IPACHTE# i7�5'UlaS3� Harnett County Department of Public Health 29741
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
p�� PROPERTY LOCATION: Pow 6a L PF."" Q—.ISSUED T0: oCa w.aON PO w 6L� SUBDIVISION LOT #
NEWX REPAIR ❑PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: :6 TO 1w(Ax—'t 1
Proposed Wastewater System Type: a.S oyCCW,d YS'8ea
Projected Daily Flow: a,60 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement []Yes �yNN
Pump Required: ❑Yes -�`f]� No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t 00 feet
Permit conditions:
Authorized State Agent:
The issuance of this permit by the Health Department in no way guarantees t e
site is subject to revocation if the site plan, plat or the intended use changes. The Impr
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date:
Permit valid for.
Five years
❑ No expiration
SEE ATTACHED SITE SKETCH
of other permits. The permit holder is resp6nsible for checking with appropriate governing bodies in meeting their requirements. This
nement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1958, .1952, .1954, .19SS, .1956, .1957, .1958. and .1959 are incorporated by references into thin permit and shall be met. Systems shall be installed in accordance
with the attached system layout
ISSUED TO: �ct�ws.ca,z Qc�+ U PROPERTY LOCATION: �OwEz1— �A4jj n
SUBDIVISION LOT #
Facility Type: SC0 �idC 1� New ❑ Expansion ❑ Repair
Basement? ❑ Yes ';15� No Basement Fixtures? ❑ Yes �No
Type of Wastewater System" �kE.OU CA a0 Gr<. (Initial) Wastewater Flow: 3roQ) GPD
(See note below, if applicable ❑) {� _
VLSRLPS,.�gs_a17w.r Win `QED �S7s_ (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size LCOO gallons Exact length of each trench t'6 feet Trench Spacing: Feet on (enter
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. re inches
Maximum Trench Depth of: S1% inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1.114" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDR 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.
inches below pipe
inches above pipe
inches total
**If applicable: / anderi and the syrtem type specled is diherent from the type spetiled on the apphinatim. / accept the specilcations of this permit.
Representative Signature:
Date:
This Construction Ruthorizade ub ea to reeoation if the site plan, plat or the intended use changes. The Constmction Authorization shall not be transferred when there is a change in ownership of the site. This
construction Authorization is subject to comps _ if Ovvisiom of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this pewit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 10
o rl(tction Authorization Expiration Date:
HTE# iiaC-3 `1 Permit # QV] Ll 1
Harnett County Depailinent of Public Health
Site Sketch
PROPERTY LOCATON: TOY.fLt—�►✓�+r QJS
ISSUED TO: v ortL-Ll SUBDIVISION LOT #
Authorized State Agent: �i 6 \o�iv�Tat_xsaof p Date: 10 I3 SI 1 7
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: l `f 1
Address: Date Evaluated: Id
Proposed Facility -3 QM% Design Flow (.1949): 34bC!Z
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Auger Boring El pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
.1940
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapm
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948).'P-�
v 945) Evaluated By: C'YA
stem T e(s '-- S o CLC, Others Present:
Site LTAR , t -t