IPACHTE# ��-e�� Harnett County Department of Public Health
27682
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: QM, f'+1dPc
ISSUED TO: P1 SQ Ca 2V Q-'N10 �-1 SUB DIVISION� LOT # 1LA14
NEVI REPAIR ❑` EXPANSE ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: `S 3� �'� 1 r
Proposed Wastewater System Ty e:
Projected Daily Flow: ® GPD
Number of bedrooms: Number of Occupants: max
Basement []Yes No
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 10 C> feet Permit valid for: Five years
Permit conditions:,. \ ❑ No expiration
Authorized State Agent:: Date: Lb 1A,17 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in oo way guarantees the issuance o er permits. The permit holder is rest nsible for checking with appropriate governing bodies in meeting their requirement;. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement emit 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: SQ ON PROPERTY LOCATION: 0 �� 2
SUBDIVISION 'I I ,) r-& ,J Ci l I G LOT #
Facility Type: C�tx� �� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** 21` � liq 0 �.- 13 c.;i S-S6 -n (Initial) Wastewater Flow: _GPD
(See note below, if applicable ❑)
r�-s �, O U c-v (Repair)
Installation Requirements /Conditions Nnmhpr of trpnrhpc
Septic Tank Size Y Q C7 d gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench I -S0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. A - :ate inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacjn : 1 Feet on Center
Soil Cover: °� 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 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 speciped is different from the type speciTed on the application. / accept the specifications of this permit.
Owner /Legal Representativ ture: Date:
This Construction Authorization is subject to revocation i e a , or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorizatiax `subject to comlpiancwith ws Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: �Opi JP
Construction Authorization Expiration Date: t o
ISSUED TO:
Authorized S
Permit # c)�( —�
County Harnett , 1• of i Health
Site Sketch
PROPERTY LOCATON: (' M) tP� Vc2
Is'oj
LOT # ILA L--)
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: (3 0( sr °ti Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ` Public❑ Individual ❑ Well
Evaluation Method: uger B ring ❑ Pit ❑ Cut
Type of Wastewater: ❑1Sewage ❑ 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
.5
�G
( rah
7 0-IQ `?
.s
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classification (.1948):-�C:3
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
!0
2f7
Site LTAR
5
.5
r