IPACHTE# \\--5=;5:1 T'C3 Harnett County Department of Public Health
Improvement Permit 2 6 8 5 2
A building permit cannot be issued with only an Im rovement Permit
PROPERTY LOCATION: X<1077a-1-,, 0ZQ-D
ISSUED TO: 4y) 6F~~1~~5~ ~~0(nGS "iNG SUBDIVISION 1 ~~~£N RL~>\e,r_- LOT # a
NEW REPAIR ❑ EXPAf~SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 CS~~~~-15'
Proposed Wastewater System Type: _C,,o air t G ~rC oc~s l
Projected Daily flow: GPD
Number of bedrooms: Number of Occupants: r° max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1 bC5 feet Permit valid for:
Permit conditions:
Five years
❑ No expiration
Authorized State Agent:: Date: aNA\ 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o permits. The permit holder is res onsible 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 Improvemen it 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: CY V1C;rs-,F.,PIND Yk 0 mfrs 1 N C- PROPERTY LOCATION: `®w C -f-L- QZ
SUBDIVISION 77' '1ra<.E., P~P.,CZ,_ LOT #
Facility Type: New - ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Q-0 ~ o N ptf,,, (Initial) Wastewater flow: 3C?3 GPD
(See note below, if applicable
C~o Ny~ rr-S \ 0 N' l% . (Repair)
Installation Requirements/Conditions Number of trenches N
Septic Tank Size 1®1-:5 a gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench E5(b feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: la= a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
Qf, inches above pipe
1-41 inches total
WATER LINES (INCLUDING IRRIGATION) MOST BE 10FT. 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 from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
o~otc~z-~,....... a uic mtc Niau, piar, ui Lilt mrenueu use a1anges. ine consrruaion Numonzanon snan not De transserreo wnen there is a change in ownership of the site. This
Construction Authorization is su~ to~compliancev~ olff"
f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: V-e~S Date: \a 11
Co ction Authorization Expiration Date: 1- ) 6
HTE#
Permit # -I(N 5
ISSUED TO: C.
Authorized State Agent:
i
Harnett Connty ]Department of 'Ttblic Health
Site Sketch
PROPERTY LOCATON: M ) ~~w Ea--Y-ID
_ SUBDIVISION'---71 4 cE~ -LOT #
i~Date:
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: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ~Public❑ Individual ❑ Well
Evaluation Method.2Au er Bo' img El Pit El Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
1
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
L5
1%
Description Initial Repair System Other Factors (.1946):
S ste
Site Classification (1948):
Available Space (.1945)
V
_'V
S
Evaluated By:
System T e(s)
CiL' n/
C-o.s /
Others Present: B,~A
Site LTAR
~~c I Sv a- aC$ 5