IPACNTE#_ Harnett County Department of Public Health 30035
ImDrovement Permit
A building permit cannot be issued with only an Improvement Permit
pp PROPERTY LOCATION: Tut aEa. �ossfi�l Lw
ISSUED TO: S 1 QGY MP'°tb- -A Oaransj--' SUBDIVISION LOT #
NEW REPAIR ❑ G% ION
S Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Mesas. 11orw�E, x5P
Proposed Wastewater System Type: WZ a REc.�ucra ons
Projected Daily Flow: 36C> GPD
Number of bedrooms: '% Number of Occupants: io max
Basement []Yes
Pump Required: ❑Ye
Type of Water Supply:
Permit conditions:
�No
s �!KNo ❑��Maay be required based on final location and elevations of facilities
11 Community res, Public ❑ Well Distance from well feet
Permit valid for.
Five years
❑ No expiration
Authorized State Agent: T li5 Date: 4 �.0 1`2 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guavas issuance of other permits. The permit holder is responsible 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 tissues. a 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 Treament 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 meL Systems shall be installed in accordance
with the attached system layout
ISSUED T0: Act TaioQSN PROPERTY LOCATION: — I uatvG2 f osxi L&v LA
SUBDIVISION LOT #
Facility Type: MP,ra.}Hame- (W4A50 New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Base ent Fixtures? El Yes El No
Type of Wastewater System" Q';F 4 0.G flvyt� ON y 5 ; E� (Initial) Wastewater Flow: -:!)CO GPD
(See note below, if applicable ❑)
ZLe
Ie
x Com. g" n' . (Repair)
Installation Requirements/Conditions
Number of trenches a.
Septic Tank Size s o b ci gallons
Exact length of each trench T O O feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: VI "30 inches
(Trench bottoms shall be level to +/_1/4"
in all directions)
Pump Requirements: h. TON vs. _
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover, 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: / anderstand the s}rtem type specified it d/herent from the type specified on the app/icadon. / accept the rpecifcatieas o/this permit
Owner/Legal Representative Signature: Date:
This construction Authomauon is subjecton if she site plan, plat or the intended use changes. The Constru<non Aushonzanon shall trot he tanslerred when there is a change in ownership of the site. This
Conssmcuon Authorization is " t to complian ith t e " ns of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: )1.5 Date:`i 1Q
on action Authorization Expiration Date: `1 ,n
HTE# ►q-5-y36�p
Permit #3�
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: a, 6z Qca\ E/ LN
ISSUED TO: - NC451� QosuaoS/ SUBDIVISION l1 LOT #
Imo l
Authorized State Agent: Q6>1S lOuvfn iOLVSOO�S Date: H V
10
SDE 1,
SOL\�J30,v�i-
ap
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):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method;R, Augr Baring ❑ Pit ❑ Cut
Type of Wastewater: `❑ Sewage ❑ 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
Minemlo y
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
)
z 5
O3�
G 5
Vrl vSI�Q
P5
3
a-�
G s
vin �lvp
W-�,`I
SBc
�n 55)Np
P
Description Initial Re air System Other Factors (.1946):
System, Site Classification (.1948):
Available Space (.1945) Evaluated By:
System Type(s) S / Others Present:
Site LTAR • �5