
�• 6
2
0 3�)
GSL
, L ,�JrvP
3's�3
53ti sc•t_
vcn g, � �P
5
� • S
Description Initial Repair System Other Factors (.1946):
S st Site Classification (.1948)-f.3
Available Space (.1945) Evaluated By: p'C
System T e(s)�'• Others Present:
Site LTAR ,
1�DOO — S io�2, Z,
VJO SiFyS ��E'd�