HomeMy WebLinkAboutIPACHTE# 15-5 3-TCSt�j Harnett County Department of Public Health 28604
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
\ ,RPROPERTY LOCATION: F-1.," 40 1
r(''�
ISSUED TO: �y c:5(-cssnES 1 ^ G SUBDIVISION LOT # a)
NEVT� REPAIR ❑ E!TSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: (53: x33
Proposed Wastewater System Te: a5°/e - r. vctr.w -�s 6n
Projected Daily Flow: 3✓ 0 GPD
Number of bedrooms: 3 Number of Occupants: C- max
Basement Dyes No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of Facilities
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well Y feet Permit valid for. ,'Five year
Permit conditions: — ❑ No expiration
Authorized State Agent: �� �� oLTe/ Date:y t) 01 7S SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees uana of other permits. The permit holder a resp. le !necking 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
Reouired for Building Permit
The construction and installation requirements of Rules .1950, .19S2, .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: C-0 h1,-\QCn PROPERTY LOCATION: "V'y 4o)
/ SUBDIVISION M s s_i- PDQ a Esc v s LOT # a)
Facility Type: SFO Cr'a T33� X New CJ Expansion ❑ Repair
Basement? ❑ Yes b� No Basement fixtures? 11 Yes No
Type of Wastewater System*" '� 5 / o \`EDV C"Va U , Sy5 sL- M (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
9�Ct�, S'Y�^Ecn (Repair)
Installation Requirements/Conditions Number of trenches ►
Septic Tank Size R o o gallons Exact length of each trench 3 ed feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: a inches
Maximum Trench Depth of a i 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: h. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: v 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: / understand the s}vtem type spelled it different from the type speciled on the app/ication. / accept the rpedh'catianr of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is 1 susadon if the she plan, plat or the intended use changes. The Construction Authorisation shall cot be transferred when then is a change in ownership of the site. This
Construction Authorization is to compli the isums of she laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATFACHED SITE SKETCH
Authorized State Agent: Reli5 Date: IT TO 1�
Construction Authorization Expiration Date: R T T 0 12Q
HTE# 15'5 -310 3 Permit # ag (. 0`4
Harnett County Department of Public Health
Site Sketch
PROPERTY LO[ATON: "ti-) 14p O�
ISSUED T0: � � � mEs I N C. SUBDIVISION M a e> a, N" LOT #
Authorized State Agent: Q.,,, Date:
ass ` t
F, O vSE
_t
70
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOILJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 17 (39 %M Design Flow (.1949): !, ri t
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method:❑ Au er Boring �:g pit ❑ Cut
Type of Wastewater: IR Sewage [J 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
Mineralog
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
p`b3�
5ew- G
Description Initial Rep it System Other Factors (.1946):
S I Site Classification (.1944
Available S ace(. 1945 EvaluatedBy:Ct7i
System TeW Q.S 0r Others Present:
Site LTAR S
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