IPAC RHTE# 11 -5' ►�w1L Harnett County Department of Public Health 29723
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: O. o V 5 4a.�
ISSUED TO: s z C. c.a oc. utLE N o mtr g Uv i.ap" SUBDIVISION LOT #
NEW" REPAIR 4 NSION ❑
Type of Structure: SAO IGC) � COT
Proposed Wastewater System Type: aS ib TLE9 V CK \ O av SSA ar 6M
Projected Daily flow: RA'tO GPD
Number of bedrooms: Number of Occupants: <L max
Basement []Yes >qNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community "5K Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent:: `s�J Date: LO� 3 I f 7 SEE ATTACHED SITE SKETCH
issoan
The issuance of this permit by the Health Department in no way guarantees the c ermin. 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 76hiii4liall 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 .1958, .1951, .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: S s 6cspr ucc.E tloco.E Rsu %Lo FrLs PROPERTY LOCATION: 01-0 V 54-a.l
SUBDIVISION LOT #
Facility Type: SFp U -0-x 60n� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes N No Basement Fixtures? ❑Yes I'>40
Type of Wastewater System** W), 'P,�jou vsy o a.l S-,'576" (Initial) Wastewater Flow: 410 GPD
(See note below, if applicable ❑)
ois'�e V-k<:AuL.,t7,t Zy) (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size 1 0 In d gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench at1 O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of.. 1$_-317 inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. 6- SQ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
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.
**If applicable: / understand the system type specified a different from the type specified on the app/icatioa / acrept the rpedlcationr of this ogmot.
Owner/Legal Representative Signature: Date:
This Construcdon Authorization is sub le bon A the site plan, plat or the intended use changes. The commission Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to complialRe.gith t viilbnLaf the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Constr '* Authorization Expiration Date:
HTE# LQ�Lil Permit # a x1123
Harnett Counter vehailment of Mihlic Health
Site Sketch
PROPERTY LO(ATON: 01-0 051Ji-)'
ISSUED TO: Si rt£ iia ^ E 9D o uae(rLS SUBDIVISION LOT # W 4
Authorized State Agent: L�162 oz_YsoV Date: 161 3I l)
117 ,
1 QtLPai�.\
-� ❑ ams
705FlL
"u SE
(r 6A f. 4)
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: Lv,-j f l J� Design Flow (.1949): L4 39�t"s
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method; Auer Boring ❑ Pit El 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
4
.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
.1943.1956
Soil
Depth (IN.I
Sapro
Class
.1944
Restr
Horiz
i
v a
o-40
S CS
vV71 151vp
�JO-K
C 5L
\)P'?- +
s 6
a
o -3t5
G St_
Viet vs)
;} 'N",6
�Sx SGL
F) SS:5/113R17
^aQ
SS,
Description Initial Repair System Other Factors (1946):
System'- Site Classification (1948):
Available Space (.1945) Evaluated By: G�
System Type(s) B- 5 /r Q. Others Present:
Site LTAR • S