IPACNTE# (1-5-4aI Harnett County Department of Public Health 29217
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 611ue- {Srm[r.h (LST, i 5 r, Ig3o)
ISSUED TO: (-)a MP / SUBDIVISION LOT #
NEW 13� REPAIR ❑ EXPANSION ❑
Type of Structure: [/,.; g__ 11w x 69 t S r=cam
Proposed Wastewater System Type: -z_6% ng=J r 1: e,,, 5;;,< .
Projected Daily Flow: Yec> GPD
Number of bedrooms: Number of Occupants: a max
Basement ❑Yes o
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: Dffi— ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 174� 1ubfic ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
E -Wyears
❑ No expiration
Authorized State Agent: Date: 0%�111IaOI+- 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 thecking 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 Permjt)
The construction and installation requirements of Rules .1950, .1957, .1954, .1955, Ass, .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 TO: M l )ten 8,,,;1-il /Joey 1 -cc, PROPERTY LOCATION: d/: ue 8r. ,c 6. GLA, i S2 l'E3n)
SUBDIVISION LOT #
Facility Type: y32 IYP'X,Sg7 ' s � C�New ❑ Expansion ❑ Repair
Basement? ❑ Yes 23 o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System"* Pvca,fo 4,a 2162. v L n _mow. (Initial) Wastewater Flow GPD
(See note below, if applicable F-1)
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 3 So gallons Exact length of each trench goo feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6-10 inches
Maximum Trench Depth of: I'6-a3l 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: (t. TDM vs. GPM
Aggregate Depth:
Conditions:
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
Q inches above pipe
t Q inches total
"If applicable: / understand the system type spec/fied is diKerent from the type spec/led on the app/ication. / accept the specifications of this permit.
Owner/legal Representative Signature: Date:
This Construction Authonzation is subject m 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 Agent: Date: 07111 120 1 T
/Jq-3 J CiJ(LfG-t av Construction Authorization Expiration Date: vY
HTE# ela IL a Permit # V3 a 1 q -
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 0I'tve, &r ,nck A—A, C52 /d3o�
ISSUED TO: (yj(It nn 60:1-� I-Ic)w�& ,It SUBDIVISION LOT #
Authorized State Agent: Date: !Q //��01'}
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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: _� Applicant: P5Jkn 4 -;It y,.a3,
Address: ob'vl 6-^ 2d - Date Evaluated:
Proposed Facility:y32 Si- Design Flow (.1949): Y gfv
Location of Site: Property Recorded: V�
Water Supply: [ uublic❑ Individual ❑ Well
Evaluation Method:[l-;Gger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑-Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: 3 . yy ,jr
❑ Spring ❑ Other
❑ Mixed
P
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.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Minenilogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN
.1956
Sapro
Class
.1944
Restr
Horiz
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space 1.1945) Evaluated By: ! ..� ✓irw� /L��f
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System T e(s) t5 i recd 4 5;1' Others Present: a' Rine-
Site LTAR p. o,