IPACHTE# AS- 5--:5<3t6 Harnett County Department of Public Health 28183
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: �v aaCLoy>� 1p N
ISSUED TO: - u 1 c z SUBDIVISION `®— LOT #
N EW)NJ REPAIR ❑ EXPANSION ❑
Type of Structure: �'Q (,3 5'
Proposed Wastewater System Type: 2 ,!SV o ® ; i oCZ�- �VE'—
Projected Daily Flow: 3 Co® GPD
Number of bedrooms: Number of Occupants: C max
Basement ❑Yes /K 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 X Public ❑ Well Distance from well k Ce) O feet Permit valid for: -Nk Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: _��� � �``w �� Date: `�— t )5— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o The permit holder is re 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 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 Permio
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 T0: � � \A I Wit_..- PROPERTY LOCATION:
_ SUBDIVISION LOT #
Facility Type: �'`� U L�3 �` i New ❑ Expansion ❑ Repair
Basement? IJ Yes 1:1 No Basement Fixtures? E] Yes ❑ No
Type of Wastewater System** 5G v ��` a �.r =�'�� (Initial) Wastewater Flow: b GPD
(See note below, if applicable ❑)
eV w) ,(j�2c�srtiwic>~,f�.S Kepair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size I ®®c> gallons Exact length of each trench CDO feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: ';'")'DL- inches
Maximum Trench Depth of: Y% ': � 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
Aggregate Depth: inches above pipe
Conditions:
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 specified is different from the type specified on the application. / accept the specifications of this permit.
inches total
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject o ion if 4e 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 is s to complian ith the of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent. QG�a5 Date: ,2 6,15 t
Authorization Expiration Date: ` 2 6
HTE#
ISSUED T0:
Authorized S
Permit # a�1-63
Marnett County Department of Public Health
Site Sketch
PRnprRTV inrATnN• t_ n4
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:' U<1;�.,.� Design Flow (.1949): 36 0.
>
Location of Site: Property Recorded:
Water Supply: jPublic❑ Individual ❑ Well
Evaluation Method: ` `7�u&er Bormg ❑ Pit ❑ Cut
Type of Wastewater: `M. 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
S`C.
1 tw - p
iJ I_ 6A'
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948):4 S
Available Space (.1945) Evaluated By:
System T e(s) Uc �-S Others Present:
Site LTAR J