IPAC RHTE# I s-y/iza2 Harnett County Department of Public Health 29212
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:_ (tei5,erve Or, t. (n_�Is.'n5 2d- 15r7 7473/
ISSUED TO: t.J SUBDIVISION ifr7asv'e— LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: K3ez— 700 x 661 5F --f.>
Proposed Wastewater System Type: z s% rl .Au l•,, s�. .
Projected Daily Flow: 4 pc. GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes o
Pump Required: es ❑ No ❑May beIred based on final location and elevations of facilities
—neType of Water Supply: ❑ Comm ublic ❑ Well Distance from well feet Permit valid for:If�rs
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: /Z �, /a o t —4 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 in compliantt with the pmvisiom of
the taws 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, .1952, .1954, .1955, .1956, .1957, .1956. 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 TO: k>c Sir nrvC 140..cPROPERTY LOCATION: fc o c>A. 5n WI
SUBDIVISION N t �— LOT #
Facility Type: qc-" r cc` s'`y 2-lew ❑ Expansion ❑ Repair
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** Papp fo z5i, n- wc.L:on S sir (Initial) Wastewater Flow: ` 6�0 GPD
(See note below, if applicable ❑)
-Lsj„ fn-'a„c 6 - •, 5 7 s C" --r (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size i ';?s- gallons Exact length of each trench /vo feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Pump Requirements: ft TDM vs.
Conditions:
Maximum Trench Depth of: ay- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 9 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 SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
6 inches below pipe
a inches above pipe
1.7 inches total
**If applicable: l understand the system type spelled vi different from the ype speciled on the application. / accept the Jped1catioac of this 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 subfect to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit At AI IACfltU Silt SAtICM
Authorized State Agent: �' �y� Date:C'�' /'lo a / `"toy5--3
Asv>>nc•. C- Construction Construction Authorization Expiration Date: c*196/aoaa
HTE# t I- S` N I I'L3 2 Permit # Z qd/03
Harnett County Department of Public Health
Site Sketch
PROPERTY LO[ATON: 42e�e-"e- or.4e- iaow.,s (La Sil 1813)
ISSUED TO: 14o.4eTnc . SUBDIVISION LOT # 9
Authorized State Agent: Date: "<`5�Zi- /aol4
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Division ofEnvironmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. !-144- Applicant. &'J :''r j leo �•�s , sn!
Address: G.> f Y/.t rk.o.r-vG Date Evaluated: 0WIT//
Proposed Facility: 332 5:4 Design Flow(. 1949): 71,c PL
Location of Sitc: Tts iti W..e— Property Recorded: )V3
Water Supply: Rfuhlic❑ Individual ❑ Well
Evaluation Method: 01/�Cuger Boring ❑ Pit ❑ Cut
Type of Wastewater: M -Sewage ❑ Industrial Process
JIICV1.
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
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1.1940
SOIL MORPHOLOGY
.1941
ER
jPROFiLEACTORS
L
#
landscape
Position'
Slope %
Horizon
DUpih
(In.)
.1941
Structure'
Texture
.1941
Consistence
Mineraln y
194E
Soil3
Wetnessl
ColorflN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
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Description Initial Repair System Other Factors (.1946):
451 S stem Site Classification 1.1948):
A9Evaluated By:
Site LTAR o ` hers Present: Q��tt
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