IPACHTE# 4356 Harnett County Department of Public Health 29927
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: tJL a 105 s ---:s,--
ISSUED co SUBDIVISION LOT #
NEW REPAIR ❑ EKPANSION ❑
Type of Structure: 02 (,a I-/ ti31 S 1c:3�>
Proposed Wastewater System Type: 'd5% Re-,vtt•bn '5 .
Projected Daily Flow: 366 GPD
Number of bedrooms: Number of Occupants: -6max
Site Improvements required prior to Construction Authorization Issuance:
Basement ❑Yes or
Pump Required: ❑Yes ❑ No f a�-�M y �Is re based on final location and elevations of facilities
Type of Water Supply: ❑ Community PubfY lin ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
®'F ve years
❑ No expiration
Authorized State Agent: e-�Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Depamnent in no way guarantees the issuance of other permin. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to nvoatios 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 taws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
squired for Building Permjt)
The construction and installation requirements of Rules .1958, .1951, .1954, .1955, .1956, .1951, .1958. and .1959 art incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout
ISSUED T0: �>can,e\ 2, Qr✓kcK5 PROPERTY LOCATION: t�<.
SUBDIVISION LOT # _
Facility Type: 300 v 0 3J-6fc'*� 2New ❑ Expansion ❑ Repair
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**c�n(b—A, cl �c n 4 (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable ❑) �e��
96y,:>v`e�+ib(1 SiS� (Repair)
Installation Requirements/Conditions Number of trenches Z �-a
Septic Tank Size I� gallons Exact length of each trench VG feet Trench Spacing: / Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at Soil Cover. (,-*IQ inches
Maximum Trench Depth of. 115 `0a� inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft TON vs. GPM
Conditions:
(Maximum soil cover shall not exceed
36" above the trench bottom)
N A inches below pipe
Aggregate Depth: INJ inches above pipe
A- ; C 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 system type speciled is different from the type speciled on the application. / accept the rpecilcationr 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 Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorisation 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: C> OI (/ / oac',
Construction Authorization Expiration Date:
HTE# 14)-S-43515 Permit # ar15a7-
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:
ISSUED T0: t 2. Pecs SUBDIVISION LOT #
Authorized State Agent: 6i �� Date:y 3 f a G / a?U! 6
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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:
Address: Ky ajo tv , Date Evaluated: 031 RO116
Proposed Facility: 3� Design Flow (.1949):
Location of Site: Property Recorded: (1�'ef
Water Supply:ublic❑ Individual E) Well
Evaluation Method: uger Bo ' ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: G,Sb,.G
❑ Spring ❑ Other
❑ Mixed
P
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1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Stmcture/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Rear
Horiz
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s) Others Present:
Site LTAR o ,tj