IPACHTE# I -S-y3` Harnett County Department of Public Health 29940
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 4 OR
ISSUED TO: +tm� SUBDIVISION LOT # f�
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: cle(L O.DaX sus 5�
Proposed Wastewater System e: ci6ro nc.a�x-Sion
Projected Daily Flow: GPD
Number of bedrooms: -- Number of Occupants: max
Basement ❑Yes Id'No
Pump Required: ❑Yes ❑ Noay b based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well hi.Qc, feet Permit valid for. yeayears
Permit conditions: ❑ No expiration
Authorized State Agent:: �� ������ Date: —1TI oZC>/fa' SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department m no way guarantees the issuance of other permits. The permit holder u 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 changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the pmvisions 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, .1951, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall he met. Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: Tammy R\\eta Coctis�cacldpn-�iK PROPERTY LOCATION: ►-3C- 4Q
SUBDIVISION LOT # _(a
Facility Type: 4G2 HDaXfyi5s 51:1;�> �- ❑ Expansion ❑ Repair
Basement? ❑ Yes Vo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System'* ;A e\ G,6{,, - r -ti_ (Initial) Wastewater Flow: GPD
(See note below, ii applicable ❑)
o�s� vL�ic�c� S (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1`�j gallons Exact length of each trench 9a feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. /:? inches
Maximum Trench Depth of: A_ 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. TDH vs. GPM
Conditions:
AvA inches below pipe
Depth: e,Si\ inches above pipe
P.lIll 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: / mmdeatand the system type specified /t different from the tipe specified 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 Authorization 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: C4' 'd ;I o
vii G„ an i Construction Authorization Expiration Date: 6gilats fw-x�
HTE# Imo' `J " `4 3gIS Permit # 1a9 cf 46
Harnett County Department of Public Health
Site Sketch
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PROPERTY LOCATON: �C,
ISSUED T0: -Tornrni Mec\ CoA -C,6. S3 cz SUBDIVISION LOT #
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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
SoxP�'
Owner: 66r& Applicant: j akec\
Address: i`Xi Dat Evaluated: 0
Proposed Facility: �2� Design Flow (.1949): 6M
Location of Site: Property Recorded: Yf
Water Supply: ubli Individual E]Well
��uger
Evaluation Method: g ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: f, 10) 47 4c�
❑ Spring ❑ Other
❑ Mixed
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
a� G
f�5®�
y�
-
a
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C,
SL
V2 5
3,5
'- 1.106
o -S
Ca- bL
✓ P
Description InitialRepystem air SOther Factors (.1946):
System Site Classification (.1948): PLou6�0^�-l1. l.Q�
Available Space (.1945) Evaluated By: Q ��
System Type(s)-?TOthers Present:
Site LTAR