IPACHTE# b Harnett County Department of Public Health 30030
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: 7Z -Q" SG'J i r --L .,jo� t�s:LsSsq SUBDIVISION LOT # I
NEW REPAIR ❑ EXPANSIONS
Type of Structure: Miaersu LA -ss— l�t1 n3�
Proposed Wastewater System Type: GoHJ @N-C10N AL -
Projected Daily Flow: ��� GPD
Number of bedrooms:_ Number of Occupants: L max
Basement []Yes 'A–No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
I?Five years
No expiration
Authorized State Agent:: Date: tt 16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees s ante of other permit. The permit hold r is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the are plan, plat. or the intended use changes. The In rovement 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: �sA rJ fL�tQ �afl Ai :�GsI�5VN PROPERTY LOCATION: �iL�!W
l SUBDIVISION LOT #
Facility Type: 'M o9 `�� "3 �/ New ❑ Expansion ❑ Repair
Basement? ❑ Yes �:Eq No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** C,o Nv CNS s oN AL. (Initial) Wastewater Flow: 3 GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 6–)�L— 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: / understand the system type spedled it different from the type spedled on the application. / accept the rpecifcationr of this permit
Date:
This Construction Authorization is su j ct to -station if the site plan, plat, or the intended use changes. The Constmttion Authorization shall not be transferred when there is a change in ownership of the site. Thh
construction Authorization Jssubiect to mmplian he proauons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �� _ »� —Q&Y 5 Date:
Authorization Expiration Date:
ty sus A t-- (Repair)
Installation Require ments/Conditions
Number of trenches 5
Septic Tank Size Se cat
gallons Exact length of each trench 1'5 S feet
Pump Tank Size
gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1 'a inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements:
h. TDM vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 6–)�L— 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: / understand the system type spedled it different from the type spedled on the application. / accept the rpecifcationr of this permit
Date:
This Construction Authorization is su j ct to -station if the site plan, plat, or the intended use changes. The Constmttion Authorization shall not be transferred when there is a change in ownership of the site. Thh
construction Authorization Jssubiect to mmplian he proauons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: �� _ »� —Q&Y 5 Date:
Authorization Expiration Date:
HTE# �I-5-4393(5
Permit # 30030
Harnett County Department of lNiblic Health
Site Sketch
PROPERTY LOCATON: N(1a1W
_
ISSUED TO: Joh du L--C-LPNZ)-L)ss//Lw6z,
A SUBDIVISION
Authorized State Agent : s 1-9�WstxziY�
Date: `) I P I) y
`;b L1
a
LOT # I—
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: 3 Q"A Design Flow (.1949):' bO
Location of Site: Property Recorded:
Water Supply:. Individual El Well
Evaluation MethodAug Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage E]Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Rear
Horiz
�S
r_
V a NSI
%x c.
Fy 5) C'
3
o-3
G 5 L
SFR I�s�wP
fn sIQ3
Description Initial R it System Other Factors (.1946): c
Systerpr Site Classification (.1948): ' f
Available Space (.1945) Evaluated By:43�
S tem T e(s) Cd Ccl v Others Present:
Site LTAR ,3
3x 138@ °d- -''A