IPACHIE # ��-s �+a Harnett County Department of Public Health 29717
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: GaaCa\2\S: Qo
ISSUED TO: I GG V pvc tpFS1(ajy1L� l.L SUBDIVISION LOT #
NEWW REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _ M o0 � t4 x-1']1
Proposed Wastewater System Type: t 'J e -p 1Caa� +E.
Projected Daily Flow: O GPD
Number of bedrooms: �_ Number of Occupants: —max
max
Basement ❑Yes
Pump Required: []Yes
Type of Water Supply:
Permit conditions:
No
'X* No ❑ May be required based on final location and elevations of facilities
❑ Community X Public ❑ Well Distance from well feet Permit valid for.
Five years
❑ No expiration
Authorized State Agent.: `Z ?i5 Date: `S Vt\ ,\ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaramees uanre of other permits. The permit holder is respo ible for cheAing with appropriate governing bodies in meeting their requiremenn This
site is subject to revocation if the sea plan, plat or the intended use changes. Thersnu mens 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 Pemtit�
The construction and installation requirements of Rules .1950, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be initialed in accordance
with the attached system layout
ISSUED TO: `1 p,14r>&1y v t L75 LLG PROPERTY LOCATION: G t a c wain Q0
SUBDIVISION LOT #
Facility Type: 0 Disc> QL41 *'`��� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes � No Basement Fixtures? ❑ Yes 'XNo
Type of Wastewater System** `d.S�1 o S)c 0 u C5 \ o es S yg 60-N (Initial) Wastewater Flow: 4% O GPD
(See note below, if applicable ❑)
S 10
':>y5. (Repair)
Installation Requirements/Conditions
Number of trenches a
Septic Tank Size 1,10(b o gallons
Exact length of each trench S feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: S1 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDM vs.
GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover. C— inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 speriled is d/lerem from the type speciled on the app/icalon. / arcept the sperilcat/ons of this permit
Representative Signature:
Date:
This Construction Authorization is stile enation if the site plans, plat or the intended use changes. The Comtruction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authori:arion .s eci m congsfia r� ovisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: (Zeh5 Date: q
Authorization Expiration Date:
HTE# 11-5-''L
Permit # z`j11-1
Harnett County Department of F' iblic Health
Site Sketch
PROPERTY LOCATON: G ?-,0
ISSUED TO: V a D� v t !_ /�_" SUBDIVISION LOT # 5
Authorized State AgentDate: -A lq� x7
G 1 tGl�2�� Q.P
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:
Proposed Facility: l.� (>�q�r Design Flow (.1949): U1�
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: CAu errB�oring ❑ Pit F-1Cut
Type of Wastewater: �J Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
I
1�5
-0
Others Present:
Site LTAR
- 29
.6?
P M tiSIP,
V1
�
0 -LA
SQ
3_S
O-�K
G 5
Vii N3IrvP
5
Description
Initial
Repair System
Other Factors (.1946):
systm
Site Classification (.1948):
Available Space(. 1945)
Evaluated By:
System Type(s)
A 3' OIL-
-0
Others Present:
Site LTAR
- 29
.6?