IPACHTE# 1- -3- Harnett County Department of Public Health
740
Improvement Permit 2 5
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C.;.,r SS Goa Y(ICY1 q4—,,
ISSUED TO: c. SUBDIVISION C.Y '0<:-L'E55 90 1 "�7E. LOT # 3d
NEWX REPAIR ❑ E? SION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: "
Proposed Wastewater System T pe: 3,5 °l0 "S�Fovt —cs �oN��— LYS�
Projected Daily Flow: S 0 GPD
Number of bedrooms: 25 Number of Occupants: max
Basement [--]Yes ><No
Pump Required: ❑Yes >9 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1C) C) feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 3 1 X' 1 "3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way gua antees the issua of ermits. The permit holder is responsibll 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 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: Q Q- \A0 en-4 1 a G.
Facility Type: GV() (33,xL2� 1" X New
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes
Type of Wastewater System **
(See note below, if applicable ❑) /
, - / ° b
PROPERTY LOCATION:
SUBDIVISION C; 19 '55 LOT # -�10
❑ Expansion ❑ Repair
:1 No
Y S-1 Em (Initial) Wastewater Flow: ® GPD
(Repair)
Installation Requirements /Conditions Number of trenches !
Septic Tank Size 1® ®O gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench Z- b ® feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 19 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: ') Feet on Center
Soil Cover: nches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. 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 specifed is different from the type specifeo ofl the app lication. / accept the specifIcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subjectbject to �voe ' if th site plan, 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 subtompliance wit rove ' the d Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 3
Construction orization Expiration Dater
HTE # � 3 — 5'- -7%( Permit # —�� AO-5
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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 ) I )�
Proposed Facility: 3 Design Flow (.1949)21
Location of Site: Property Recorded:
Water Supply: Public[] Individual El Well
Evaluation Metho . er Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ 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
t
L. 5
1.
&
C�
'
WV,
0
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948):f�
Evaluated By-_Qj
Others Present:
Available Space (.1945)
System T e(s)
d => .ct
Site LTAR
S
dA S
t�