IPACHTE# ��`S 3 1 �' Harnett County Department of Public Health
Improvement Permit 27292
A building permit cannot be issued with only an Improvement Permit
P PROPERTY LOCATION: W t2t Q4-1
ISSUED TO: }`J gate. C- i.1— SUBDIVISION LOT # 1
NEW REPAIR ❑ EXPANSION C�
Type of Structure: M p�,a . 4 c (n
Proposed Wastewater System Type: - aevvEcti Ont P.L,
Projected Daily Flow: -r),4 C) GPD
Number of bedrooms: Q=)- Number of Occupants: 1- max
Basement ❑Yes cX No
Pump Required: ❑Yes '�< No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ), Public ❑ Well Distance from well ib0 feet
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
Permit valid for: Five years
❑ No expiration
Authorized State Agent:: y> Date: 'b( S t' ) j SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua er permits. The permit hold 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 Improvemen it 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: N d r-4 P, Qv aa-- .-t- PROPERTY LOCATION: Q s r r:
SUBDIVISION LOT # �-
Facility TYDe: Mca�t. \kc5Mg,. Q\1y ^-7 )R( Nnw r-1 Fvnnncinn f-1 Q—;.
Basement? ❑ Yes N,' No Basement Fixtures? ❑ Yes A No
Type of Wastewater System ** C-0"O C-. "r t cs N tss,L. (Initial) Wastewater Flow: aL' O GPD
(See note below, if applicable ❑)
v cvv Er, a; a N P. i-, (Repair)
Installation Requirements /Conditions Number of trenches Q-
Septic Tank Size t a ti gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench t ®® feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. N—a � inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: G' 1 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
�® inches below pipe
Aggregate Depth: inches above pipe
_ inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: /understand the system type specified is different from the type specified on the application. /accept the specipcations of this permit
Owner /Legal Representative Signature:
This Construction Authorization is subj revocat
Construction Authorization is ssbiectlto-comoliancci
Authorized State Agent:
if the site plan plat, or the intended use changes. The Construction Authorization shall not he transfer
lsi¢�s o( -aws and Rules for Sewage Treatment and Disposal and to the conditions of this
yc- 5 Date:
Authorization Expiration Date:
Date:
there is a change in ownership of the site. This
SEE ATTACHED SITE SKETCH
H T E # \ � - S• -1 1 � —
Harnett County
Permit # ; `? a° -
De a'l- llent of lllblic Health
Site 'etell
PROPERTY LOCATON:--
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent:7N���� -Z0 Date: j ll)3
MW
M,
OEMM
M
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: � WlrO -1 Design Flow ( 1949): a46:d
Location of Site: Property Recorded:
Water Supply: .Public❑ Individual El Well
Evaluation Method Auger Boring [I Pit r-1 cut
Type of Wastewater: �_E �ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
D epth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
1,5
3�r36
`fix
V'� sJ
dIla�, 7'\
G_;ts
3
K c
J:�j 53
Description
Initial
S ste
System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: Cy ;
Others Present:
Available Space (.1945)
jRepair
System T e(s)
C U cis
Site LTAR
vt
L