IPAC RHTE# QA- S- r ~2X Harnett County Department of Public Health 2 5 2 9 3
Improvement Permit
A building permit cannot be issued with only an I provement Permit
PROPERTY LOCATION-
ISSUED TO: ~v M Cots SUBDIVISION r` QQr{~r- LOT #k 19
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -)rFd So 5'-G
Proposed Wastewater System Type: 4L.), 6 as" f 44clur .rte.
Projected Daily Flow: J 6 GPD
Number of bedrooms: .7 Number of Occupants: C. max
Basement ❑Ye~s91"No
Pump Required: EIYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
3l e years
❑ No expiration
Authorized State Agent:: (0/c,,c 1'ti~Ua--k Date: ~ /2da'{ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health 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, .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: V~ ~o.cs Bw PROPERTY LOCATIQ cec flel.
SUBDIVISION 6' e t Fkr t f LOT # t
Facility Type: flew ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater S stem*' o ~.S' f a c ~ -J: ; T as e
y _ ~ C-4 (Initial) Wastewater Flow: GPD
(See note below, if applicable
Pu' CA'.c P\. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Sized gallons Exact length of each trench 0 feet Trench Spacing: g Feet on Center
Pump Tank Size l oao gallons Trenches shall be installed on contour at a Soil Cover inches
Maximum Trench Depth of: QZ6 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 s "r ^ a A\ inches below pipe
d ~ t- boc.~e
Aggrega Depth: inches above pipe
Conditions: f- Oti r 414 ~S ll a J ~e•.~ F~ c c [ inches total
2r..-:.~~fle~z 6stcdo,L~O:~r Coar~/ VC" dc~pof~ e~ 14 c~`t~rcr~.>?~~Y
*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: Date:
This Construction Authorization is subject to revocation if 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.
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 Date: 7~z~ 2~s
Construction Authorization Expiration Date: z o/ y
Jun 05 09 08: 18a mic(.el esker 91082(.540
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Division of Environmental Health
On-site Wastewater Section
SOILY SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM[
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
r is O Individual
( 1 A r Boring
Sewage
01 ICCI.
Property ID:
Lot
File
Code:
Applicant:
( ) Well
[ ]Pit
[ ) Industrial Process
Date Evaluated: ~ ~ ~
f
Property Size:
Property Recorded:
[ ) Spring [ j Other
[ j Cut
( ) Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
_
.1942
Sod
Wetness/'
Color
.1943
Solt
Depth (IN.)
.1956
Saprc
Class
.1944:
Restr
Horiz
Profile ,
Class
& LTAR
0-22
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Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946): _
Site Classification (.1948);
Evaluated By: L
Others Present: