IPACHTE# 13- 5 -arn Harnett County Department of Public Health
hDrovement Permit 27377
A building permit cannot be issued with only an Improvement Permit
/� !�r/_ PROPERTY LOCATION:�2 /q3-7 &,1 -k X r26
ISSUED TO- Cii, rK6 ac� ATE SUBDIVISION 63 67n i� S LOT # 1 s-0
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ONo
Pump Required: ❑Yes ❑ No ❑ MMaa e required based on final location and elevations of facilities
Type of Water Supply: F-1 Community L�f Public ❑ Well Distance from well feet Permit valid for: C"Five years
Permit conditions: 47 ,Z) y , , ❑ No expiration
Authorized State Age <�—' " % ' Date: S- °/q -13 SEE ATTACHED SITE SKETCH
The issuance of this permit by 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 t e 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 T0: S�.if% ri 1%7r - PROPERTY LOCATION: /` .3'7 /- 9 -&+ri9 141)
SUBDIVISION 074.C� QMV5 LOT # /gam
Facility Type: New ❑ , Expansion ❑ Repair
Basement? ❑ Yes 2"' No Basement Fixtures? ❑ Yes E o
Type of Wastewater System ** � W (Initial) Wastewater Flow: . 4eZ GPD
(See note below, if applicable ❑) P
a
zltoel�-�.�. � (Repair 54, v
Installation Requirements /Conditions Number of trenches i —(91 -52-1 -�&f C +
Septic Tank Size CO-6 gallons Exact length of each trench feet Trench Spacing: /
Z Feet on Center
Pump Tank Size gallons Trenches shall be installed on contou at a Soil Cover: inches
Maximum Trench Depth of: 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
% / L inches total
WATER LINES (INtLUDING IRRIGATION) MUST BE LOFT. 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 app lication. / accept the specifications ofthis 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. 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 Jtt Al MUM 311 )11t 11.t1
Authorized State A G Date: '��' JW -/
Construction Authorization Expiration Date: — i 4 v
5
H T E # 13..! i�-3 I C' 5- �
Permit # 2:1 '2) 777
n,ti -nett County Department of Public fle,"Ith
Site Sketch
.15-1 .
/,D-?
40
/0 C/
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: C l__
Address: Date Evaluated:'
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Wo1-�
Evaluation Method: uger 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
Std
6-1_ i
Description
Initial
System
Sys
Repair em
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available S ace (.1945)
System Type(s)
Site LTAR