IPACNTE# 17"5-qk/y Harnett County Department of Public Health 29772
Imorovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: `;15L 3 OJaaHC Ccc, vf 2..1 t�C 1.&4
ISSUED TO:T W ro lgSi EXPANSION ❑ SUBDIVISION LOT #
NEW R AIR ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3n s X b7v t n curs\ H a,�.
Proposed Wastewater System Type: C'r r, t/
Projected Daily Flow: In GPD
Number of bedrooms: tiA� Number of Occupants: t—ser, max
Basement ❑Yes DWO
Pump Required: Dyes ❑ No III �ay bee r quired based on final location and elevations of facilities
Type of Water Supply: ❑ Community Ld�Publlc ❑ Well Distance from well Srp feet Cf^ f eJ Permit valid for:
Permit conditions:
ears
❑ No expiration
Authorized State Agent: �A Date: "2 /oG /C4r, 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 it 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, .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: 'C CSn t W -eAle m1 , PROPERTY LOCATION: 2 SC 3 0,4-16 cx,e. ZA. ( QC TSS)
SUBDIVISION LOT #
Facility Type: Avcaot �>.t f iC,U G P—New ❑ Expansion ❑ Repair
Basement? ❑ Yes � Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" ci nu . 4-1 j - (Initial) Wastewater Flow: /Uo GPD
(See note below, if applicable ❑)
C-ee>ihV. C-arr..i-ai. S7s. (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size It>p-L gallons Exact length of each trench 5 o feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Pump Requirements: h. TDM vs.
Conditions:
Maximum Trench Depth of: /a inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
E inches below pipe
R inches above pipe
V;2 inches total
"If applicable: / understand the ryrtem type rpedled it different from the type specified on the application. l accept the rpedlcationc of thir pem7it.
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 Authonianon IS subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit ltt MIAMI) lilt bRtILH
Authorized State Agent: _, = — - gig Date: ! "ei/C✓&
Jzsq-x`+o 2 ✓ ,✓2 2 of Construction Authorization Expiration Date: I 7/Gr.
HTE# 1 i _ 5 - 4 a(,ltl Permit # .9 C1
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: '26Ce 3 6�;L Grnve "2c� CSCE 153x,
ISSUED TO: -ye-)o SUBDIVISION LOT #
Authorized State Agent: Date: t :2 / UG
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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: _VZ. n / W i, A ICIJ
Address:yy o,IC4(v y L.h. rt)Date Evaluated: I;IIZl/ f
Proposed 4N, 4: ♦'t/1 Hcoy Design Flow (.1949): 160 E,Pq
Location of Site: Property Recorded: *Oj
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method: ❑-A-tqge� Borin ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet
Property ID:
Lot #:
File #:
Code:
Property Size: C, ; S.l 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
Minenflogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Rest/
Horiz
a,3
L 3
o -S
('c/�j
-a�
4w
o 4e7
PS
N
t_ s%
C> -1a
64-
✓�
to 3c'
r3 jl�L
Fqq 474f
01,05
6,35
Description Initial Repair System Other Factors (.1946):
S stem Site Classification (.1948): Qr'e+v 6, IJ 5..•l...tF,
Available S ace (.1945) Evaluated By:'+rf-
System Type(s) - zcd Others Present: J
Site LTAR 0, a e. 5 5