IPACHTE# 11 -5 -Hak m3 Harnett County Department of Public Health 29720
Authorized State Agent: Date: `1 , aS 117 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss f her permits. The permit holder is respo sible 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 Improve "Int Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the taws 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, .1957, .1958. and .1959 are incorporated by references inro this permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: M1"TC)" i>Qv1: PROPERTY LOCATION: G� S;gwq L
SUBDIVISION STLOT # :)L,
Facility Type: `'�D 1 "6� New ❑ Expansion ❑ Repair
Basement? ❑ Yes ';Fi: No Basement lxtures? ❑Yes ❑ No
Type of Wastewater System** ��� e�x2C,N DN S7er6M (Initial) Wastewater flow: 3� GPD
(See note below, if applicable ❑)
as;—/o Raj. SYS. (Repair)
Installation Requirements/Conditions Number of trenches 'c).
Septic Tank Size 1000 gallons Exact length of each trench 1D O feet
Pump Tank Size gallons Trenches shall be installed on contour at a .1
Maximum Trench Depth of: 3� inches
(Trench bottoms shall be level to +/•1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: feet on Center
Soil Cover, 1a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
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.
**If applicable: / onderrtand the system type rpeciled it different from the type spelled on the app/kation / accept the rped(rrtionr of this permit
Owner/Legal Represen Si nature: Date:
This Construction Authoritarian is subject to re ' n 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 ahj�t m complianit.h the of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: a���� X15 Date: "t
Authorization Expiration Date:
Improvement Permit
A building permit cannot be issued with only an Improy�ment Permit
'B—,
ISSUED T0: MIL—Mort
op PROPERTY LOCATION: C t' E raPRyc
& a s_S iaso t�65 Laic- SUBDIVISION Z70*41E,r g2yA,ii
LOT # Q,
NEWW
REPAIR ❑EXPANSION
❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
SV0
(l'a°6IJ
3
Proposed Wastewater
System Type:
a.S° a Vfouoc, 1i TEwr1
Projected Daily Flow:
0
GPD
Number of bedrooms:
3
Number of Occupants: C. max
Basement ❑Yes
><No
Pump Required: []Yes
—IQNobe
Ma required based on final location and elevations of facilities
Type of Water Supply:
❑ Community Public ❑ Well Distance from well feet Permit valid for.
Five years
Permit conditions:
❑ No expiration
Authorized State Agent: Date: `1 , aS 117 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss f her permits. The permit holder is respo sible 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 Improve "Int Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the taws 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, .1957, .1958. and .1959 are incorporated by references inro this permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: M1"TC)" i>Qv1: PROPERTY LOCATION: G� S;gwq L
SUBDIVISION STLOT # :)L,
Facility Type: `'�D 1 "6� New ❑ Expansion ❑ Repair
Basement? ❑ Yes ';Fi: No Basement lxtures? ❑Yes ❑ No
Type of Wastewater System** ��� e�x2C,N DN S7er6M (Initial) Wastewater flow: 3� GPD
(See note below, if applicable ❑)
as;—/o Raj. SYS. (Repair)
Installation Requirements/Conditions Number of trenches 'c).
Septic Tank Size 1000 gallons Exact length of each trench 1D O feet
Pump Tank Size gallons Trenches shall be installed on contour at a .1
Maximum Trench Depth of: 3� inches
(Trench bottoms shall be level to +/•1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: feet on Center
Soil Cover, 1a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
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.
**If applicable: / onderrtand the system type rpeciled it different from the type spelled on the app/kation / accept the rped(rrtionr of this permit
Owner/Legal Represen Si nature: Date:
This Construction Authoritarian is subject to re ' n 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 ahj�t m complianit.h the of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: a���� X15 Date: "t
Authorization Expiration Date:
HTE# a cl —7 a+(7 Permit # 11- 5-ti�jb3
Harnett County Department of Public Health
Site Sketch
pQ PROPERTY LOCATON: C'Sr-,? Ewe DU
ISSUED TO: M ON l>Ulti �Ot—ES IH(- SUBDIVISION &Tpx�y LOT #
Authorized State Agent: '�ix�alF Date:
� 7
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SSC, A2�W
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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:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual F] Well
Evaluation Method. Auger Bo 'ng ❑ Pit ❑ Cut
Type of Wastewater: 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.)
.1956
Sapro
Class
.1944
Restr
Horiz
16-L�1
S3K S
55JaS
ra: 443
f
Description Initial Repa'r System Other Factors(. 1946):
S ste Site Classification (1948)x{3
Available Space .1945) WEvaluated By:Q
System Type(s) ;' / 9V Others Present:
Site LTAR •45