IPACr
HTE# cQ - s,~ g~ Harnett County Department of Public Health
hDrovement Permit
25493
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Cs-,2s5,C1Ani LA c A-
ISSUED TO: Q,, VAoc-,ca IN c.
SUBDIVISION V0-1Z,1 _5-, lcao rL~
LOT # 10
NEW, „ REPAIR ❑
~
E; ANSION ❑
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~J
3
xt
Proposed Wastewater System Type: t.5 °le eCsp u z ~ y t f
Projected Daily Flow: 3E~
GPD
Number of bedrooms: 3
Number of Occupants:
max
Basement ❑Yes No
Pump Required: Nes ❑ No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply: ❑ Community
Public ❑ Well
Distance from well 1O feet Permit valid for.
Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: ASV' N' nZ Date: , G)31 09 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees a iss ce 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: MC ~~s2 oM~ c C. PROPERTY LOCATION: ~"R?~~~A s Lac i~~
SUBDIVISION Fcst~Es~ ~2.p LOT #
Facility Type: \'5~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes "2 No Basement Fixtures? ❑ Yes "F>(No
Type of Wastewater System* " 5~/a ~ vc~ Zc ~yST~ yr (Initial) Wastewater flow: _ GPD
(See note below, if applicable
~-P (Repair)
Installation Requirements/Conditions Number of trenches T
Septic Tank Size S c~-c> ~ gallons Exact length of each trench SCt feet
Pump Tank Size 1OD O gallons Trenches shall be installed on contour at a
Maximum Trench Depth of 1q inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM o f~
I%
Conditions:
Trench Spacing: Feet on (enter
Soil Cover: 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
*(f applicable: /understand the system type specifed is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Si nature: Date:
This Construction Authorization is subject to revocatw site p Iat 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 tYj~o compliance "hAa~e the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: VS Date:
Construc Authorization Expiration Date: _
HTE# Ut -5--KX3 5 Permit # ~'IfI3
Harnett Connty Depa linent of hiblic Health
Site Sketch
PROPERTY LOCATON: CMQ,sINN ,%,j
ISSUED TO: c3mpo~ r\4rf1C; ~w SUBDIVISION f;QL-!S-~ LOT # 165
Authorized State Agent: (0F-AvFrr, a~~JOCZF Date:
I
~.e
Pcf
A2
f
i
V
tL►~-
r
As
uepartmuiaul aiwi "111luilt, nuawi, aliu waiuiai I-Qvui~-
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
W-Oubiic (j Individual
[Auger Boring
[ jewage
Property ID:
Lot
File
Code:
Applicant: f
Date Evaluated: ? e 'vt
Property Size:
Property Recorded:
Well [ ] Spring Other
[ ] Pit [ ] Cut
Industrial Process Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
A 941
Consistence
Mineralogy
.1942. _
Soil
Wetness/
Color
i`,:.1943
Soil*
Depth (IN.)
.1955
Sapra"
Class
r .1944
Rests
Horiz'-
Profile
Class ,
& LTAR
L j_
c-Li
010
fT
Description
Initial S stem
R pair System
Available Space (.1945)
'1
1
System Type(s)
aS`'e aE.~
Lee
Site LTAR
_ ) 7
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: 13