IPACNTE# 1q-5-L-`133-?Cj Harnett County Department of Public Health 30009
Improvement Permit
A building permit cannot be issued with only ag Improvement Lea n
PROPERTY LOCATION: ! a,cGy�,G I t1AAR L.
ISSUED TO: g1rk.6osos1) t4 GV Stotn 04* E.5, SUBDIVISION Sue•unCEL.L'Sw LOT # �
NEWX REPAIRE+xp����NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: "q<3��
Proposed Wastewater System Typ� `Vo W6 Ga 10tJ/5`6 M
Projected Daily Flow: 360 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes �No
Pump Required: []Yes XNo ❑ 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: Date: 3 )a0 11'51 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the wnte of other permits. The permit holderuis responlible for checking with appropriate governing bodies in meeting their requirements. This
site is subject m revocation if the site On, 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 pmvisiom 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 .1958, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in acmrdance
with the attached system layout.
ISSUED T0: pR � 5'roa C�s't �6r" 65 PROPERTY LOCATION: P%QP0�16- -tri'.s L—
SUBDIVISION SV. cn&LLa a LOT #
Facility Type: �i lv n�6) New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" `x"10 at-, Sw, HJ'f\ (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable ❑)
o
9S /-0
2eJV(Z:fb0N Sy �.,�
(Repair)
inches below pipe
Installation Requirements/Conditjons
Number of trenches L
(� Aggregate Depth:
s Rncr'oy�z �epr, ft fps
inches above pipe
inches total
Septic Tank Size T 00 O gallons
Exact length of each trenchii3,� feet
Trench Spacing: 9 Feet on Center
Pump Tank Size gallons
Trenches shall be installed on
contour at a
Soil Cover: G inches
Maximum Trench Depth of:
I$ 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:
(t. TON vs.
_ GPM
inches below pipe
Conditions: PC�L<<1 �C
�arC'j
(� Aggregate Depth:
s Rncr'oy�z �epr, ft fps
inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE TOFF. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
*If applicable- l underrtand the wifem type rpetiled it different from the type rpeciped on the app/nation. / acreat the rpecificationr of this permit.
Representative
Date:
this Lonstruction Authorization is su I revocation if the sire plan, On or the intended use changes. The fanstrumon AuthonmDon shall not be translerred when there is a change in ownership of the site. This
construction Authorization is subject to compliance w 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: 3 0 IQ
onstruction Authorization Expiration Date: 3
HTE#
1l-5- x.133 -l9 P # 3000
erm ,
Harnett County Department of Miblic Health
Site Sketch
(� \, PROPERTY LOCATON: N, T., a\ I- � e.AtI-
ISSUED TO: ` >>o N a5'N Or,Rotn� SUBDIVISION S u Mm&y-Li NLOT #
Authorized State Agent: -1\5 �L (� �oL\<SU�CfY Date: 3,�UI 1�
�E CsLvsl-1 Aocp Noczo P�Pt7 ACAASs
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ta-T'
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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
Sheet:
Property ID:
Lot #:
File #:
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: PjpQr% Design Flow(. 1949): .��tCl Property Size:
Location of Site: Property Recorded: JJ
Water Supply:ublic❑ Individual ❑Well ED Spring
Evaluation Metho r Bo g F] pit ❑Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
❑ Other
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 (IN.)
.1956
Sapro
Class
.1944
Resn
Horiz
S�1
d -a0
Q LS
IQ
L5
VPLry31VQ
a��}0
SgK XL
FK
Ic,,la� 3Z t
s 1)
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):47-5
Available Space (.1945) Evaluated By:
System Type(s) 'a.S 4 Y Others Present:
Site LTAR At