IPAC RHTE# Is -5- y3gi32 Harnett County Department of Public Health 30065
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: V3. Q 1GtC VIA ( (7L l • L6 "L_ I 11
ISSUED TO, ;NQ N'e b r><Prrne-g SUBDIVISION LOT #
NEW 5K REPAIR ❑ E%PA ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �'SQi (C ',A s x --k-:>
Proposed Wastewater System Type: a6%v /lri
Projected Daily Flow: &e C> GPD
Number of bedrooms:umber of Occu ts: C- max
Basement ❑Yes &KO
Pump Required: []Yes ❑ No ay bb —1red based on Final location and elevations of facilities
Type of Water Suppl (�J". El Community ubliLl�P c El Well Distance from well �a� �' feet
Permit conditions: NMO s_SLev ours&., S.0 _r a. ..: na : nY _ 1 a ✓An.` t.
Permit valid for. 5;-Fyears
we_,,2� ❑ No expiration
Authorized State Agent: /t,:� Date: �i I ��c ) R SEE ATTACHED SITE SKETCH
Be issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responable far 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
Recoiled for Buildine Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references inm this permit and shall be met. Systems shall be installed in accordance
with the attached system layout
ISSUED T0:
PROPERTY LOCATION:
W -
lam}
Facility Type: IL 'fit X 61 Sem
SUBDIVISION
ids New ❑ Expansion ❑
LOT IF 1
Repair
Basement? ❑ Yes to Basement Fixtures? ❑ Yes E-1No
Type of Wastewater System** A "c%AQ Q6Jb
(Initial) Wastewater Flow:
36,(�) GPD
(See note below, if applicable 01
Jbo Is-),
Installation Requirements/Conditions
Septic Tank Size t OCA gallons
265'o 15,, Repair)
Number of trenches
Exact length of each trench
feet Trench Spacing:
Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover. C
inches t�—r• �urL��
Maximum Trench Depth of: t -Q 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: IL TDM vs. GPM
Conditions:
inches below pipe
Aggregate Depth: r v inches above pipe
0 i inches total
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.
**If applicable, / understand the system tipe .specified /t dihIerent from the type specified on the application. / accept the fpecilcationr o/ 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: i' Date: v5 13I 1 0101
Iia ip[Lfa C-.>gfU Construction Authorization Expiration Date: aS 31 ) aO 3
IQ 5- 439aIfz- 30064 -
HTE# 31432, Permit# 3CC)r�5
Harnett County Department of Public Health
Site Sketch
i e PROPERTY LOCATON: W`GCC/ ` 6it1,
ISSUED TO: S`. -C-- SUBDIVISION
LOT #
Authorized State Agent: Date: U6I31 11goIQo
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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
5. Si n(r',�cl
Owner: Applicant -
Address:
Address: W • 6,uL.� 6> - Date Eva uated: C 6/r+llp
Proposed Facility: 30(y 5F3> ���Pesign Flow 1.1949): G�
Location of Si Property Recorded:
Water Supply: ubli Individual ❑Well
Evaluation Method: Auger B g ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: 1%44<
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOILMORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
,1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
L 43w
u-?,
vot~14
01,5
(" 7771 �G
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6.35
iqL
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rat (,j
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Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): Qrc�.+[, v , .Iq SV.jnJo-lV
Available Space (.1945) Evaluated By:
System Type(s) Others Present: A
Site LTAR