IPACHTE# 03 -- Harnett County Department of Public Health
Improvement Permit 27681
A building permit cannot be issued with only an Improvement Per it
PROPERTY LOCATION: M t't�1P1 tZ
ISSUED TO: M5 q C -0 qL\J C,;C 143 qJ SUBDIVISION 1 tea 6 C-N Pe A r - LOT # �
NEW REPAIR ❑ EXP ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '�S V` Q �� �Z �>` L V3
Proposed Wastewater System Ty e: �.S° o S0 C y � t 0 N
Projected Daily Flow: Ty GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ><No
Pump Required: ❑Yes o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well I ®O feet Permit valid for: Xive years
Permit conditions: ❑ No expiration
Authorized State Agent: �\� ti �� Date: 10 -4 )3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holder is res onsible 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 it 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, .1957, .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: q ra (2"') PROPERTY LOCATION: M�tiC
3� SUBDIVISIONS 1 r� C- 0
�' ®, � � � LOT
facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basemeqt Fixtures? ❑ Yes No
Type of Wastewater System" a.5!® 9•C'Qv>'J ''J cr)
(Initial) Wastewater Flow: 3g® GPD
(See note below, if applicable ❑)
®la
Svc., ��1J (Repair)
Installation Requirements /Conditions Number of trenches '
Septic Tank Size 'LOCO gallons Exact length of each trench `-1 S- 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: \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
c� r Aggregate Depth: inches above pipe
Conditions: C--A QC. S"��t -Z a'� J0 s W I-1- .. 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: l understand the ryrtem type speciTed is different from the type specifled on the application. l accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to f the site plan, plat, or he intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization " to compliance the pr i o e Laws a Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: a ww Date: 10
Construction Au rization Expiration Date: _
HTE # t 3 -5 0-7 —1
ISSUED TO:
Authorized State Agent:
Permit # C4
Karnett County Department of Public Health
Site Sketch
M
PROPERTY LO(ATON:-- OMAo_,;,, -
— SUBDIVISION —T� ft q)13 1-4i-L LOT # -Q.CA
1G2 ko Li) )3
l -1C!D0L)5Date: I I
M.-
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: 1_ -,
Address: . Evaluated I
Proposed Facility: 3(M Design Flow (.1949):
Location of Site: Property Recorded: c�
Water Supply: Public❑ Individual El Well
Evaluation Method: Auger Bo 'ng ❑ 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
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
L-1' ` is
G`>
Site LTAR