IPAC RHTE# Harnett County Department of Public Health 29914
Improvement Permit
(✓� �`���� A building permit cannot be issued with only an Improvement Permit �s ' PROPERTY LOCATION: r\7L Qtr — 0
ISSUED T0: SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: 'd 6 cZ. -:5 vZ�,t� u 14 s X 40
Proposed Wastewater System Type: 'ol c� (Le l.Y_l:cun S 5 -
Projected Daily Flow: i 0 GPD
Number of bedrooms: Number of Occupants: max
Ca N
Basement []Yes
Site Improvements required prior to Construction Authorization Issuance:
o �
Pump Required: ❑Yes ❑ No C3 May be based on final location and elevations of facilities
Type of Water Supply: ❑ CommunityuLsVP blit ❑ Well Distance from well .Gt feet
Permit conditions:
Permit valid for.
P-Fiv—ey—ears
❑ No expiration
Authorized State Agent: _ CDate: (:-�31cx-f) 6k>(8 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuana of other permit. 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 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 �c�F-jf)Qa (acSnZc,ke--F PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: age 5A,OrA W Sy'x'aot mew ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** °0Syo (Le_a.aLA�0f� 5,g 6c� � (Initial) Wastewater Flow: �_ GPD
(See note below, if applicable EI)
'd 5% (`t.r--V�c---1-:bra S r s. (Repair)
Installation Requirements/Conditions Number of trenches j
Septic Tank Size k C-x*3� 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: C� inches
Maximum Trench Depth of: 1 cG' 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
Conditions:
11-2 L- inches below pipe
Depth: W l'- inches above pipe
_ H T'� 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: / understand the #Ytem type rpechfed it different from the type rpeafled on the application. / accept the specihcannor of thif permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use changes. The Construction Amhoraation 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
and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: C)G ) aof cd
�dxUE a c_o 67�2, s Construction Authorization Expiration Date: 3 kcg I acsa3
HTE # I S' q �?64oa CZ_ Permit # a C1 9 1 q
Harnett County Department of Public Health
Site Sketch
CAJA¢ PG`Aokesl5on PROPERTY LOEATON: N c- a 4- a te
ISSUED T0: CACnf1W Gon 7,0e--7— SUBDIVISION LOT #
Authorized State Agent: il—���t�� � i �S Date: 3/ 6ctC
tq6l
96% eL C—k ,z -C, o rj
(L�-- PR k z Aar-=ik
aUo'
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s
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: (eltsyke,\ yGt1Zc�)L�&
Address: NO) gyral Date Evaluated: 01 I 'til l $
Proposed Facdtty: a32 SWM if- Design Flow (.1949): 7'b <ef�
Location of Site: ,� - Property Recorded: yrs
Water Supply: 93 runlic❑ Individual ❑ Well
Evaluation Method: Auger Bop- ❑ Pit ❑ Cut
Type of Wastewater: ErSewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: lb -aa %-t'
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
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
.1943.1956
Soil
Depth (IN.)
Sapro
Class
.1944
Restr
Horiz
W I.5
V �,(��
r
Qs
aro+
o •3
2,q
L 3%
Q -3q
34.1
3y
G3
3
L aim
�"�
�2 �s
✓� yfe�
►d 3,
A, SQL
Sj"
u (25
ivy
Go�`k
(.
30
c.3
Description Initial it System Other Factors (.1946):
System Site Classification (.1948): Unsu:q-.�b�cJ��ov�:ivnat`, Suet-�b(e.
Available Space(. 1945 L Evaluated By: (}q� L„�rtn z>•
System T e(s) 5Gcb- '23 v Others Present: i3
Site LTAR