IPACHTE# 3�'S -37a a. Harnett County Department of Public Health
Imurovement Permit 27504
A building permit cannot be issued with only an Improvement Permit �}
cc� PROPERTY LOCATION: Q- P Q.�5S c ----
ISSUED T0: t-� �. 4Ca�0+� t ma c- SUBDIVISION C_- rP2ESs ''oIA-T I- LOT # -I-
NE REPAIR ❑(PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �a� L3�*x� �1
Proposed Wastewater System Ty e: %E�ve.� S d,N ay5
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes >� No ❑ M y be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: -� , c'" `` ❑ No expiration
Authorized State Agent:: Date: S 12 3 1 Y3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o 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 Mq<hall 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: i �, PROPERTY LOCATION: C.. -
SUBDIVISION C.^t ('Q- L55 0 t �1 F LOT # I.
Facility Type: �' �Q �3^�`t1� / New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes "N No
Type of Wastewater System" �-So� a � ��UL ,� � et-NJ J-r S- 6 -rte (Initial) Wastewater Flow: 3 Q GPD
(See note below, if applicable ❑)
Qu ,nQ �1 G .-Ole y C5�\ 0 u (Repair)
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size 10 d ® gallons Exact length of each trench :1'8 0 feet Trench Spacing: c— Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (; inches
l 7 tC t
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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
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.
*If applicable: /understand the sr stem type specified is different from the type specified on the application. / accept the specipcationr of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject fo 7evocatia the sit Ian, 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 su compliances Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: S
Constru ' n Authorization Expiration Date:
HTE# Permit # QL7)9)�
Harnett County Departinent of Public Hetalth
Site Sketch
ISSUED TO: PROPERTY LOCATON: C—j � Z ) CA, \3 Qj)
SUBDIVISION LOT #
Authorized State Agent: (c3i1 vE� 'To ate:
C-,T-, iZD
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:
Address: Date Evaluated:�(,�
Proposed Facility: 3 QOQ-\ Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply:
V PublicE I ndividual ❑Well ❑Spring
Evaluation Method: Augoring ❑Pit ❑ Cut
Type of Wastewater: .__R 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
'3
E LI
r�
h `y
\f!PA,
0.3a
'J `1
dcrtcv7 �2� 3°1
2 Q ('214
0- :3 &
VVI
�}
Description
Initial
System,/
Repa'r System
Other Factors (.1946):
Site Classification (.1948): '?_S�
Evaluated By:
Others Present: —
Available Space (.1945)
V
V
System T e(s)
Site LTAR
x
'3