IPACHTE# 1�� �l3177 Harnett County Department of Public Health 30041
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
�t^� PROPERTY LOCATION: 6E,P, JI V;" >) L, LN
ISSUED TO: vm L1Swrr w5S 0� Non E3 SUBDIVISION S% MM"- I -N N LOT # a I
NEW REPAIR ❑ EXP ON 0 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SAO (,SO "3S-
Proposed Wastewater System Type: "l„ V.CDuc:ns sSA atr%
Projected Daily Flow: "*it) GPD
Number of bedrooms: y Number of Occupants: max
Basement []Yes � No
Pump Required: ❑Yes ❑ No '>4ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well feet Permit valid for:
Permit conditions:
Five years
❑ No expiration
Authorized State Agent: Q_r,TN5 Date: a 1 �3A SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee uanr3e a of other permits. The permit holds is respon k for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revoation if the site plan, plat or the intended use changes. The oYemeni 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 Permtt)
The construction and insulation requirements of Rules .1950, .1957, .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: Pts 6 GAS 10 is `,j ats5 0 ..E5 PROPERTY LOCATION: �i TS= V L (—
SUBDIVISION 5„ LOT #
Facility Type: SF9 LSD "35� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** Qj- i �/o R 6Dv C�T t O r•t Sy J i 6>ti (Initial) Wastewater Flow: Lib O GPD
(See note below, if applicable ❑) _m
aS !o
V�5� - /5 - (Repair)
Installation Requirements/Conditions
Number of trenches l
Septic Tank Size it) oQ gallons
Exact length of each trench n,—] 5' feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of. tl� inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs.
GPM
Conditions:
Trench Spacing: 1) Feet on Center
Soil Cover. V_ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / uadetstand the system type rpeciled is different from the type speciled on the app/iutiat. / accept the specih?anons of this permit
Signature:
Date:
This Construction Authorization i m revoation if the site plan, plat or the intended use changes. The Construction Authoriaation shall not be transfereed when there is a change in ownership of the site. This
construction Authorization i�auhj`to compli rovisions 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: y 13 0 '8
"tillinstruction Authorization Expiration Date: LA 12 01
HTE# I" - Permit # 3WLy\
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: B EAuS �` Ul- L. N
ISSUED TO:QNdo Cu5Toe-Au0��`� SUBDIVISION SvMrrx<j7L1N 1- LOT# �
Authorized State Agent 0.G��s Co��a", 1 07bDo(�� Date: Ib 0I hti
Agent �r
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: ll., gDq `r Design Flow (.1949): LA -0 �0
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method• Augexnorong ElPit El cut
Type of Wastewater: mage ❑ Industrial Process
Sheet:
Property ID:
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
Soil
Depth (M.)
.1956
Sapro
Class
.1944
Restr
Horiz
0-u�6
Iva t�S�NQ
5
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948): S
Available Space (.1945) Evaluated By:
System Type(s) Others Present:
Site LTAR ,�