IPACHTE # ®�� ®� �� Harnett County Department of Public Health
Improvement Permit 27402
A building permit cannot be issued with only an Im rovement Permit
PROPERTY LOCATION: �ac�,C
ISSUED TO: v y A__; -1' o s4 SUBDIVISION LOT #
NEW , REPAIR ❑ E 1ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S 5'O L (66 n LA 0`
Proposed Wastewater System Type: s °yo �.ovc ; ) C) N
Projected Daily Flow: "3 GPD
Number of bedrooms: '3 Number of Occupants: max
Basement []Yes >< No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 10C) feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: — 311-11 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit hold r i s re onsible 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 Improverne 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. p
ISSUED TO: �A yz. ® PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: �Q �� 0� nt �-�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** as- ei %® o 0 C:> > cJ N 2 yS; �-„rc, (Initial) Wastewater Flow: 2!1� ® GIRD
(See note below, if applicable ❑)
a�SO /C' UC -:_� k Q (Repair)
Installation Requirements /Conditions Number of trenches a.
Septic Tank Size 1 O 0 C) gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench -1 S_ feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 3-3 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: tip. ` inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
* *If applicable: I understand the system type specified is different from the type specified on the application. / accept the specifications of this permit
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to on if the site n, 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 subo complianch th "ogo Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 3 11"
Authorization Expiration Date:
HTE # � -25 — 5 — 30Fl )
Permit #
f1arnett County Department of Public He(alth
Site Sketch
I -K
k - •
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: 3 �`l��
Proposed Facility: Design Flow(. 1949): 3GO
Location of Site: Property Recorded:
Water Supply: Public❑ Individual
: ❑ Well
Evaluation Method ._Auger B ing El F1 cut
Type of Wastewater: 01$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
Depth (IN .)
.1956
Sapro
Class
.1944
Restr
Horiz
lvC1 S5�`7LSL�
I6 `
G
Jet. ;4 ��1�t D
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated B Y:
Others Present:
Available Space (.1945)
V
System Type(s)
' 3 ' - `.
G; 5
Site LTAR
6