IPACHTE# 4- Harnett County Department of Public Health 29560
Imorovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: IMC411 ,rl YAr74 ( }a r2 1 6,-Q
ISSUED T0: � j14&rto" Wr-)t 0 , %J, -6 C5 - SUBDIVISION LOT # _'5/
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Vi . 6
Proposed Wastewater System Type:
Projected Daily Flow '/��% GPD
Number of bedrooms: 54- Number of Occupants: 16 mag
Basement ❑Yes 2'lio
Pump Required: []Yes ❑ No ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Ei-lftublic
❑ Well Distance from well feet
Permit valid for.
Permit conditions:
❑ 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 if 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 m conditions of this femur..
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 pemit and shall be met System shall be installed in actordano
with the attached system layout.
ISSUED TO: St -k( Ae ZlAsi
PROPERTY LOCATION: lm4pn
Q na� 52 1 9th,-
facility Type: 2 S ro (SS 'YSO�)
SUBDIVISION
ew ❑ Expansion ❑ Repair
LOT #
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 25
CA, -5 t<--,,
(Initial) Wastewater Flow: yid GPD
(See note below, if applicable ❑)
A�—C'rccr
tYlw tte.a. SSS (Repair)
Installation Requirements/(onditions
Number of trenches 5
Septic Tank Size t z- s a gallons
Exact length of each trench feet
Trench Spacing: 7 Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover. inches
Maximum Trench Depth of: Z-0 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: k. TDH vs.
GPM
G inches below pipe
Aggregate Depth: -r inches above pipe
Conditions:
s :— 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 / onderztand the ryrtem type speri6ed is diKerent !mm the type sperileC on the app/kation. / accept the speclTb onr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revoation if the site pian, 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 pemis. Stt ATTACHED SITE SKETCH
Authorized State Agents Date: c' / r- C, T9
Construction Authorization Expiration Date: o-4 l t o I t o zi
HTE# I �s -q 146 Permit # Z C/jcx-�)
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Mom 2,6 C52 1663
ISSUED TO: S�u0v,4.J4P, jA(>ff2a 6�3 SUBDIVISION LOT # _I
Authorized State Agent: �� /�_�,��-��_� Date: 6 ZU r�
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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
Owner: -4' Iicant S';/%7Yv e
Address: �y11A , / Date Evaluated: CJy/ �On
Proposed Facility:Design Flow (.1949):to:'
Location of Site: /�L 7r"J Property Recorded:
Water Supply: 2-Kublic❑ Individual Well
Evaluation Method: uger Bo ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:/ / 3 '! 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
.1943.1956
Soil
Depth IN.)
Sapro
Class
.1944
Restr
Horiz
i
L Z%
o -ib
GP 6c
)jj
yU
o.
�3b
X sic
G S F s=
79f/C�If ems"
30
0-V
3
L Z;i,
0-d
U 5�
c�-
'%rh
ya
o .4 -
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948):
Available Space (.1945) Evaluated By:
System T e(s) `°' Others Present: �ndlpc� GJlTi`n� ��,
Site LTAR