IPACHTE#17"55"3-116`34 Harnett County Department of Public Health 29670
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Ve
ISSUED TO: G;-� -J ROQ�;1 NSO N U a Mli SUBDIVISION G A s6w 6SC LOT # L
NEWLr REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO D
Proposed Wastewater System Type: Pv+n ie a P�EOUC.YiO4 Sys F�
Projected Daily Flow: 4'1 C) GPD
Number of bedrooms: 4— Number of Occupants: Q max
Basement ❑Yes e:KNo
Pump Requirei ❑ 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: 7� � 1 Y� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the rade of other permi . The permit holder is responsible ?clucking 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 Impro ement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the previsions 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, .1957, .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. n
ISSUED TO: GR�2/ ``;(76Taspst �ocnEj PROPERTY LOCATION: G An eNE,.Yt C5 a-,
SUBDIVISION G"-. ii LOT # 46
Facility Type: �� �sa''�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 9V meted �.SP/a QGDU�j du S �s � (Initial) Wastewater Flow: ti O GPD
(See note below, if applicable ❑)
Pu ^e'To 3-,- ;It QSA . S& (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size I Ooo gallons Exact length of each trench feet Trench Spacing: 9 Feet on Center
Pump Tank Size texN0 gallons Trenches shall be installed on contour at a Soil Cover: l; Ta inches
Maximum Trench Depth of. –c-14 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/.I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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: l understand the system type specAed is different from the type spealled an the application. l accept the spealrcani ms of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is s 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 mmpliaaC rovisio s 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:
Authorization Expiration Date:
HTE# l 7- 5 x-11651-4
ISSUED TO:
Authorized State Agent:
Permit # 167a
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: �A G�6S5 Qom.
SUBDIVISION C; LOT l 1 LOT #
ToLXSM-N-) Date: '7I'71 �7
a—r� /
2vr.fa
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: A)00 j4,rN Design Flow (.1949): SSC
Location of Site: Property Recorded:
Water Supply: _'®'Public❑ Individual ❑ Well
Evaluation Method Auger Ndng ❑ 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
Minemlogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Site LTAR
L5
V 30
G St
qf?L
ill! �c,
G- is
J�rt rtir
40451
G zs
vR. Nj)u(
s.
Description
Initial Repair System
Other Factors (.1946):
S st
Site Classification (.1948):P5
Available Space (.1945)
1 V V
Evaluated By: OT
System Type(s)
aS'°i
Others Present: —
Site LTAR
S