IPAC RHTE# o'i~- s= a(IJ gA Harnett County Department of Public Health 2 5 2 9 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATI N: ~ cl Cos,-ii !eJ
ISSUED TO~•~ SUBDIVISION //o -k g-cr r.~.l LOT #
NEW e REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '5-FO X~ }«Q~
Proposed Wastewater System Type: PL5 - Ul -
Projected Daily flow: 3 ~.0 GPD
Number of bedrooms: .7 Number of Occupants: max
Basement ❑Yess [ No
Pump Required: L fYes ❑ No ❑~May~b ''required based on foal location and elevations of facilities
Type of Water Supply: ❑ Community LS Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
0 -Five years
❑ No expiration
Authorized State Agent.: 12L:"` 2~-C-5(''-,l~' Date: 7 2s! 2U69 SEE ATTACHED SITE SKETCH
The issuance of this permit by the alth 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
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, .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: ~v G '-1"c~:~a"• PROPERTY LOCAT71 14JCa'-k -
SUBDIVISION rt¢2.- LOT # /5/
Facility Type: -f-f 4D ❑ New ❑ Expansion ❑ Repair
Basement? ❑ Yes l"No B ment Fixtures? ❑ Yes ❑ No
Type of Wastewater System** p,;I% (Initial) Wastewater Flow: 3(kG GPD
(See note below, if applicable ❑)p
P,, to S7e k-,3 -cam (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /W 11 gallons Exact length of each trench 60
feet Trench Spacing: Feet on Center
Pump Tank Size 06o gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: /8 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: ,--5'i--- 4k"L A"-'A }7.r J~~ inches total
--'a qxk, z- M
~f 5 tfd c c~~
**If applicable: / understand the ryatem type rpeci6ed different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
ims tonstruction autronzation is sunfect 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
C
Authorized State Agent: ///L, J'-
Date: `7`/ /~2002
Construction Authorization Expiration Date: 7 Y 2 o/
_Jun 05 09 08s18a mic( Al eaker 91082 .i40
SOUT11F.ASTEN SOtI. & 1?NVIRONmr,,NTAL ASSOC, I!YC.
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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):
[ ] Public [ ] Individual
( ] Auger Boring
[ ] Sewage
JI lu"t.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ ] Well [ ] Spring
(J Pit [ ] Cut
[ J Industrial Process [ J Mixed
[ ] Other
P
R
O
F
SOIL MORPHOLOGY
..1941
OTHER. "
PROFIILL FACTORS L
L
E
#
1940
Landscape
Position/
Slopee%
Horizon
Depth
(IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.194z
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapra
Class
1944
Restr
Horiz
Profile
Class
& LTAR
y. i ~
~ ) C___
~ - - ~1 -
,ter
Y.3 C,
,
Y
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
(
7
Other Factors (.1946):
Site Classification (.1948): ~f
Evaluated Byj
Others Present: