IPACHTE# Z') -LJ
Harnett
County Department of Public Health
29817
(Required for Building Permitj
Improvement Permit
.1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references
into this permit and shall be met Systems shall be installed in arm theme
A building permit cannot be issued with only an Improvement ermit
PROPERTY LOCATION: _ N)
ISSUED T0: �n wy o
ri A ro G U .
PROPERTY LOCATION: M 0.4,1
SUBDIVISION
Facility Type:
LOT # ] Ei
NEW REPAIR ❑
Type of Structure: r'i9.a . E'ioon
EXPANSION
('a$'X"'I 0'
_NcN6
� Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type: R,
mi S p 2.S" o
of S o e SyS .
(See note below, if applicable ❑) _1
PMt }
Projected Daily Flow: 360
GPD
o
Sys (Repair)
Number of bedrooms: 3
Number of Occupants:
`o max
Basement ❑Yes XNo
Exact length of each trench YQ
g 0 feet
q
Trench Spacing Feet on Center
Pump Tank Size . oo cl gallons
Pump Requjred�lfes ❑ No
❑ May be required based on final location and elevations of facilities
Maximum Trench Depth of 1 J — )IJ inches
Type of Water Supply: ❑ Community
Public ❑
Well Distance from well feet Permit valid for.
five years
Permit conditions:
in all directions)
/
❑ o expiration
GPM
®
o
Conditions: I, a e„, m v ryec cr ro OF
Aggregate Depth: inches above pipe
C.o V 62 N Et pt;D ON" flc>A lnttr �E O inches total
Authorized State Agent: ����51� �S Date: S J 1 ) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu be er permus 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 emit 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.
WAILH LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable- / ondearand the system type spedfred vi different from the type spechfed on the app/icatiom / accept the rpecihcadonr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is so to vocation if the site plan, plat or the intended use changes. The Construction Auth rnzation shall not be transferred when there is a change in ownership of the site. This
Construction Authorization i subject to comer a wi ovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATrACHED SITE SKETCH
Authorized State Agent: tk 5 Date: 41 A > 7
struction Authorization Expiration Date: a 31—
Construction Authorization
(Required for Building Permitj
The construction and installation requirements of Rules .1958, .1957,
with the attached system layout
.1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references
into this permit and shall be met Systems shall be installed in arm theme
ISSUED T0:
PROPERTY LOCATION: _ N)
n c - Q,c
SUBDIVISION MC -N eIIL4.
MSN None xklOp
lXc.Qy LOT # Ito
Facility Type:
)K New ❑ Expansion ❑ Repair
Basement? ❑ Yes >;� No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" Quf—Ne o
`c��10 Q.E0✓G410, Sy TE,sn
(Initial) Wastewater Flow: 3(00 GPD
(See note below, if applicable ❑) _1
PMt }
��d�oD,
o
Sys (Repair)
Installation Requirements/(onditions
Number of trenches 1
Septic Tank Size A o 0 Q gallons
Exact length of each trench YQ
g 0 feet
q
Trench Spacing Feet on Center
Pump Tank Size . oo cl gallons
Trenches shall be installed on contour at a
Soil Cover: G— inches
Maximum Trench Depth of 1 J — )IJ 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. TON vs. _
GPM
inches below pipe
o
Conditions: I, a e„, m v ryec cr ro OF
Aggregate Depth: inches above pipe
C.o V 62 N Et pt;D ON" flc>A lnttr �E O inches total
WAILH LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable- / ondearand the system type spedfred vi different from the type spechfed on the app/icatiom / accept the rpecihcadonr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is so to vocation if the site plan, plat or the intended use changes. The Construction Auth rnzation shall not be transferred when there is a change in ownership of the site. This
Construction Authorization i subject to comer a wi ovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATrACHED SITE SKETCH
Authorized State Agent: tk 5 Date: 41 A > 7
struction Authorization Expiration Date: a 31—
HTE# ) 7 — 5 — 3% Permit # 3-W-7
Harnett County Department of Public Health
Site Sketch
PROPERTY LOEATON: n tiCXC Q
ISSUED T0: �o v �A G U SUBDIVISION
Authorized State Agent•. t-,Vlst i ,L-
T
MCC-� 0" Vr UCL
F>NQL. 1-A"j 0lTS lF
syss6NS is ro 6T
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SORAITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: `Y`�t`'s� Design Flow (.1949): -A 6 c'
Location of Site: Property Recorded:
Water Supply: .Public[] Indi dual E] Well
dEvaluation MethoAuger Boring Pit Cut
Type of Wastewater. ,�ewage iC1ndustrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
P
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL. MORPHOLOGY
.1941
071
-PROFILE FACTORS
Profile
Clefs
& LTAR
.1941
StruchrH
Texture
.1941
Consistence
Mineralo
.1942
Soil
Wetnesst
Color
.1943
Soil
IN.
.1956
Sapro
ClxSS
.1944
Restr
Horiz
I
o f
O 30
G Sz
v�� 1^
loyon�arCkb
54< 3G
Irn
6
C' `� �
vm �� �
C,2'4 0L
-
SU..
s3
;Site
ption Initial R air System Other Factors (.1946):
S st Site Classification (.1948): PS
le S e (.1945 Evaluated By:
T s V n Others Present:
AR —