IPAC RHTE#/d---Z37q!i/Z Harnett County Department of Public Health
Imurovement Permit 2 6 4 0 4
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 111
ISSUED T0: f') S rg' Skuj,~ SUBDIVISION T/f/ d C y~zs o U/lO LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: s5i '
Proposed Wastewater System Type: ZS%fG'4rAtfZ.tZ(/3~ s_
Projected Daily Flow: (000 GPD
Number of bedr ms: S' Number of Occupants: ✓O max
Basement Yes ❑ No
Pump Required: ❑Yes ❑ No M be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Age 0""W'> Date: /Z'Z1a w SEE ATTACHED SITE SKETCH
The issuance of this permit a 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 to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .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 TO: &6*f S PROPERTY LOCATION:
SUBDIVISION /U ZZ L #
Facility Type: New ❑ Expansion ❑ Repair
Basement? Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** /{/~AiJ.t iL L 7 ZS'% (Initial) Wastewater Flow: O tJ GPD
(See note below, if applicable
M,404 yo~P Zl"% I U~ (Repair)
Installation Requirements/Conditions Number of trenches Z-
Septic Tank Size Zoe gallons Exact length of each trench Z 50 feet
Pump Tank Size 14-0 Q gallons Trenches shall be installed on contour at a
cif Maximum Trench Depth of: /9" inches
2 -X - -IL gV vAklrS (Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Z inches above pipe
✓ Z inches total
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.
**If applicable: l understand the system type specified is different from the type specified on the application. l accept the speciflwions 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 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 Age . f Date: f Z - 29 -16
Construction Authorization Expiration Date: Z 7-
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Harnett County ]Department of INiblic Health
Site Sketch
PROPERTY LOCATON:.s/r- / 12/~
ISSUED T0: ~lLlf~n) S ,f i'r~i•>~ SUBDIVISION / OT #
Authorized State Ag ~ ~ Date: /z -z 4
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Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
Cam:
SOIIJSI TE.EVALUATION File
for ON-SITE WASTEWATER SYSTEM:
Owner Applicant:
Address: Date Evaluated: I Z -7Z-'/`?-Z F -le)
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property l(mrded:
Watet Supply; psel C I ndividual ❑ Well ❑ Spring ❑ Other
Evaluation Method: ger Boring ❑ Pit Cut
Type of Wastewater. age ❑ Industrial Process Mixed
a
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
'T'HER
PROFQ$ FACTOAs
L
9
Lowsm"
Posidow
Slope %
Horizon
Depth
(IM)
.1941
strugmw
Terdice
.1941
Consistence
Mineralogy
.1944
soil .1,043 .1916 .1941
Wetn"d soil 32pre Restr
Color Dko-g IN. Clap Hons.
Proms
CAN
ALTAR
I
A
o -b
71
fri
A-4
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31
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Site ClsssiEcation t(. 1948~
etf B ,
Evtthaed By, Othas Prexat.