IPACHTE# $ -- G Harnett County Department of Public Health
Improvement Permit 27680
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ri cacxssrzy j�
ISSUED TO: 0(L�n1- 5 5 SUBDIVISION LOT #
NEW'k REPAIR ❑ EXP�A SION 171 Type of Structure: � 09 <��r - I'
Proposed Wastewater System Type: ;.'S to kf.0 vc-S -S 0 1,Q
Projected Daily Flow: �`� d GPD
Number of bedrooms: i 1 Number of Occupants: QZ max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public Well Distance from well 6 ®® feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent: � �� Date: `® X3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance ermits. The permit holder is respo Bible 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 Per all 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: PROPERTY LOCATION: e -,L-/ Q.D
SUBDIVISION LOT #
Facility Type: f") 0 D �f -� New ❑ Expansion
Basement? ❑ Yes -*� No Basement Fixtures? ❑ Yes Xt
Type of Wastewater System **
(See note below, if applicable ❑) d
`,�—v L �- yC�; t0"3 (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size 1 ® ® Q gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
❑ Repair
Exact length of each trench ! b
Trenches shall be installed on contour at a
Maximum Trench Depth of:
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
(Initial) Wastewater Flow: %_ GPD
feet Trench Spacing: Feet on Center
Soil Cover: �� inches
inches (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 specified is different from the type specified on the applicatiom l accept the specifications of this permit.
Owner /Legal Representative I Date:
This Construction Authorizatio bject to revocatio Z,,,, Ian, p 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 subf liance with ois s aw d Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: )
Constructio horization Expiration Date: —
HTE# 13 - - l E,I Permit # :�n („$ n
Harnett County Department of Public Health
Site Sketch
,-4 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:
Address: Date Evaluated-
Proposed Proposed Facility: 4A Design Flow (.1949):0
Location of Site: Property Recorded:
Water Supply: 'Public❑ Individual ❑ Well
Evaluation Method:,kAuger 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
De th (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
_S"
VPI
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By: cj '-
Others Present:
Available Space (.1945)
System Type(s)
S plc
15
Site LTAR
_S"