IPACHTE# tg - 5- L13-1 i Harnett County Department of Public Health 30016
Improvement Permit
A building permit cannot be issued with only an ImFroyment Permit
nn PROPERTY LOCATION: PPCN 142gv L,
ISSUED TO: CfLEGY� ° K CuStOsww NO M ES SUBDIVISION S u rn rw-ies —) N LOT #
NEW)s REPAIR p fYPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO l50 x60)��
Proposed Wastewater System Type: as �• r ^ o JG.! o „ts 5 -Ji
Projected Daily Flow: O GPD
Number of bedrooms: 4 Number of Occupants: $ max
Basement []Yes No
Pump Required: ❑Yes 'K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ", Public ❑ Well Distance from well feet Permit valid for. , five years
Permit conditions: ❑ No expiration
Authorized State Agent: \ !� v�'vS Date: 3 )�I Iq SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the nce of other permin the permit holder isis — 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
Reouired for Building Permit
The construction and installation requirements of Rules .1950, .1952, .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 TO: pR �Gnva r+ WST are. ACM 6.S PROPERTY LOCATION: PV P%CaA E n.AS L.
SUBDIVISION Suruff-xErIL)m LOT #
Facility Type: SFP LSO x6� X New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basemggnt Fixtures? ❑ Yes ❑ N
Type of Wastewater System'* 2 5 °!e gez'vyS t o o IF
Type (Initial) Wastewater flow: L'%Q GPD
(See note below, if applicable ❑)
as°1°
Installation Requirements/Conditions
Septic Tank Size f o O O gallons
Pump Tank Size gallons
Pump Requirements: h. TON vs. _
Conditions:
E Dv cSv of N Z" /5 - (Repair)
Number of trenches S
Exact length of each trench 2"At feet
Trenches shall be installed on contour at a
Maximum Trench Depth of 1I inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
_ GPM
Trench Spacing: Feet on Center
Soil Cover: ro inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
If applicable: / unde7tand the rystem type speciTed is d///ereot !i the type specified on the app/ication. / acrept the rpecifcatioos of permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject in 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 Authorization is -u fiance wi a provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent. Date: 3 lQ
nstructicn Authorization Expiration Date: --0 W
NTE# M- 5' Permit # 30O1�o
Harnett County Department of Public Health
Site Sketch
n PROPERTY LOCATON: obu 6 `a.N 1 L,
ISSUED TO: P2CzG510N I USTOM ,�otn/65 SUBDIVISION S�Imr�Eat�nj LOT#
Authorized State Agent:y6�S LWNEse `�olx]�[7C1F� Date: 31l`b
'� lG NNS) EXv5Kw4, lA,4Ne- 1S L6OCWCD 1�j
a Q.a ) N F % &z -v wi&-. caw,51A P N S>
Hpao P,\PL '�)A LCV6LI iANy.. kQt-tl.
t'7 0
101
1 lJ
3o t35,nS E
Miflo' 6 "TaL11L
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIWSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: t
Proposed Facility: (A Q C)4 � 0
Design Flow (.1949): L) ', O
Location of Site: Property Recorded:
Water Supply: ® Public❑ Individual ❑ Well
Evaluation Method: An Baring ❑ Pit ❑ Cut
Type of Wastewater: q Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
.1940
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope%
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
LS
z
Q 3a
Ci S
Ct u51hi
49
`�X 5CL
� SSI SP
3
G
'S
Description Initial Repair System Other Factors (.1946):
Systo Site Classification (.1948): Q5
Available Space (.1945) V Evaluated By: p�
System Type(s) 9-S /r C, Others Present:
Site LTAR 5