IPACHTE# 13- -5150- Harnett County Department of Public Health
Improvement Permit 27366
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: --,Z I!eal
ISSUED TO: �s'.,�d� ,.5 �.. SUBDIVISION Ft f s nti5 LOT #
NEW G7' REPAIR ❑ EXPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -59>
Proposed Wastewater System Type:
Projected Daily Flow: sf GPD
Number of bedrooms: — Number of Occupants: max
Basement ❑Yes Ef No
Pump Required: ❑Yes ❑ No 2" MM`avbe required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L!t Public ❑ Well Distance from well feet
Permit conditions: e
Permit valid for: 13 Five years
❑ No expiration
Authorized State Ag .. Date: �/ SEE ATTACHED SITE SKETCH
The issuance of this permit by a 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, .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: Ca PROPERTY LOCATION: 541' `'try°)
SUBDIVISION 6' i?ldl „r,, LOT #
IS—
Facility Type: l" New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" QS--OA (Initial) Wastewater Flow: t&O _ GPD
(See note below, if applicable ❑
v 2` m < U/ air)
Installation Requirements /Conditions Number of trenches 2
Septic Tank Size f ZSU gallons Exact length of each trench 2cO feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 22> 1 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: 6'?'t. � a,9 ry< a4 '�, – � _ inches total
WATER LINES (INCLUDING 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: ! onderstand the system type specified is different from the type specified on the app /icatiom / 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 ownershin of the cite_ 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
Authorized State Ag Date: 3
Construction Authorization Expiration Date: q-8-18
HTE# 13 -5--30SO3
Permit # 2--7 5 (c (,,,,
H(arnett County Department of Public Helalth
Site Sketch
4,2A �
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot #:
File #:
Code:
Owner: Applicant: z -1" j - � - 5 0
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): L( Property Size:
Location of Site: Property Recorded:
Water Supply: ❑'Public❑ Individual ❑ Well ❑ Spring
Evaluation Method:[] Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
❑ Other
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
!
r
0
0-�,p
Z `i^ tiU�
SC"e,i
(
1 try,
r
3 ti
V
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space (.1945)
System T e(s)
Site LTAR