IPACHTE# 1 �-' S'ad a.� Harnett t t e t of Public Health
ImDrovement Permit
A building permit cannot be issued with only an Improvement Permit
\��1 PROPERTY LOCATION: 1 1 m 6 F_
ISSUED TO: mot, CLPSL,G 1A0 r-6.s SUBDIVISION Q��i O sJS V a l -S7 LOT #
NEW-K REPAIR ❑ EXP+ISIGN El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S� < 5� ICJ J
Proposed Wastewater System Type:
Projected Daily Flow: L GPD
Number of bedrooms: 14 Number of Occupants: `� 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 feet Permit valid for: ;,Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: °� Date: 1��13' 1'�- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee e ' uance 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 them d 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 Trea ment and Disposal and to conditions of this permit.
Reauired 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: , t_,r C�--� .P �c �0 C"N f,- S PROPERTY LOCATION:
SUBDIVISION PYV-r Q) P6 Pb LOT # 4�—
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes �KNo
Type of Wastewater System ** °l� ' oucrs� a W (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
(Repair)
Installation Requirements/Condhions q
Septic Tank Size t O od gallons Exact length of each trench LA '- 5(�) feet Trench Spacing: ) Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. 1.)--N inches
Maximum Trench Depth of: a4--Z 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
* *If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit
Owner /Legal Representative Signature:
This Construction Authorization is subjec
of the site. This Construction thorization IA
Authorized State Agent:
Date:
site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
ction Authorization
Date: 1- 13 )-.,
Expiration Date: 1 13 1
HTE# cw1� Permit #
Harnett County Department of Public Hettlth
Site sketch
PROPERTY LOCATON: i ►cv E N
ISSUED TO: SUBDIVISION 9N- TSnN -s PO1 q—i LOT # Li
Authorized State Agent: C� -t.�', �Oi -�V�LL �aLl n } Date: t --N-j 13_ 12,-
r
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: L10(- 4Y-Vdn Design Flow(. 1949): �0
Location of Site: N Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: '�'p 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 %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
J
G-)O
.-6
Description
Initial
Systeyn
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:(}
Others Present:
Available Space (.1945)
System Type(s)
Site LTAR
8
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