IPAC RHTE# I 91 Harnett County Department of Public Health 2 9 2 1 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: c�I@f Sln0riE( SUIIAWM -7,)i S2 ISS
ISSUED TO: �i MiC�goll� �S(GSctir1� SUBDIVISION LOT#
NEW V OPAIR ❑ EXPANSION ❑
Type of Structure: 302 G6'X-491 4s
Proposed Wastewater System Type: �—
Projected Daily Flow: 3c.o GPD
Number of bedrooms: 3 Number of Occupants: Yo max
Basement []Yes
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: Dyes ❑ No P'rlay be re uired based on final location and elevations of facilities
Type of Water Supply: ❑ Community lc ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
years
❑ No expiration
Authorized State Agent: 4���-✓�✓>>r�/%�asfS Date: e�II a /aCt=t 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 revoatton 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 she 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, .1953, .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: Sere.�� rA',c,LsrsLP_ Plcr,rc_^-L PROPERTY LOCATION: (9181 66dWr'jnt`nscn QA,,ns I I
SUBDIVISION LOT #
Facility Type: 30"L 66'X431 0c l w ❑ Expansion ❑ Repair
Basement? ❑ Yes C,7LMr— Basement Fixtures? ❑ Yes C� Nth
Type of Wastewater System** 51c d6= .,,m. (Initial) Wastewater Flow: 3Lc� GPD
(See note below, if applicable ❑)
(Repair)
Installation
Installation Reguirements/Conditions Number of trenches 3
Septic Tank Size soc>o gallons Exact length of each trench 90 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of: i9 o 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 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.
6 inches below pipe
of inches above pipe
A inches total
**If applicable: / understand the system type specifsd it different from the type specified on the app/icadon. / accept the spedficationr of this permit
Owner/Legal Representative Signature: Date:
This constructions Authorization is subject to revoation 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
Constructions 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: 6 li 1 a 1.3 of ---1
A"'s>n ' "" " "`� Construction Authorization Expiration Date: 0�ih 9 1 a6da
HTE# l j- 5- q Q 16 4 Permit # a cli l%
Harnett County Department of Public Health
Site Sketch
PROPERTY LOEATON: a l81 Slhu'iGZd i5(L l5b)
ISSUED TO:7� X AI (-m SUBDIVISION LOT #
Authorized State Agent:, ia-�7 Date: o cl h a / as t'4
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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: �CfG+J p, 1M iG•{�e{�
Address: 'LI bI 5 kr;li'7"e� . .LA -Date Evaluated:
Proposed Facility: f.. 3a2 S�T> Design Flow (.1949): 390 & b
Location of Site: Property Recorded: 9'e j
Water Supply: [9-P'u`nic❑ Individual ❑ Well
Evaluation Method:❑-7ru-9er Boring ❑ Pit ❑ Cut
Type of Wastewater: 2-gewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: -7.3,9 A
T
v
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
4
.1940
Landscape
Position/
Slope%
Horizon
Depth
(in J
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
<AR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN
.1956
Sapro
Class
.1944
Restr
Horiz
tvl'
- L5
OP5
3b+
I
G-35
to
Z+
G
3%
o•I�
6l( 4-3
✓ f
Ole 3
34+
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): t,},q yam,'-/uldt�P�a ✓%S, `ra«� S.�t •d-z,/s !�
Available Space (.1945) Evaluated By-
System
y:S tem Type(s) 4LA5 v /Lt. Others Present:
Site LTAR .y 1S I(>-