IPACHTE# /s s=3sd8q Harnett County Department of Public Health 28150
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit /
PROPERTY LOCATION: A � � ea n Qka-ad � C h'�J Ck td-
ISSUED�TOO � a�'� C �c✓ SUBDIVISION LOT #
NEW LJ REPAIR ❑ t EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5-f-- ►b'1 61 Y6 0
Proposed Wastewater System Type: aS'b .eco
Projected Daily Flow: 1/E 0 GPD
Number of bedrooms: q Number of Occupants: max
Basement ❑Yes CR4o
Pump Required: ❑Yes ❑ No le May be required based on final location and elevations of facilities ,�
Type of Water Supply: El Community Public F-1WellDistance from well feet Permit valid for. Eali-ye years
Permit conditions: ❑ No expiration
Authorized State Agent::��Health
r— . �zs- .�� f Date: Z / G /Z-/3- SEE ATTACHED SITE SKETCH
The issuance of this permit by t artment in no way guarantees the issuance of other permits. The permit holder is responsible 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_ 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 TO: 1 �.}t 1�-r� �'� PROPERTY LOCATION: /''�� ��� ��R�� C���cl• ��.
SUBDIVISION LOT #
Facility Type: fF LrJ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2' No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** a12 %Ze.JQ (Initial) Wastewater Flow: S<c 6 GPD
(See note below, if applicable ❑)
n2i� /ecru` c>• T`74- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /000 gallons Exact length of each trench —700 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: f 9 -AZ Y inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Pump Requirements: ft. TDH vs. GPM
Aggregate Depth:
inches below pipe
inches above pipe
Conditions:: -� GeM.�'� o,r• -/ ,4., e �- �°ti r� �- pc�'.c r ;,> r Ltc �s inches total
C"'—'e c'
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 app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the 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
err ATTRr1Ir1% Me eV[Trri
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit JGG XI IRUIGU 3 IL annus
C !
Authorized State Agent: tl% Date: r�`��
Construction Authorization Expiration Date: —a -Z,6
HTE#
S: s'- 3S'"a 8 N Permit # oZ b 15— 9
Harnett County Department of Pablic Health
Site Sketch
PROPERTY LOCATON: Zk'49-, � Ck,4 C/,,jrCk XJ'
ISSUED TO: /kA C." k+ C�c,r V SUBDIVISION % LOT #
Authorized State Agent: �c • Date: a
/4 c LQ, C C-/ yr 2�
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: Design Flow (.1949):
Location of Site:�/ Property Recorded:
Water Supply: U Public❑ Individual ❑ Well
Evaluation Method: ❑ A ger Bopkig ❑ Pit ❑ Cut
Type of Wastewater: Q Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
of ,/J,//
- -/J
l " V1-2 Z�l
Cl f L
fel
�� ��',5 ,P'
Ar_
��Vf
G- �G%
; 41f,A,11°
PJJ
U •2Z6
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (.1945) Evaluated By://,e--
System Type(s) o2J' r— • Others Present:
Site LTAR