IPACHTE# ,3 -® Harnett County Department of Public Health
Improvement Permit 27676
A building permit cannot be issued with only an Improvement Permit
_ PROPERTY LOCATION: C ce(l cji,, Loa,?
ISSUED T0: e>v tf- ®C s ) �-A Ql. SUBDIVISION �G 1.- t'�1�R1�� �Nla� <-: �N LOT #
NEW!I REPAIR ❑ EXI)i ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: `��1� gCs»G-� \ 0 r1 'Z>YS C--rr'�
Projected Daily Flow: GPD
Number of bedrooms: S Number of Occupants: 10 max
Basement ❑Yes ;1�qo
Pump Required: ❑Yes �FZ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -N� Public ❑ Well Distance from well 1®Ci feet Permit valid for: Five years
Permit conditions-----z- _ ❑ No expiration
Authorized State Agent:: T15 Date: °�\Z- ��15 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss?tKkof other permits. The permit holder is respo8sible 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 Improve ent 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: L- QEJ2.S PROPERTY LOCATION: cm oQ
Facility Type: syo
Basement? ❑ Yes -tNl, No Basemen
Type of Wastewater System ** Q-S 0 IG
(See note below, if applicable ❑)
c.
SUBDIVISION �t`Ils S N�� t �r�,E Susht=.� LOT #
New ❑ Expansion ❑ Repair
t Fixtures? ❑ Yes X1 No
�C;'� ti U cat S �zl (Initial) Wastewater Flow: �� �1 GPD
C�VG' awl � �5 i lr (Rpnairl
Installation Requirements /Conditions Number of trenches 1
Septic Tank Size S C? gallons Exact length of each trench C) feet Trench Spacing: c) Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour 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 inches below pipe
Aggrgate Depth: inches above pipe
Conditions: _ o Q2Ml s\t - I WfyM -,
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 1OFT. 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 application. / accept the specifIcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Au 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
Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
Authorized State Agent: 'V.r--N Date: 9 4)` i
Co4sihiction Authorization Expiration Date: `i T-�
SEE ATTACHED SITE SKETCH
(c,
HTE# [4� �� Permit # ,
Harnett County Department of Riblic Health
Site Sketch
VI
, , -, C, & Y,) �, 0-� �5 aot"Qz
- , " "S2, \� N
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:
Proposed Facility: �jgO�u� ' Design Flow (.1949): 6065
Location of Site: Property Recorded:
Water Supply:
t3l Public❑ Individual El Well
Evaluation Method :-,Auger Boring ❑Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ 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
,
sof
j
JZVX4
jam'
0
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): jr
Evaluated By: Cj-1<
Others Present:
Available Space (.1945)
System Type(s)
O'S I
Site LTAR
$-
,