IPACHTE# 1� 5-�`iad Harnett County Department of Public Health 30076
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: c t--Ozro'v (Zcl 62f58 )
ISSUED TO:.� e 1�IafkL Iyrc. rd Gb SUBDIVISION LOT # _
NEW 20, REPAIR ❑EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _3616- Hl X U at %i I>
Proposed Wastewater System Type: ags ✓ma c E.r .� ��=
Projected Daily bedrooms:
GPD
Number of bedrooms: S Number of Occupants: % max
Basement []Yes No
Pump Required: []Yes ❑ No Z May bee rreei based on final location and elevations of facilities
Type of Water Supply: ❑ Community <�Public ❑ Well Distance from well .'y A feet
Permit conditions:
Permit valid for.
years
❑ No expiration
Authorized State Agent: Date: <--Y, SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible [or checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation H 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, .1951, .1950. and .1959 are incorporated by references into thu permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: 5040,s-j"�- Prxrs4F� PROPERTY LOCATION: 3Q54 Qu (¢y5 CAcaS ")NS (2,�-(2�I6J
SUBDIVISION LOT #
Facility Type: rt Ixya' F p-�New ❑ Expansion ❑ Repair
Basement? ❑ Yes 17-1 o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" a5�o 1"%y'LZdc\ 5ys(ent. (Initial) Wastewater Flow: 34G GPD
(See note below, if applicable ❑)
Q4 -,'X, /t o a > Za 64,—Aavl (Repair)
Installation Requirements/Conditions Number of trenches 13
Septic Tank Size 1 0<1:� gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contourt a
Maximum Trench Depth of: a4- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
0
Trench Spacing: / Feet on Center
Soil Cover. IU inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
t -JA, inches below pipe
Depth: inches above pipe
NIS 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 type specified is different Imm the type specified on the application. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This concoction Authorization is subject to revocation if the sire plan, plat or the intended use changes. The construction Authorization shall not be transferred when there is a change in ownership tithe site. This
concoction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewa a eatment and Disposal and to the conditions of this permit ILL AI IACMLU lilt SRLILM
Authorized State Agent: ����� Date: Ololal I6
I�wpc6� CtRtJ Construction Authorization Expiration Date: c-�C,lal 1W3
HTE# '!S A4,AL Permit # 30ai (
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
Authorized State Agent —=�—
C'<���
(S N i t_���'��
PROPERTY LOCATON: Q,� - (-5P— !S��
SUBDIVISIDN —ter LOT #
Date:
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Esq
Owner. 6.40-- Ap hcant:q��
Address: 3.W-4(Z'q_S � '�� }Cf� Date Evaluated:
Proposed Facility: �. `�� Design Flow (.1949�)h: 36f>
Location of Site: Property Recorded:7`^-'
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Auger<�Bori��SS'' ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size: C), 66A3::__;
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(ht.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profle
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (M.)
.1956
Sapro
Class
.1944
Restr
Horiz
W
ow -SLL-
Fl
Q,`j
q44
Li4+
a,3
L 14-0
v
&q- L5
OIL A6d <V
L6
CtIv- qa�
s
es
Description Initial Repair System .Other Factors (.1946):
System Site Classification (.1948): �fciv ihiolic.�'(,y �s.Eyt,�p�Q
Available Space (.1945) Evaluated By: - ^
System T e(s) _-� — Others Present: k`Wselz�
Site LTAR