IPACHTE# Harnett County Department of Public Health 29758
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 1 1_e not c S w : FJ fl .a . ( 5& 1 4 a� )
ISSUED T0: T� Fc��A /A 5 S'-- LCi SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: 301 x t bo t G F t; c n_
Proposed Wastewater System Type:C i fir.. acct \ 5 :7 c
Projected Daily Flow: 'A0o GPDe. n c
Number of bedrooms: — ti Number of Occupants:Qjo r max
Basement ❑Yei ET No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: Dyes ❑ No ay bee quired based on final location and elevations of facilities
Type of Water Supply: ❑ Community fYPublic ❑ Well Distance from well feet
Permit conditions:.
Permit valid for.
94ire—ye—ars
❑ No expiration
Authorized State Agent:: � �� �� Date: 11) 1 /., � �o 14 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 cha g wish appmpnate 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, .1952, .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
eA
ISSUED TO: 1
Facility Type: 30'X Ivor 0 12 -New
Basement? ElYes Ek -Co Basement Fixtures? ❑ Yes
PROPERTY LOCATION: 1-5 Le7n:e Sv;�1 2�.C5tZ tyaR,
SUBDIVISION LOT #
❑ Expansion
❑ No
❑ Repair (-54h9(J9vJ,4--6 M4X
Type of Wastewater System" c' n\I 61(-c,.wA SV s (Initial) Wastewater Flow:
(See note below, if applicable ❑)
;)ac7 GPD
C-G(Ny .
C, t'u\uc.\ S,;p s
(Repair)
Installation Requirements/Conditions
Number of trenches .5
/
Septic Tank Size gallons
Exact length of each trench
feet
Trench Spacing: Feet on (enter
Pump Tank Size gallons
Trenches shall be installed on
contour at a
Soil Cover. inches
Maximum Trench Depth of:
G4 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. TDH vs.
GPM
inches below pipe
Aggregate Depth: inches above pipe
Conditions:
v of inches total
WATER LINES (IN(LUDING 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: / understand the system type specified is different from the type spedfied on the app/kation. / accept the cpedfcatioar of this permit
Owner/Legal Representative Signature: Date:
This Construction Authoritarian 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 At AI IAL11tU lilt MtIIM
Authorized State Agent: ._fir57 Date: t I I I L /;?otq
Construction Authorization Expiration Date: F I I 16 2nd
HTE# (i - S —L4 a L 3 _q Permit # a `t f"S 8
Harnett County Department of Public Health
Site Sketch
a PROPERTY LO(ATON: '76% Lonnrr_ sm: t(n 2.\ ( 52 ry ag�
ISSUED T0: T �`�S LCA SUBDIVISION LOT #
Authorized State Agent: -�_ �/� Date: I L i 11(o /901-4
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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: -04 r�'5 LCL
Address: Lemie z t Date Evaluated:
Proposed Facility: Die Design Flow (.1949): 6
Location of Site:operty Recorded: , j
Water Supply: tic❑ Individual Well
Evaluation Method:uger Bo ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: � 5 ,_5 a
❑ 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 J
.1956
Sapro
Class
.1944
Restr
Horiz
L w,o
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<
V�
y
)q. tic
Q� SL
s / iy
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L
1a-38
g1C 5r,
F/ 5/rte
.fig
o.3
50.1
lr9o�i.
If>"-�G'
o.lon {rcn5;
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) 1 Evaluated By:
System Type(s) Others Present
Site LTAR