IPACHTE# )$ -5L"3 Harnett County Department of Public Health 30046
Improvement Permit
A building permit cannot be issued with only an Improvement Permit o
a,/� PROPERTY LOCATION: ll- a vm,-,,, a R.
ISSUED T0: —Dc cAPaz.o r vc'5wa GUrn SUBDIVISION OcsNgLP Y)PkKe uM LOT #
NEW)< REPAIR ❑ EXPANSIONJI Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Mct0ULwra-
Proposed Wastewater System Ty e: e�.S% �ouc.'SkGN
Projected Daily Flow: 3 &m GPD
Number of bedrooms: 3 Number of Occupants: _max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet Permit valid for.
Permit conditions:
AFive years
❑ No expiration
Authorized State Agent:: � t 5 Date: 5.1 )S 14 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee 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 changes. The 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 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, .1 9S7, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be instilled in accordance
with the attached system layout q� \
ISSUED TO: oCt,ALO vj�aw 6Ur-N PROPERTY LOCATION: .46' 0s,1 Q.o
SUBDIVISION 00MNLO MP,N C vers LOT #
Facility Type: N1oo�Lctz (�$ %6� '�K New ❑ Expansion ❑ Repair
Basement? ❑ Yes `K No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 5e/e RGOVC'i s0 N Sy V" e.nn (Initial) Wastewater Flow: 36 GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: Ci Feet on Center
Soil Cover. G -% inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: / ondeataod the ryttem type rpeciled /t different fmm the type rpeciled on the application, / accept the rpecifiiatiom of this permit.
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if the site pian, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
concoction Authorization is sable lance with dig 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:
Col ruction Authorization Expiration Date: S )s
QjS /0
RE.ouoS I PN -1"-/5 . (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size 'Lo (3 6
gallons
Exact length of each trench ❑ S feet
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 54-a.0 inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements:
ft. TDM vs.
GPM
Conditions:
Trench Spacing: Ci Feet on Center
Soil Cover. G -% inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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: / ondeataod the ryttem type rpeciled /t different fmm the type rpeciled on the application, / accept the rpecifiiatiom of this permit.
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if the site pian, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
concoction Authorization is sable lance with dig 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:
Col ruction Authorization Expiration Date: S )s
HTE# V� 5L -t3 Li
Permit # 30 0t }
Harnett County Department of I' tblic Health
Site Sketch
ISSUED TO: �c
PN CHUM
PROPERTY LOCATON: NaxL Nb ioN
SUBDIVISION LieNALO (1 P uM LOT #
Authorized State Agent:
1s � rvyt-' oai--
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:❑ Auger Boring ❑ 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
MineralogyColor
.1942
Soil
Wetness/
.1943
Soil
D th (M.)
.1956
Sapro
Class
.1944
Ruar
Horiz
),9
o.zjj
as
o�
s3IV5�-L_
r2 55)
lei��
4
9,4-
S8 K Sc.L
t :5,.5),e
34,44
sg�ei
F2 35)3C'
4
INC
Description Initial R air System Other Factors (.1946):.p
Systeny Site Classification (.1948)
Available Space .1945) Evaluated By:C'<
System Type(s)) Others Present:
Site LTAR 44