IPAC RHTE# I1-5-4)(0512 Harnett County Department of Public Health 29219
Improvement Permit
A building permit cannot be issued with only an 198��o�v��ement Permit
/�� PROPERTY LOCATION: ' Quer Porva. a,.6Chut4I@ �o a 1 S/L 110ea1
ISSUED TO: 1 JAnil"NCarlSEl�(i�� _�nC_. SUBDIVISION �%v�. O:r LO� l
NEW REPAIR ❑ EXPANSION ❑ Site Improvem nts required prior to Construction Authorization Issuance:
Type of Structure: c/ r3 2 19;0, x sol 5 r�
Proposed Wastewater System Type: 'GSk� /Le_<A,,st ✓` S-,5 ,
Projected Daily Flow: Sr 9E:) GPD
Number of bedrooms: Number of Occupants: i3 max
Basement []Yes lil or
Pump Required: ❑Yes
Type of Water Supply:
Permit conditions:
C3'Ro ❑ May buired based on final location and elevations of facilities
❑ Community ublic ❑ Well Distance from well feet
Permit valid for.
91-1ve—y—ears
❑ No expiration
Authorized State Agent•.:4��„13�__!r»i r!�Date: C X/15/ 4?0 la 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 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 .19S0, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shill be installed in accordance
with the attached system layout.
ISSUED T0: W4 DA (�n5�riut--ion lnc— PROPERTY LOCATION: y -FY AV2e" Q�,nd Oc �[Sy.L,l"Ln•>
t SUBDIVISION OL T #,
Facility Type: V64 5o I X 5 t S Tl,,> D—fe-w ❑ Expansion ❑ Repajr
Basement? ❑ Yes Co Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**
ZSi,
(Lerl.S 0 < „
(Initial) Wastewater Flow: YL3c GPD
(See note below, if applicable ❑)�_��,�
XbC1a
c� �Cr%'on 5 a> 6 . (Repair)
Installation Requirements/Conditions
Number of trenches S
Septic Tank Size 1 aW
gallons
Exact length of each trench feet
Trench Spacing: C/ Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: J a inches
Maximum Trench Depth of: 2-4/ 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.
G inches below pipe
d inches above pipe
I of inches total
**If applicable• / nnderstaad the srfvem type iperifled is different from the type speciled on the application. / accept the speciltanims 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 Authomrstion shall not be transferred when there is a change in ownership of the site. This
Construction Authorisation 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: dy�/ s� cs Gi q-
Rrae�2t ,ci.rz t.�, Construction Authorization Expiration Date: >/15Ie7Uo`a
HTE# -S-- LhtoS12 Permit # �%� 1C(
Harnett County Department of Public Health
Site Sketch
s� iy�r
PROPERTY LOIATON:_ti'L/ r{ e, P.,! 1�c� LLh,ly �!v 2d.)
ISSUED T0: L`? nn C3r1S nc . SUBDIVISION Ausj . A # 51
Authorized State Agent: ' ��J��.95 Date: IS/ aoI
/�'L��J 2�i7J1„T-1 U fry
sY
c,y a �c�JR- to
7
xl
pl, . PG s m� s�
50` x So'
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Srp
Avfaz-' PoNb 02
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: LO nn C✓ns Fr. c,'4` �/t Z^'z- -
Address:lAJ� Qonzt (-air ,$ Date Evaluated: �9/tlll �—
Proposed Facility: `'
y '5r -t> Property
Flow (.1949): CSO beg
Location of Site: Property Recorded: Ye5
Water Supply: ,,----.,, /,/ Public❑ Individual ❑ Well
Evaluation Method: huger �MMori�nn ❑ Pit ❑ Cut
Type of Wastewater: �. ewage ❑ Industrial Process
Sheet
Property ID:
Lot #:
File #:
Code:
Property Size: 1 A 4- i c.
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
#
.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 J
.1956
Sapro
Class
.1944
Restr
Horiz
L q%
o g
6L
3
L LI
O. la
sL
wk Wy
10
qcl
G•35
LI
4
OZ 5L_
t8 -3v
/arc SG
F! SP
� PS
30
S
Nx
C'-1�
C'q 5 c
i- mrf
IL -3G
136 5G
6
�5
3�rP
Iactk.
—
? 5 °
sc
vas
Description Initial [Repair SystemOther Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By:
System T e(s) Q c /t.4 L E
Others Present: k1lJ �`3 L"�' n i nc"-6
Site LTAR p 31 u.