IPACHTE# Harnett County Department of Public Health 29415
Improvement Permit
A building permit cannot be issued with only an Impptoy emen,[,Permit
PROPERTY LOCATION: Q.D
ISSUED TO: Ye I- LY(Y N SUBDIVISION LOT #
NEW>q REPAIR ❑ -EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S'@ O (,606.r/��
Proposed Wastewater System Type: `QL o t'V>OVRI off YJ .
Projected Daily Flow: UF'10 GPD
Number of bedrooms: I'T Number of Occupants: max
Basement ❑Yes �;No
Pump Required: Dyes o May be required based an final location and elevations of facilities
Type of Water Supply: ❑ Community KPublic ❑ Well Distance from well feet
Permit conditions:
Permit valid for: Five years
❑ No expiration
Authorized State Agent:: rCb s'>7 Date:1� 2[ 117 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ins o1 cover permits The perms haMa n rtsp rw for checking with appropmn gmerning bodies in meeting their requirements. This
site is subject to remwtion if the site plan. plat or the intended use changes. The Improviremaut Permit shall not be affected by a change in ownership of the site. This Transit is subject to compliant, with the provisions of
the laws and Rules far Sewage Treatment and Disposal and to conddom of this permit..
Construction Authorization
(Required for Building Permit)
The mnnrvction and imtallabon requirements of Rules 1950..1952..19S4..1 its, .19S6..19S7. A9SR. and .1959 are incorporated by references nm this permit and ship be rami. Systems shah be installed in accardane
with the attached system layout.
ISSUED TO: PP.Q' yoC4 PROPERTY LOCATION: SabS Q-'Q.NV ,,j P,0
SUBDIVISION — LOT #
Facility Type: SF9 �60r"5 0 / New ❑ Expansion ❑ Repair
Basement! ❑ Yes 13K No Basement Fixtures! ❑ Yes bkNo
Type of Wastewater System" aS to a IR—ED vyA Ny si Sy 5 . EM (Initial) Wastewater Flow: Lill0 GPD
(See note below, if applicable ❑)
PCr cwvp 10 l0 '40 SY5, (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size 100 0 gallons Exact length of each trench -S !E;-0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over. (9-StB inches
Maximum Trench Depth of: TY+'=d 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
Aggregate Depth: inches above pipe
(onditions: 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.
`9f applicable: / undeatand the r)rtem qpe sperihed it different from the type rperihed on the application. l acrept the rpetihtationr of thir permit.
Owner/Legal Representative Signature: Date:
This Commusu an 'action is subject to revocation if the site plan, plat or the intended use changes. The Construction Authorization shah not be transferred when there is a change in ownership of the site. this
construction Authorizationwith misiom of the taws and Rules fm Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: vz—'15 Date: D -: !�
nAlruction Authorization Expiration Date: a Lzx"d.�—
HTE# I � -S t -;167-3L-) Permit # a(�'-+�S
Harnett comity Department of Public Health
Site sketch
Q PROPERTY LOCATON: N2J65
ISSUED TO: ` P SUBDIVISION LOT #
Authorized State Agent: QT'S
1) 11M, vl-iaDIt Date: 213�1�
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:Design Flow(. 1949):'-;87;.
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation MethodiR Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: II Sewage ❑ Industrial Process
Sheet
Property ID:
Lot #:
File #:
Code:
Property Sim:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
4
.1940
landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILEFACTORS
Profile
Class
<AR
.1941
Slnlcture/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
wetness,
Color
.1943
Soil
De th(IN.)
.1956
Sapro
Class
.1944
Rear
Horiz
Site LTAR
�t
3S
3
O_
s�
J -
Description
Initial Repair System
Other Factors (.1946):
System
Site Classification(. 1948).�7.
Available Space(. 1945)
i
Evaluated By:.
System Types)
.r `, �..w
Others Present:
Site LTAR
=