IPACZ-7 '7
HTE# t/--' 9s" Harnett County Department of Public Health
murovement Permit 2 6 7 7 5
A building permit cannot be issued with only an f provement Permit
PROPERTY LOCATION: r k Ackc+-Ms-
a- 1,4
ISSUED T :,S , PX0.5'cs, jaactif nara.~/ n q SUBDIVISION
.e f- nc, LOT # 3
NEW IZ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: YFO So k 80 % rFC) /c),< U 8
Proposed Wastewater System Type: &n:f fir" edvc ,°F , JY-14 -
Projected Daily Flaw: i60 - GPD
Number of bedrooms: S fi3 FJ4'' 'Number of Occupants: / to max
Basement ❑Ye~s/
Pump Required: L~Yes ❑ No ❑ May be required b ed on final location and elevations of facilities ~
Type of Water Supply: El Community El Public Well Distance from well 1 U O feet Permit valid for: E/
years
Permit conditions: ❑ No expiration
Authorized State Agent:: 4S A41-, Date: ZI Z17 42 a// SEE ATTACHED SITE SKETCH
The issuance of this permit b Health Department in no way guarantees the 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, .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: 5 V 04'0, ~G ne~rciS( c~e2g PROPERTY LOCATION: k:, k / cdd. s ,ed .
SUBDIVISION Jc.) - o rt e LOT # 3
Facility Type: S $ a X 80 SF-66 V c) K `/v New ❑ Expansion ❑ Repair
Basement? ❑ Yes 21`~ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ;pil,p 4-~ pZ ~y 2ed oc; o& Syf'4-,, (Initial) Wastewater Flow: 960 GPD
(See note below, if applicable
~Q P -)'G k-'1-4•,0, fY1-I (Repair)
Installation Requirements/Conditions Number of trenches J
Septic Tank Size /as n gallons Exact length of each trench /8 O feet Trench Spacing: Feet on Center
,4 Pump Tank Size /(PS 0 gallons Trenches shall be installed on contour at a Soil Cover: inches
s -P~ -n. /mood titr. -r Maximum Trench Depth of: /8 °vZ0 inches (Maximum soil cover shall not exceed
I qti~ / 00o y att~.~r (Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: SIR-0 CG1
jVo VP1c~ cr t/c
inches below pipe
Aggregate Depth: inches above pipe
r -Lc r yS 19---, inches total
c1 c,r ,rc(1 Gee
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
O UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifIcatiom of this permit.
Owner/Legal Representative Signature: Date:
This Lonstruction Authorization is subject to revocation it the site plan, plat, or the intended use changes. the Lonstrucbon 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: LG Date: ZZ / 1-2 °y/
Construction Authorization Expiration Date: 11 7 n2 (S/
}w- -6 ^a.s`-T` C)A s
/ S- ol? 7 9 L/
HTE# /l " a 7 9 Permit # oZ -7 -7--r-
arnett County Department of Public eat
Site Sketch
PROPERTY LOCATON: k:s k
ISSUED TO: r V N 57m. 4A c, r `t nyf a~ SUBDIVISION 3o, LOT #
~ pp
Authorized State Agent: Date: Z? /0Z W
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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
Owner: Applicant: /
Address: Date Evaluated: /1(f/z°«
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual Well
Evaluation Method:EAuger Bot*ng ❑ Pit ❑ Cut
Type of Wastewater: (Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
SOIL MORPHOLOGY
.1940
1941
OTHER
L
E
Landscape Horizon
/
.
PROFILE FACTORS
.1942
#
Position
Depth .1941
Slope % (In.
Structure/
T
.1941
Consistence
Soil
1943 .1956
Wetness/ Soil Sapro
.1944 Profile
exture
J
Mineralo
Color D th IN. Class lass
Restr Class
Horiz & LTAR
of
rf-J~
a. J
I
6 - 2y G /S-L
✓ 1VjA"1
Description
A
Initial Repair System Other Factors (.1946):
S stem Site Classification ( I9441f,
vailable Space .1945)
System Ty e(s) J
Evaluated By'6
Site LTAR
`
Others Present: r+-~