IPAC RRHTE# C~-G1Dcn2 \R,R arl'ett County Department of Public dealth 25035
Improvement Permit
MME CA,,SC . A building permit cannot be issued with only an Improvement Permit
Ar'ti~T PROPERTY LOCATION: C E-&Y-ytu.E, (11AkJ fN-\ V-D
ISSUED TO: SUBDIVISION J~~z vN C3~F.s LOT # 1S
NEW REPAIR ❑ E ANSION E1 o Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: L ^x 5 I< 1-43
Proposed Wastewater System Ty e: as"G yes; to w
Projected Daily Flow: LAId GPD
Number of bedrooms: "9~4 4 Number of Occupants. max
Basement ❑Yes '1~ No
Pump Required: ❑Yes ❑ No ",May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well lp® feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: Sd 7 d SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ' i nce 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.
P Q1M1L-y ~0~ 4, CO H
ISSUED T0: PROPERTY LOCATION: CcEc~v»e Cwvczc~a R~
SUBDIVISION JQ•~I tly O¢. LOT # 15
Facility Type: I New ❑ Expansion ❑ Repair
Basement? ❑ Yes "5< No Basement Fixtures? ❑ Yes No
Type of Wastewater System** ~s°1avc~ ~c~>J Sys CM (Initial) Wastewater Flow: 3~6 GIRD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size ~a®O gallons Exact length of each trench y®Qfeet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: M®~r S~,E- V;-2 V,r_1 t>\L
Trench Spacing: Feet on Center
Soil Cover: C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: I understand the system type specified is different from the type specified on the app/ication. / accept the specircations of this permit.
Owner/Legal Representative Signatur : Date:
This Construction Authorization ' subject to revocati i p la( 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 s to fiance with the visa th ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Q&VVt~ GOIJ ti ~-6 ~ ri
'Wb Date: t
k ion Authorization Expiration Date:
HTE# Ord Permit # as43~
Harnett County Department of 1' iblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON:
SUBDIVISION SP,-i L-) 0 9 LOT # 15
1,~~°CoLKSfloC _ Date: tc'~I I b`~
p
G
\ 4---11
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a3~~ ~ PASLj, 1
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Uepolll i IUI IL UI CI IV IIUI[IIIGIIt~ I Icol~ IIU ~.uw~u.
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Property ID:
Lot
File
Code:
Applicant:
Address:
1-
`
\
`
Proposed Facility:
3 O
1
E017iz f"N 00
Design Flow (.1949):
~d<~) cJ~
Location of Site:
Water Supply:
~KPublic
[ ] Individual Well
Evaluation Method:
Auger Boring
[ ] Pit
Type of Wastewater:
`(~kSewage
[ J Industrial Process
Date Evaluated: t6l U?
Property Size:
Property Recorded:
[ ) Spring [ j Other
[ J Cut
[ J Mixed
P
R
a
F
SOIL MORPHOLOGY
1941
OTHER
PROFILE FACTORS
1
L
E
#
1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
A941 '
Consistence
Mineralogy
.1942
Soil
Wetness/'
Color
•,.1943
Soil
Depth (IN.)
.1956
Sapra
Class
.1944
Restr
Honz
Profile
Class ;
& 4TAR
S c,
"3 - -P,
I
'57:0,.l`
:5
iu~JQ
~~,1
S~r_..
~t~r"(Z der )e.r~
S
Description
Initial System
P>epair System
Available Space (.1945)
System Type(s)
2
R~
Site LTAR
i3
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: C3%
Others Present:
1X 3 Wf Q. 13,-~JL
011 s. ~G- >rorv Ai ova 5~ oc,;
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