IPACHTE5--'PDHarnett County Department of Public Health
ImDrovement Permit 2 6 7 3 0
A building permit cannot be issued with only an Improvement Permit
t l` PROPERTY LOCATION: PJ G Ems} 5~~~
ISSUED TO: ~Q '00-0>\ ri~Nrors SUBDIVISION LOT #
NEWX REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M hr V1dMs
Proposed Wastewater System Type: '-;k5 Svc.: ~0,14
Projected Daily Flow: Qo ® GPD
Number of bedrooms: '3> Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes 'K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '~i< Public ❑ Well Distance from well L O (Zti feet Permit valid for: Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent:: ~ v Date: i i \ )%A l ~ ) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o mitt. 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 Perm II 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, .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: ~Ed-M PROPERTY LOCATION: 6&:J .5
5
SUBDIVISION LOT #
Facility Type: n n,,4 "A0MG__ CaL►~~~ot-l~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes '9~ No Basement Fixtures? ❑ Yes ~<No
Type of Wastewater System** a.5°lp (ZLoyy:NdN S y ~t;N (Initial) Wastewater Flow: GPD
(See note below, if applicable
pu mP~ d `~~l o V-Sny CnyoN (Repair)
Installation Requirements/Conditions Number of trenches S
Septic Tank Size In O gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench ~A O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. ~S inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Sign re: Date:
This Construction Authorization is subject to revocation if the ' an, t, 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 s~~tecompliance wit a prov of nd Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: `Y.L-.5'5 Date: 1~ l l1
QA -
Construction thorization Expiration Date: t~ l~ 1~
HTE#
Permit # "(-I 60
Harnett County Department of Public Health
Site Sketch
PROPERTY N• g
ISSUED TO: SUBDIVISION LOT
Authorized State Agent: Q~~•S av '~6SmRP
X IZ-v 5
Date: X0 ),~A)
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: 00011' Design Flow (.1949): ,O
Location of Site: Property Recorded:
Water Supply: 12'Public❑ Individual ❑ Well
Evaluation Method: ❑eidCu_gerB g ❑ 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 %
SOIL MORPHOLOGY
1941
Horizon
Depth 1941 .1941
(In.) Structure/ Consistence
Texture Mineralogy
a -rte '7y 0 d'i--~- ~ t~L • A1P
OTHER
PROFILE FACTORS
.1942
Soil .1943
Wetness 1956 .1944 profile
Color Soil Class
D th IN. Class lass Horiz & LTAR
_Z>
i~i~50ellkk
Z•
L
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Description
Initial Rep
S st
r System
Other Factors (.1946):
Site Classification (.1948):
Available Space .1945)
Evaluated B
S stern T
e(s)
A.S eb- V`
y:
Other
P
Site LTAR
s
resent:
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