IPACHTE# V7 `5 -Li NSS-7 Harnett County Department of Public Health 29542
Improvement Permit
A building permit cannot be issued with only an Improvement Permit ter'
PROPERTY LOCATION: 30 RPRG�IE
ISSUED T0: A -C 151 oe� �7 OM HrrrnE,� SUBDIVISION GXLu,0
LOT # �
NEW REPAIR ❑ Exw� SION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: G VD C55 -3J
Proposed Wastewater System Type: ZAS -/G 14COU(2:06 .r g-s-js,
Projected Daily Flow: 4010 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ><No
Pump RequiredXies ❑ No XMay 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: 6 tl I lSEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i re of other permit. The permit holder i respons le for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revootion 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.
Construction Authorization
(Required 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 he installed in accordanre
with the attached system layout
ISSUED TO:VCLzc k 5 I f)'J omr PROPERTY LOCATION: 30 AQthca ��fl a L
SUBDIVISIONLOTv ry1 �g7 L� r1 LOT # I
Facility Type: s�� ' S New F-1Expansion❑ Repair
Basement? El fes No Basement Fix res? 1:1 Yes XNo
Type of Wastewater System" Q J m Sy3 Sir (Initial) Wastewater Flow: L" W6 GPD
(See note below, if applicable ❑)
Pv r 1? 1 0 74��b RED . (Repair)
Installation Requirements/Conditions Number of trenches S
Septic Tank Size P o 0 o gallons Exact length of eachtrenc�S feet Trench Spacing: 1 Feet on Center
Pump Tank Size S aaRs gallons Trenches shall be installed on {ontour at a Soil Cover: eq inches
Maximum Trench Depth of: 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: ft. TDH vs. _ GPM inches below pipe
P q� Aggregate Depth: inches above pipe
Conditions: E�trh T gv,sFp s �ez�o�a.L F2U<1 tyPoLT�peS�S LSS
inches 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 / undeatand the ryttem type spealed it different from the type speciled on the app/icatiaa / accept the cpe6kcatims of this permit.
Owner/Legal Representative the
Date:
This construction Authorization is subject to revocrtion 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 Autlwri:ationznce with the provisions of the laws and Rules for Sewage treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �La Date: 6` 1a11�
ruction Authorization Expiration Date:
HTE# 5-x-11551
Harnett County
Permit # a `151ta
Department of ll�lblic Health
Site Sketch
PROPERTY LOCATON: 30 PPPUNE. "Tyli>o t.
ISSUED T0:
OC PROPERTY
,. Pn
SUBDIVISION 5CrL,-), LOT # T
Authorized State Agent: Rbcs oLxjnV Date:
1�5
/�
3t-
nlci oto NCt.C.H 9-D
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: Lt gq�XZ�4\ Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply:.Public❑ Individual E] Well
Evaluation Method" Augr B ng ❑ 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 J
.1956
Sapro
Class
.1944
Restr
Horiz
Description InitialR it System Other Factors (.1946):
S st Site Classification (.1948)5
AvailableSpace (.1945) y Evaluated By: 0 -K -
System 1e(s) 0 7 M ? /t P a MCI Others Present:
Site LTAR '-t