IPACHTE# 1� -S �1)b9i Harnett County Department of Public Health 29667
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
`` PROPERTY LOCATION: C -TF j_� L g _
ISSUED T0: G�✓ly Vi MyrS o N rs of 5 Ll—Ci SUBDIVISION C-, ocs 6 C 51- LOT # 10�
NEW REPAIR ❑ KPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO (U3-�34J
Proposed Wastewater System Type: as% CD iso J nim
Projected Daily Flow: L�KQ GPD
Number of bedrooms: !11 Number of Occupants: 12i max
Basement []Yes A No
Pump Required: ❑Yes -,f� No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community A Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: y\ �\- 94L±15 Date: G�1301) ) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees th`ee ce of other permits. The permit holder is respo ible for checking with appropriate governing bodies in meeting their requirement. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Imp nt 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 requirement of Rules .1950, .1951, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be inuallad in accordance
with the attached system layout \\
ISSUED T0: GeV--) �oE3Zr-`s5o + YY0M(5 Z j G PROPERTY LOCATION:
`J�1L13 �`3% SUBDIVISION Q cG t\sGS� LOT # y
Facility Type: 1 X New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Bent fixtures? ❑ Yes o
Type of Wastewater System** RED v Gts d ry -1 . & rcN (Initial) Wastewater Flow: I 'Wo GPD
(See note below, if applicable ❑) w
2,S /o
Installation Requirements/Conditions
Septic Tank Size S oma gallons
Pump Tank Size gallons
Pump Requirements: h. TON vs. _
Conditions:
QSO U Git t7 N S 25 , (Repair)
Number of trenches 1
Exact length of each trench WIll" feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: )"'i inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. k inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable: / aaderrtaad the ryrtem type rpedhed it different Imm the type spec/bed on the application. / accept the rpecifcationr of thir permit.
Owner/Legal Representative Signature: Date
This tonstmcdon Authomation is�bject 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 sire. This
Construction Authorization is subject to us!_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: Date: 6 30 11-1
Consruction Authorization Expiration Date: 6 3o -J
HTE# ` "5 - z}1 4,15
Permit # QN l
Harnett County Department of Public Health
Site Sketch
PROPERTY LO[ATON: () G.�vE.,,t aJC,%-4E
ISSUED T0: Ro��NSd r1 Wam& SUBDIVISION C 20 C-, LOT #
Authorized State Agent: -iS5 �LA ev -T 0 L±$D4v&Date: 6I30I l�
2u6A2
CT-
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: j
Address: Date Evaluated:(�.� 0 l
Proposed Facility: L _;;0vc\ Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual F]Well
Evaluation Method:�Auger Bo '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
.1956
Satire
Class
.1944
Restr
Horiz
1P
oar.
s�
W a NSINP
556P
-aZ,
6 5L
\Az'1 '15
s5/1lNP
P 5
"1
Description Initial Repair System Other Factors (.194(1):
System,/ Site Classification (.1948): 6z j
Available Space (. 1945) V IEvaluated By:
System Type(s) !v R Others Present:
Site LTAR . kAj