IPAC RHTE# Harnett County Department of Public Health
Improvement Permit 26951
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: tioc*
ISSUED T0: N ~NS;21/G5GS2,~ SUBDIVISION ®p~.~,o>,T)- LOT #
NEW REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5'Zo C 5s %t5"
Proposed Wastewater System Type: 2WZ-7o 9-COUCsCN0,4 '5'
6-, rc~
Projected Daily Flow: L-'N d GPD
Number of bedrooms: Lj Number of Occupants: 11Z max
Basement ❑Yes No
Pump Required: ❑Yes No
Type of Water Supply: ❑ Community
Permit conditions:
❑ May be required based on final location and elevations of facilities
Public ❑ Well Distance from well k Q C / feet
Permit valid for:
Five years
❑ No expiration
Authorized State Agent:: ~ a
The issuance of this permit by the Health Department in no way guarantees the iss e
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: ~L 1'111 SEE ATTACHED SITE SKETCH
other permits. The permit holder responsible for checking with appropriate governing bodies in meeting their requirements. This
ne Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: H'r } 1-4!1-, ay CF-VOQ5 PROPERTY LOCATION: ca
SUBDIVISION S~ ax.mo LOT # _
Facility Type: ScO~,~s"✓ X New ❑ Expansion ❑ Repair
Basement? ❑ Yes .-'IN\ No Basement, ~Fix„t,u,.,r~es? ❑ Yes A No
Type of Wastewater System' aS /o ~vUCr,1 n,,r S:4' VF-si\ (Initial) Wastewater Flow: L'~ GPD
(See note below, if applicable
2S%E~~ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 100 0 gallons Exact length of each trench C-O feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: VI inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: C1 Feet on Center
Soil Cover: 1 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions: ~'1 ~rr,crwr, of Bs= GCrvy-~ Gyt2 C-t~,c1 NN FNE1D inches below pipe
inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST 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:
This Construction Authorization is subject to if t e sit n, plat, 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 isampliance t o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: q-&• Date: Q~ )7
Const 'on Authorization Expiration Date: ?
HTE# Permit # I
Harnett County Department of Niblic Health
Site Sketch
PROPERTY LOCATON: -D oc,~5 ~.J
ISSUED T0: SUBDIVISION 0 fLOT #
Authorized State Agent: WL)v fg, -bL,SDO(Z~ Date: a~
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Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On-Site Wastewater Section Property ID:
Lot
SOIL/SITE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Code:
Owner: Applicant: ` l
Address: D
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valuated: t
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Pr
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i
opose
ac
lity:
j
Design Flow (.1949): Property Size:
Location of Site:
Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well
❑ S
ri
p
ng ❑ Other
Evaluation Method:[] Auger Boring
❑ Pit ❑ Cut
Type of Wastewater:
❑ Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F SOIL MORPHOLOGY
I .1940
OTHER
.1941
L Landscape Horizon PROFILE FACTORS
E Position/ Depth .1941 .1942
# Slope % (In, .1941 Soil .1943 .1956
Structure/ Consistence Wetness/
.1944 Profile
Soil
Texture Mineralo Color De th IN, Sapr°
L5 ( Class
Restr Class
Horiz & LTAR
x
,T
L t(F-'rl, -5) N4
n
n DX
Description Initial R air System Other Factors (.1946):
Available S ace 1945) S ste Site Classification (.1948): 'C3
.
S stem T e(s) Evaluated By: (3o~
Site LTAR t Others Present: