IPACHTE# !I- S—g°?7d3 Harnett County Department of Public Health 29799
Imn3rovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:—vJa�� ��"7r�,p h y 2:dt�( � il;As 2.A. SL r`%(3)
ISSUED T0: 1 �mGeslw a t4c) ka,5 .ins, SUBDIVISION / /ef-S�twL LOT # to
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 432 Go+>ctFS1 5=b
Proposed Wastewater System Type: 25Y (lrr.1 t krr S c
Projected Daily Flow: Y8c, GPD
Number of bedrooms: —/- Number of Occupants: E;max
Basement ❑Yes E 'No � -
Pump Required: ❑f�
Yes "No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community [?-Fu—blic ❑ Well Distance from well feet Permit valid for.IvC'3-F —years
Permit conditions: ❑ No expiration
Authorized State Agent: �� Date: �l�d wY�B SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Depamom 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 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 Permjt)
The construction and installation requirements of Rules .1950, .1951, .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.
ISSUED T0: t_u nlecrlcnc bonaa� Tne. PROPERTY LOCATION: 79 Tr-WAa Clh r(tT�lsdn52�S, $(t lc(
SUBDIVISION t o CLP s e t �- LOT # �1Z
Facility Type: 1112 Lo' x aS s S CYMFvi ❑ Expansion ❑ Repair
Basement? ❑ Yeso Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System`* 05y , A -r-'4 (Initial) Wastewater Flow: y t- GPD
(See note below, if applicable ❑)
(Repair)
Installation Requirements/Conditions Number of trenches _�L
Septic Tank Size gallons Exact length of each trench —C� feet Trench Spacing: % Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: / v inches
Maximum Trench Depth of: orf inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/_I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: A - 3c„,e nn Cc2r„c E j O' Nh 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 6 evrent /ram the type specified on the app/icatioa / accept the rpecilcaaons o/ this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the Bice plan, plat or the intended use changes. The Construction Authorization shall not be tmnslerred 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: "t a6/ate
�sJCJr .: C �1Y�GA I3.� Construction Authorization Expiration Date:y!
HTE# 11-5--4;1ya.3 Permit # a C/ 1-c9
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: as IL�� 2'%be a lIins rU Sa 10
ISSUED TO: ='nC• SUBDIVISION -t-1 LOT # _12)
Authorized State Agent: Date: r'/
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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: LVA�,� µu" � 1 ``c
Address. It 4.se-C- L. + I a Date Evaluated: of
Proposed Facility: LiV=;Z- �(> Design Flow (.1949): P6�
Location of Site: Property Recorded: WA
Water Supply: uhlic❑ Individual ❑ Well
Evaluation Method:Auger ring ❑ Pit ❑ Cm
Type of Wastewater: ❑ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: 1, Q(,�'
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
4
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogv
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
L a�,
o a�
rQ (
0.43
Z4,
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r
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YO
G1US
3
L 31`o
GR 6S
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Pcv-er�
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Description Initial Repair System Other Factors (.1946):
system Site Classification (.1948):
Available$ ce (.1945) Evaluated By: AC
System T e(s) Others Present: �"�
Site LTAR 0,4(c 1 o, 4L5