IPACHTE# (1'& 43s'a0 Harnett County Department of Public Health 30018
Improvement Permit
A building permit cannot be issued with only an Improvement permit
PROPERTY LOCATION: COGS Y'o
ISSUED TO: H,, VA CoNS'ccixyyixS SUBDIVISION ()per's-.,0t-rT LOT #3a3
NEWX REPAIg ❑ { PANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5F0 5-6 xr� J
Proposed Wastewater System Type: Z3,%° ° S'6c»cr11 o u s
Projected Daily Flow: C. OO GPD
Number of bedrooms: 5 Number of Occupants: 1y _max
Basement Dye s No
Pump Required: ❑Yes No
Type of Water Supply: ❑ Community
Permit conditions:
❑ May be required based on final location and elevations of facilities
�X Public ❑ Well Distance from well feet
Permit valid for. AFive years
❑ No expiration
Authorized State Agent: e 'j5 Date: 3 a� 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees gamv of other permits. The permit holder is response le 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 in compliance with the provision 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 is accordana
with the attached system layout n
ISSUED TO: ' Ns�LV
cC:Te3W PROPERTY LOCATION: Oo c,.> 14
S� �53-x SUBDIVISION OAKC�05r LOT #309
Facility Type: 9 56� New ❑ Expansion ❑ Repair
Basement? ❑ Yes I No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 2i�% P�Eo C; f v o tv (Initial) Wastewater Flow: r000 GPD
(See note below, if applicable ❑)
`�S�%° � , Syg, (Repair)
Installation Requirements/Conditions Number of trenches _ S
Septic Tank Size I '.zt�O gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench a 10 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: `I Feet on Center
Soil Cover: 6' �inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: / understand the system type specified /s different from the type specified on the application. / accept the rpecifIcationr aphis permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is sub en to rewcanon d the me plan, plat or the intended use changes. The Conswmon Aushorwuon sha8 not he tmnsfmred when there is a change in ownership of the site. This
Construction Authorizafion is subjen to cons wish ovisions of the Laws and Rules (or Sewage ireatmens and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: a Date: -5
Rnstruction Authorization Expiration Date: 3 'J,3
NTE# I'I-5- 3SaO Permit # 3C
Harnett County Department of Public Health
Site Sketch
PROPERTY LOLATON: O(3Gs V -Z,
ISSUED T0: ± } i mot 52y of o2S SUBDIVISION to LOT # 3_._03
Authorized State Age7t��Lb t, Y 6i i oL sao > Date: 3) ,�� I )-6
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: Date Evaluated:
Proposed Facility: Design Flow (.1949):(;!M
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Au Boring ❑pit ❑cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property 1D:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ 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
.1943.1956
Soil
Depth (IN.
Sapro
Class
.1944
Restr
Horiz
1
Ly
2s
o -M
a
o-43
s
-MA N��"P
�•�Z
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948);%
Available Space (.1945) 11� Evaluated By:
System Type(s) Others Present: —�
Site LTAR ,d