IPACHTE# d 1-5- a-1 Vo Harnett County Department of Public Health
hDrovement Permit 26855
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N ,,c-Z7 V-S~ 9-p
c~ Le No G-,' G SUBDIVISION Y L, P,c.E LOT
ISSUED TO: C--u '
NEWX REPAIR ❑ EXPA ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~ ® (,5S " ~
Proposed Wastewater System Type: a6c'`o Q~~ ay c 5. o N 5~5
Projected Daily Flow: 3~ O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community )K Public ❑ Well Distance from well Cbd feet Permit valid for: )<Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: N~~y ~ Date: \-4-11~.111 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ' nce of other permits. The permit holder is response le 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 Im ement 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, .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: CU mC f'~r►p ~~Q srC Co NPROPERTY LOCATION: 62
SUBDIVISION ' o c~N L~~G LOT # 1'1
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes -X, No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** S~VV Ucs,-1 C) rv Sys ~r r~ (Initial) Wastewater Flow: 3fc) GPD
(See note below, if applicableX)
S 0 ?\aov c,> > (i j-) r- n (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size 1 <>a o gallons Exact length of each trench t 3 ® feet Trench Spacing: c1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: aa-~ 36 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: ft. TDH vs. GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
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: l understand the system type speciled is different from the type spec/led on the application. l accept the specilcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocR he site plan, 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 sukect~teompliance witRs k _ of th and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: y i2L~ys Date: 1 `~J 16 1
Construc Authorization Expiration Date: ~E
HTE# ~~®5-~'")}`bl Permit #s5
Harnett County Department of iblic Health
Site Sketch
PROPERTY LOCATON: M ~c tzo Ga.._' Z
ISSUED TO: a E2 MEN C. SUBDIVISION Pi- R, c 6 LOT # _
Authorized State Agent: ~2L~~s LwG2 IaLYS~J Date: ~`a116111
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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
Sheet:
Property ID:
Lot
File
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well ❑ Spring
Evaluation Method Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
❑ Other
P
R
O
F
I
L
1940
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
#
Landscape
Position/
Slope %
L~
Horizon
Depth
(In.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil .1943
Wetness/ Soil
Color Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
5 ~l`(o
CS
G S
Vn 1'~~ 'j
5
?y
N~
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948):f 1
Available Space (.1945)
Evaluated ByO-\
System T e(s
a C.
Others Present: $
m
Site LTAR
. ~
.