IPACHTE# 1&6-y5a,( Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Imp
PRnprRTY InrATlnm. ILIP
ISSUED TO: �y�c\.4 Sw nava )/v or, cc.nnnn SUBDIVISION
NEW Q-� REPAIR ❑ EXPANSION ❑
Type of Structure: k — 9q1)e-:q0 St;�
Proposed Wastewater System Type: 26%, CLELyIAnnS 5
Projected Daily Flow: a/cc36 GPD —�
Number of bedrooms:Number of Occupants: _max
Permit
t..N
30052
S 2
LOT 1
Site Improvements required prior to Construction Authorization Issuance:
Basement ENSo
Pump Required: ❑Yes ❑ NoERSP�oblic
required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Well Distance from well h..s Ar feet
Permit conditions:
Permit valid for.
91ive years
❑ No expiration
Authorized State Agent: 6�� Date: irc I a01Q) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permit. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site Iplan, 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 previsions 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 requirement of Rules .1950, .1952, .1954, .1955, .1956, .1951, .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:
-a� IIJ
�A�'Jc.+.'[a N -J. n cjc a ,%nn PROPERTY LOCATION: (%� \ J 1cs,�non �r • �CL tyteE k r �
SUBDIVISION LOT #
Facility Type: 011 9`� k 7 of I o ❑ Expansion ❑ Repair
Basement? ❑ Yes C-1 o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ;2 6X- 1 v L 'o n Swsyk,8m, (Initial) Wastewater Flow: 8C1 GPD
(See note below, if applicable ❑)
2'6,yc:v I t 5 (Repair)
Installation Requirements/Conditions Number of trenche 3
Septic Tank Size 1 gallons Exact length of each trench 100 feet Trench Spacing: 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: N. TDM vs. GPM inches below pipe
�f1 cxlN�)g,wr �-Guc: �ly/ni �t5�y �n2ilUn a gate Depth: rya inches above pipe
Conditions: nrA 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, / underrtand the sruem type spe6fed it different from the type .specified on the application. / accept the rpeci6cationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorisation is subject in 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 sire. This
anstmcnon Authontatron is subject to compliance with the previsions 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: o s /�5) olotG
( on,EsJ Construction Authorization Expiration Date: o5kxr I oma --3
(-�.Q)
HTE# Permit # 3OC>6Q
Harnett County Department of Public Health
Site Sketch
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p PROPERTY LO(ATON: 1(06- 0la6twti S?C"rJS e�
ISSUED T0: :5-csrCtwgAp(\ SUBDIVISION LOT #
Authorized State Agent: �� Date: C>s1Q9� quf1
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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
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\ V LM 4OwnerUJt�&% �
Address: is " IXOW vrr 21 -Date Evaluated: {150
Proposed Facility- �geffr�BiIori3;
�� //S, Design Flow (.1949):5E r `J
Location of Site:roperty Recorded:
Water Supply:❑ Individual ❑ Well
Evaluation Method:❑Pit F1 cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: 1 , p71 -kc,
❑ 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
Soil
Depth (IN J
.1956
Sapro
Class
.1944
Restr
Horiz
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Description Initial Repair Syste Other Factors (.1946):
System Site Classification (.1948): Vnoo 5•dkk'> ,54'A• 'Vk-C,
Available Space(. 1945) Evaluated By: J�
System T e(s) U D
i Others Present: ' R'' 6_xrl',
Site LTAR