IPAC RHTE# ()F500-Q05 t5-R Harnett County Department of Public Health 25509
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
((~'11 PROPERTY LOCATION: ~ \ t 1
ISSUED TO: `~l--r `\0 -1 (A,& g3rnC 9 SUBDIVISION gVN c r 'J LOT #
NEW,;d REPAIR ❑ EXPANSIO ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S(-- a 5a 3i (3 f1"~1C
Proposed Wastewater System Tye: '2 s' '/-ctl~ck,~r Sy
Projected Daily Flow: -1, GPD
Number of bedrooms: ON ft Number of Occupants: max
Basement ❑Yes D~ No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community V Public ❑ Well Distance from well _j~_ feet Permit valid for. $F five years
Permit conddions•. P"VC~ p, l S( {e
❑ No expiration
t 1 U-- C -3. \r rrC
Zii-rAlt C n As s~6QL;rN~ n A n T~ aF c- s LJ-4c,
Authorized State Agent:: Date: 6e - a la- 3 SEE ATTACHED SITE SKETCH 7s, L, -14,.,
The issuance of this permit by the H th Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This & k
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 ..f
the taws and Rules for Sewage Treatment and Disposal and to conditions of this permit- fL,il~
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: so~c` d f PROPERTY LOCATION:
SUBDIVISION 0A he ,arc LOT #
Facility Type: JrF 5a sC 31 3I~ -New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement F'~ tures? ❑ Yes -&-N o
Type of Wastewater System c.", , 4.4j, N-- (Initial) Wastewater Flow ~o3 GPD
(See note below, if applicable lip lc
fZ ~ ~ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench JO D feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: _ S inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conch
Trench Spacing: / Feet on Center
Soil Cover. b inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
'x inches total
*If applicable: /understand the system type specified is dil/erent from the type tpecired on the application. / accept the speci6ca#i ns of thif permit
Owner/Legal Representative Signature: Date:
tills cunsuucuon numonzanon is suotect to revocation it the site plan, 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 is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: NN ~ \ ~::~w
Date:
psi
Construction Authorization Expiration Date: L
HTE# ~r 0' do S~ r z- Permit # 2 5- y
Harnett (county Department ~-biic Health
Site Sketcl
C-A OA PROPERTY LOCATON:
ISSUED T0:~c~/►`~~ SUBDIVISION S LOT # _ (o 'L
Authorized State Agent:
iq"
4- 4- o `er
a
.1 f CIA"
A
l kAL
V4
~S
5t-f-kln~
13
C
Date: 06 c? b - 3 1
Do-- ~ Qq r) ,0-
~I
illy(P wk
i pol ~A t ri ;A ( ( J-e I gRc 4-1
ueparullem of CIIV 11 Ui 11llellt, r'ledMl, d11U IVdtUldf MUZ3UUIt Ub
Division of Ertvironmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: dns f
Address:
Proposed Facility: ~C-4) Design Flow(. 1949):
Location of Site: ~1\ t
Water Supply: Public Individual
Evaluation Method: ( uger Boring
Type of Wastewater:A I Sewage
JI ICGt.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
(j Well (J Spring
[ J Pit Cut
[ J Industrial Process (J Mixed
( I Other
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
.1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942
SoiF
Wetnew
Color
.1943
Sop
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile ,
Class
& LTAR
f-
2
V r/t iC
-
t
S At
, q~
(9
00
v,(-Iq
W, L
X ~
u i
` y
6
~
0-`ft-
YL
If
,tt2~
l 2 sz
A-C
vv 0',
19
A ) L
Description
Initial System
Repair System
Available Space (.1945)
~
System Type(s)
i
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present
M