IPACHTE# 11-5- y A337P Harnett County Department of Public Health 29232
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 5 5153 Mi 11 e - (i.,A . 6 5 a t -4'O 8
ISSUED T0: (A. Anti nfl j SUBDIVISION LOT #
NEW &
REPAIR ❑ %PANSION ❑
Type of Structure:
5 LJ M Hg 3'x �QI
Proposed Wastewater
System Type: 25 %ab
Projected Daily Flow:
moo: a40 GPD
Number of bedrooms:
d Number of Occupants: max
Site Improvements required prior to Construction Authorization Issuance:
Basement []Yes
Pump Required: []Yes ❑ No ETIray be required baseddoo final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public L�YVlell Distance from well V00 feet
Permit conditions:
Permit valid for:
94"ars-
0 No expiration
Authorized State Agent: o /1 Date: lalo a / a 1 :4- 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 Permit)
The construction and installation requirement of Rules .1950, .1952, .1954, ASS, .1956, .1957, .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: Mac21( PROPERTY LOCATION: STAR /N; Iles- lLd C.Sr% 14pQ$)
,� SUBDIVISION LOT #
Facility Type: S 0 M N 13 t x ad EY- lew ❑ Expansion ❑ Repair
Basement? ❑ Yes E4-1ro � Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 'i 5 % 4 1 u L. dc; QA, 3 V -f 1�� (Initial) Wastewater Flow: 0146 GPD
(See note below, if applicable ❑)
PorA A ko ro16% C[". S '.-V Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 1 0 rX) gallons Exact length of each trench a.30 feet Trench Spacing: _ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6 inches
Maximum Trench Depth of: /e 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 — inches below pipe
Aggregate Depth: — inches above pipe
Conditions: — 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 sXifem type speciled is different from the type spedled on the application. / accept the specilcadonr 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 Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and m the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: G — Date: /0 r— 4014
/kaon a GJq<,ka) Construction Authorization Expiration Date: /o/oG/aaaa
HTE# - S- 4 a'33'/ R- Permit # 3 G a 3 a
Harnett County Department of Public Health
ISSUED TO:
Authorized State Agent:
I
PUMn TO
4
ae0U Lt
(LSA L
A/ -,-mak
Site Sketch
PROPERTYLOEATON: 9'98 M,11er fZA. (S( 1"4-06)
SUBDIVISION LOT #
Date: w/oG/ A o t_ ---
G
_ gmwx moo` —
Cu -r %eTrL
A n. to
TO ao L4a 1? -o$>
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: N14,41— QGt.-.fel
Address: Saa Milltr 0 -Is Date Evaluated: 16///)/—
Proposed Facility: �� $w.. it Design Flow (.1949): `% 6(xp
Location of Site: Property Recorded: li-
Water Supply: ❑PuNICE] Individual ell
Evaluation Method: AugerBon ❑ Pit El cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:' q .:N4fi
❑ 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
.1956
Sapm
Class
.1944
Restr
Horiz
t
L 376
o -Y
(,G L5
VIA 4,:% P
g - X
fyfr� sa-
Q-
-6(,+
Njt.�
04"- '
--
L 9
(d
Vk a51w°f�
14 a�
��
rnCyse 5
Pg
-W
3
L ?%
b-luo
(Pt Lb
✓9 ti)a( f
L4
c-26
�0_a
'A K 21,
loc or S,5�
es
Description Initial Repair System Other Factors (.1946): 1
System Site Classification (.1948): t>^OS Ui %l.tG�('fOVt �'L�•.tlj $vr �-�jlo
Available S ace (.1945) Evaluated By:
S stem T e(s) y5 Others Present:
Site LTAR