IPACHTE# -q3 (ebb Harnett County Department of Public Health 29760
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Kia n 7 ([ C 52 /•!6
ISSUED TO: AA;,-at/.t0M SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 532 55'YG2a 6r-->
Proposed Wastewater System Type:
Projected Daily Flow: _(a c r�> GPD
Number of bedrooms: Number of Occupants: 10 max
Basement ❑Yes�-
Pump Required: Dyes El No [9'May be�'�ed based on final location and elevations of facilities
Type of Water Supply: ❑ Community C301ublic ❑ Well Distance from well feet Permit valid for. Bean
Permit conditions: ❑ No expiration
Authorized State Agent:G�� �i�t� �� � Date: F I I (5 / ;Wot-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 tor 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 requirements of Rules .1950, .1957, .1954, .1955, ASK .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 Iayauc
ISSUED T0: PROPERTY LOCATION: k, %:n 2 .A srL r 3
SUBDIVISION LOT #
Facility Type: 5a2 55 XG9 A 5, 9 [}—Ie�w ❑ Expansion ❑ Repair
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 'A 5 w /te4&' k, 1 5 ;. --Jr (Initial) Wastewater Flow: 66c> GPD
(See note below, if applicable ❑)
25%v i%.�+>yb=czn 5s� (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size t'a5o gallons Exact length of each trench 125 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: W inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: R. TDH vs. GPM
Conditions:
Trench Spacing: 5�' Feet on Center
Soil Cover. /a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
wA inches below pipe
Aggregate Depth: 4 inches above pipe
r"A 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 is different hom the type specified on the app/icadon. / accept the specifIcationr 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. Ibis
Construction Authorization is subject to compliance with the previsions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �' �i�� Date: II It -201-1
c—�2ri, tJ Construction Authorization Expiration Date: it ) 151 -dc;'aa
HTE# -44 "� 6� Permit # a /I 6C)
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: 4:1PI rz ood C s rt tyU3�
ISSUED TO: Sof; (oeaeral Cwo roc6r� SUBDIVISION LOT #
Authorized State Agent: Date: till t6 si0t�
0
L- " 5
ST
—Lep -s'
K t'(J L I rJ Co L 5 2 14C33j
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
M11crw'.1 � A �✓1a/
Owner: Mojja Applicant: �"� «fMfG{•cr�
Address: I�t /lel , CyL / ate Evaluated: I I I I I
Proposed Facilitty:j;2 c� esign Flow (.1949):
Location of Site: Property Recorded: j �'
Water Supply:ublic❑ Individual ElWell
Evaluation Method: uger Borin ❑ Pit ❑ Cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:' , (e G A C
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horimn
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
Rau
Horiz
L
a�
1 s
" f/ A
fps
GW-
10 s�
3
L S`
0..29,
&C L
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ct Ls
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Te(s) a6' Others Present: apc�e,'
Site LTAR