IPACHTE #3 L� -5-3.) Harnett County Department of Public Health 28011
Improvement Permit
A building permit cannot be issued with only an Improv ent Permit �I
(^� PROPERTY LOCATION: �-C—.G u r- 1
ISSUED TO: —�CyS �.�1t_Ap.t SUBDIVISION LOT # --
NEW '�` REPAIR ❑ EXPANSION
Type of Structure: T) 0,+m 'at) ME
Proposed Wastewater System Type: ° oGnvcs� p ;�
Projected Daily Flow: '� C) GPD
Number of bedrooms: -3, Number of Occupants: max
Basement ❑Yes —;KNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes --;�INo ❑ May be required based on final location and elevations of facilities
Type of Water Su ly: ❑ Community Public ❑ Well Distance from well \60 feet
Permit conditions:
Authorized State Agent:: �, —
The issuance of this permit by the Health Department in no way guarantees the issuance
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Permit valid for:
Five years
❑ o expiration
Date: `? I ils !l y SEE ATTACHED SITE SKETCH
s. The permit holders respo ible for checking with appropriate governing bodies in meeting their requirements. This
shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1958, .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: L- v tls"
SUBDIVISION LOT # -�
Facility Type: ��C1�`r= ��T'ar6� New ❑ Expansion ❑ Repair
Basement? ❑ Yes '><,,No Basement Fi tures? ❑ Yes '19—�No
Type of Wastewater System ** `�- °lp vim) e; S`4 C— s,,, (Initial) Wastewater Flow. GPD
(See note below, if applicable ❑)
2WSX 4 PJ SE'S 76n (Repair)
Installation Requirements /Conditions Number of trenches_
Septic Tank Size ! CQ<7 <n gallons Exact length of each trench G b feet Trench Spacing: C� Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: 6")a. inches
Maximum Trench Depth of: �1 7�� 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
Aggregate Depth:
Conditions:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
* *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 Authorization is subjec tion if iRkAQ1an, 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 1�'tt.(�compliance " the p ' o e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
onstr n Authorization Expiration Date:
HTE# V J Permit # a-�CS��
Harnett County Department ent of Rtblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
M
PROPERTY LOCATON: u LAs11a L
1P`C.® SUBDIVISION LOT #
M
p
t
v
�G� C�ovAJi1> �ts� 12-p
Date:
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: '�j P,A� Design Flow (.1949):36
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method Auger 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
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
1 -
t„ 5
Description
Initial
S st m
R "pair System
Other Factors (.1946):
Site Classification (.1948):��
Evaluated By:
Others Present:
Available Space (.1945)
System Type(s)
'V °Ji�
2
Site LTAR
1 -