IPACHTE# Iq-6-q3Q1li Harnett County Department of Public Health 29795
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
,//�yy� � ' 1 PROPERTY LOCATION:_
ISSUED TO' �KQcS no(7c— tt0(�tQSy SUBDIVISION LOT #
NEW C� REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3 �7 5/`®
Proposed Wastewater System Type: `'gams�—
Projected Daily Flow: yFSO GPD
Number of bedrooms: 4�— Number of Occupants: _max
Basement ❑Yes o
Pump Required: es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1c ❑ Well Distance from well feet Permit valid for.1f
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: '51 I Q I non/ If 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 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 sublets to compliance with the provision of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permjt)
The construction and installation requirements of Rules .1950, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in aaordane
with the attached system layout
ISSUED TO: Qo b .nc t—AO PROPERTY LOCATION: C, t Iwy 5 S
SUBDIVISION LOT #
Facility Type: 2-1 rew ❑ Expansion ❑ Repair
Basement? ❑ Yes Elm Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** P� n k o Q, R k s(Initial) Wastewater Flow: V i6C-)GPD
(See note below, if applicable ❑)
?ucvn Az aS`/o 0�,.. 575 - (Repair) n��4��
Installation Requirements/Conditions Number of trenches
Septic Tank Size I a 50 gallons Exact length of each trench /tea feet Trench Spacing: q Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/•I/4"
in all directions)
Pump Requirements: (t. TDH vs. GPM
Conditions:
Soil Cover. I/ aZ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
/-, N inches below pipe
Aggregate Depth: vA. inches above pipe
ty pC inches total
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.
If applicable: / undeatand the system type rperihed it diKecent lions the type rpecihed on the app/icaoon. / accept the JpecifcalI 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 communion 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 to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent. Date: d 1 rl ct ) 20/ ¢�
rk�jz c— Construction Authorization Expiration Date: I I q I de83
HTE# y3a1 1 Permit # ak-4 1-5
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: rV C� 14 t 1 S6
ISSUED TO: N�), C� OQOQ SUBDIVISION LOT #
Authorized State Agent — I���--r^��—`,,�5 Date: 0l/ 19'
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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: &tV "k pplicant: 17,eA VO6V-
Address: NwY 54 Date Evaluated: cy{ ILI)a
Proposed Facility: 4 y L Design Flow (.1949): low
Location of Site: Property Recorded: ✓C1
Water Supply: 2 Public❑ Individual ❑ Well
Evaluation Method:[LPmger�Boring El Pit ❑ Cut
,/
Type of Wastewater: sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: �, i( A e
❑ 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 (M.)
.1956
Salim
Class
.1944
Rmtr
Honz
L 3%
&-too
C.'L s,
y�.,f
116
r
33+
9c""�
2,3
L 3%
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Id -a4
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):j>fpv�3�`O rL.n,P�ij �`7 \•e
Available Space (.1945) Evaluated By: a _'
S stem T e(s) Others Present Af1A %e'er Gvt-6 t>' 46245
Site LTAR