IPACNTE# + a- ��q Harnett County Department of Public Health 29568
Improvement Permit
A building permit cannot be issued with only an Improvement una . ,sPermit
r�PROPERTY LOCATION: Ln , I s R <s c C SGL I lc]o
ISSUED TO: _r—'Ckm 4 & f�atlw _ 7ti vcaSY SUBDIVISION LOT #
NEW [P� REPAIR EY EAPANSION ❑
Type of Structure: 1/3 2 C l X ( 9.5' �
Proposed Wastewater System Type: ZS`ii; 5
Projected Daily Flow: '/SA o GPD
Number of bedrooms: 'i Number of Occupants: ✓' max
Basement []Yes Yes I
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ❑ No D -fay beer quired based on final location and elevations of facilities
Type of Water Supply: ❑ Community 17YPublic ❑ Well Distance from well feet
Permit conditions:
Permit valid for. D -five years
❑ No expiration
Authorized State Agent: Date: SEE ATTACHED SITE SKETCH
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 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 fir Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requiremenu of Rules .19SD, .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 T0: Ciµnn_T�l_� T�,�S t1 PROPERTY LOCATION: (raou,_ Milt Roo,cl ($R oUo)
SUBDIVISION LOT #
Facility Type: 146(L0vx (a1'5 p—New El Expansion El Repair
Basement? El_ Yes Vo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 2-5io e2 �1uc� L, vn � yS�t-� (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
Z.571", 3"k -,,k (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I Z60 gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Pump Requirements: ft. TON vs.
Conditions:
Maximum Trench Depth of.. ZD inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. 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
L inches above pipe
t z inches total
."If applicable: / undeatand the rpiem type rpeciled it different from the type specilred on the application. / accept the rpecilcatianr of thir 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
construction Authorization is subject to compliance 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: 'lis' Date: (i a / C5%Zvs -4
Construction Authorization Expiration Date: o�ij /o61 wzZ
NTE# S 169 Permit # 2 9566
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: C:C,np_ rt; II S.2 14 C4
ISSUED TO: K - ,11R - T A: k\ SUBDIVISION LOT #
Authorized State Agent Date: 0 q 05 261
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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
n
Owner:T�7nL-tIlApplicant•.
Address: `GAQ, M i I 20- IIate Evaluated:
Proposed Facility: y/12 5 Fa Design Flow (.1949): 2/E,&v PD
Location of Site: Property Recorded: -ye-5
Water Supply: ❑'( u lic❑ Individual ❑ Well
Evaluation Method: ❑_At g_er�Boring ❑Pit ❑ Cu[
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: Z. 5Cf 4 c
❑ Spring ❑ Other
❑ Mixed
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
Sapro
Class
.1944
Restr
Horiz
Llj
o-8
& SL_
8-
0/t
2
L�/o
(,- I
lo,qo
�a su��
S �
T3V11'I,G36"
404-
o•�/
3
��io�$����
►-�s�y
s
O-
0
8 yG
04 sc%
�l� f�
sft �i
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): PrG�,Si�� Jlv.'Eit/gLQ_
Available Space (.1945) Evaluated By: n
System T e(s) z5` Others Present: 11n�pe C.J(n��Ac f1s
Site LTAR