IPACHTE # 1-5L►I U3 Harnett County Department of Public Health 2971
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
\\// `\ PROPERTY LOCATION: D OGs ?-1i)ISSUED T0: M c1�� Rome.j LL_G SUBDIVISION Q AKt+�o�i LOT # 9 !o
NEW REPAIR ❑ E) ISION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S� ILytt "6a-�
Proposed Wastewater System Type: 7 5°/e AGOJC,BN X95,
Projected Daily Flow: ti4 0 GPD
Number of bedrooms: L-)— Number of Occupants: `� max
Basement Dyes No
Pump Required: ❑Yes 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. >KFive years
Permit conditions: ❑ No expiration
Authorized State Agent: �mZ1-)
The issuance of this permit by the Health Department in no way guarantees ce
site is subject m revocation it the site plan, plat, or the intended use changes. !Mhe
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date:
SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsibl{ for checking with appropriate governing bodies in meeting their requirements. This
hment Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provision of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .19S2, .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.
ISSUED T0: V)C� 1�sc' 1 -LC- PROPERTY LOCATION: Do rs Ro
SUBDIVISION 0hvtS SON a LOT # `t L
Facility Type:S�=cJC4L' ,�7 a New ❑ Expansion ❑ Repair
Basement? ❑ Yes ', No Basement Fixtures? ❑ Yes 'l(No
Type of Wastewater System** 4"Sya R6pu Cr3 t O ,J S irS�E x� (Initial) Wastewater Flow: H' b GPD
(See note below, if applicable ❑) h
a.So/a G;, q Sym (Repair)
Installation Requirements/Conditions Number of trenches L
Septic Tank Size \ 0 ® et gallons Exact length of each trench -)S- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Y4!� inches
(Trench bottoms shall be level to +/•1/4"
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
Trench Spacing: C1 Feet on Center
Soil Cover: G 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 SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type speciled is different from the type speciled oo the app/icadon. / accept the cpecificationr of this permit
Owner/legal Representati ature: Date:
This Construction Authorization is subject to revou a 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 AuthorizationtYbject to compli z h the p of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: v Date: =
Co truction Authorization E%Djratlon Date:
NTE# N-1-5-4ti %b% Permit # a-, I I
ISSUED TO: "
Authorized State Agent:
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:
VID
431 O L1L SUBDIVISION a)c .g .S 1 LOT #
��$ o�t�f2iouva Date: `Y11i1± 1
t5tt
1-4 --,ad ho L),56
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:1��
Proposed Facility: Design Flow (.1949): 4: rJ
Location of Site: Property Recorded:
Water Supply: YvPubliC❑ El Well
Evaluation Method Augleer BBo ing ❑ Pit ❑ Cut
Type of Wastewater: [5K6ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
L
E
4
.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
Soil
Depth (IN
.1956
Sapro
Class
.1944
Restr
Horiz
r. S L
QFTL,,01vQ
Y3-35
331Ac I;
L)
Description Initial Repair System Other Factors (.1946):
Systgfn Z Site Classification (.1948): P I
Available Space (.1945) V Evaluated By:p<
System Type(s) / Others Present:
Site LTAR -